Revista espanola de cardiologia最新文献

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Corrección en el artículo del Grupo de Trabajo de la SEC y el Comité de Guías de la SEC «Comentarios a la guía ESC 2024 sobre el tratamiento de la presión arterial elevada y de la hipertensión», Rev Esp Cardiol. 2025;78:296-300 对美国证券交易委员会工作组和美国证券交易委员会指导委员会文章《对ESC 2024年高血压和高血压治疗指南的评论》的更正，Rev Esp Cardiol. 2025;78:296-300

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-06-11 DOI: 10.1016/j.recesp.2025.05.011

引用次数: 0

Abordaje y consumo de recursos sanitarios en la miocardiopatía hipertrófica obstructiva en España: un estudio de la vida real 西班牙阻塞性肥厚性心肌病的卫生资源消耗和负担：一项现实生活研究

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-06-11 DOI: 10.1016/j.recesp.2025.04.004

Roberto Barriales-Villa , Luis Escobar-López , David Vilanova Larena , Joel Salazar-Mendiguchía , Ainara Echeto , Ignacio Hernández , Elena Rebollo-Gómez , Juan Ramón Gimeno

Introduction and objectives

Obstructive hypertrophic cardiomyopathy (oHCM), whose symptoms range from dyspnea to heart failure or sudden cardiac death, accounts for approximately 70% of all hypertrophic cardiomyopathy cases. This study aimed to analyze the lack of comprehensive data on oHCM management and determine its clinical and economic burden in Spain.

Methods

This retrospective observational study, based on electronic medical records (BIG-PAC), enrolled adults from 1 January 2014, to 31 October 2022, from the time of HCM diagnosis. The analysis focused on epidemiology, patient characteristics and management, transitions between New York Heart Association (NYHA) functional classes, healthcare resource utilization (HCRU), and associated costs.

Results

A total of 752 oHCM patients were included (mean age: 63 years; male: 57.6%). NYHA functional classification at diagnosis was as follows: 12% NYHA-I, 47.9% NYHA-II, 31.5% NYHA-III, and 8.6% NYHA-IV. The prevalence of HCM and oHCM was 28 and 7 per 10 000 individuals, respectively. Patients received a mean of 2.4 (SD 1.5) treatments, mainly beta-blockers. Only patients in NYHA classes III and IV underwent septal reduction therapies (SRT) (13.1% and 47.7%, respectively); 38.7% and 35.5% of NYHA-III and -IV patients who received SRT, respectively, improved to a lower NYHA class. Symptom severity, as measured by NYHA class, was associated with increased rates of hospitalization, cardiovascular events, mortality, and higher HCRU and costs. Mean annualized, direct, adjusted health care costs ranged from €4142 (95%CI: €3110-€5175) in NYHA-I to €16 677 (95%CI: €15 482-€17 872) in NYHA-IV.

Conclusions

This is the first Spanish study to evaluate oHCM patient management and to demonstrate its impact in terms of increased hospitalizations, mortality, HCRU, and healthcare costs, trends that parallel the progression of symptoms by NYHA functional class. Patients who underwent SRT showed partial symptom improvement.

梗阻性肥厚性心肌病（oHCM）的症状从呼吸困难到心力衰竭或心源性猝死，约占所有肥厚性心肌病病例的70%。本研究旨在分析西班牙缺乏全面的oHCM管理数据，并确定其临床和经济负担。方法本回顾性观察性研究基于电子病历（BIG-PAC），从2014年1月1日至2022年10月31日，从HCM诊断开始。分析的重点是流行病学、患者特征和管理、纽约心脏协会（NYHA）功能类别之间的转换、医疗资源利用率（HCRU）和相关成本。结果共纳入oHCM患者752例，平均年龄63岁，男性占57.6%。诊断时NYHA功能分类为：NYHA- i占12%，NYHA- ii占47.9%，NYHA- iii占31.5%，NYHA- iv占8.6%。HCM和oHCM的患病率分别为28 / 10000和7 / 10000。患者平均接受2.4次（SD 1.5）治疗，主要是β受体阻滞剂。只有NYHA III级和IV级患者接受了间隔缩小治疗（SRT）（分别为13.1%和47.7%）；接受SRT治疗的NYHA- iii和-IV患者分别有38.7%和35.5%改善到较低的NYHA级别。NYHA分级测量的症状严重程度与住院率、心血管事件、死亡率、HCRU和成本升高相关。NYHA-I的平均年化直接调整后医疗保健费用为4142欧元（95%置信区间：3110- 5175欧元），NYHA-IV的平均年化直接调整后医疗保健费用为16 677欧元（95%置信区间：15 482- 17 872欧元）。结论：这是西班牙第一个评估oHCM患者管理的研究，并证明其在增加住院率、死亡率、HCRU和医疗费用方面的影响，以及NYHA功能等级与症状进展平行的趋势。接受SRT的患者表现出部分症状改善。

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引用次数: 0

Diferencia SA-VA negativa para el diagnóstico de taquicardia auricular durante la sobreestimulación ventricular de la taquicardia supraventricular 心室上心动过速过度刺激时诊断耳速过速的SA-VA负差异

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-06-11 DOI: 10.1016/j.recesp.2025.03.008

Raquel Adeliño , Víctor Bazán , Axel Sarrias , Jesús Jiménez-López , Júlia Aranyó , Felipe Bisbal , Joan F. Andrés-Cordón , Julián Rodríguez-García , Pablo Jordán Marchite , Carlos Eduardo González-Matos , Roger Villuendas , Nuria Rivas-Gándara , Jesús Almendral

Introduction and objectives

The stimulus-atrial minus ventriculo-atrial interval (SA-VA) difference during ventricular overdrive pacing of a supraventricular tachycardia is used to differentiate atrioventricular reciprocating tachycardia (AVRT) from atrioventricular nodal re-entrant tachycardia (AVNRT), but positive values have always been reported. In atrial tachycardia, the SA conduction is unrelated to the tachycardia mechanism, allowing for negative SA-VA values. We postulated that a negative SA-VA may serve as a criterion for atrial tachycardia in patients with supraventricular tachycardia and ventricular overdrive pacing from the right ventricular apex.

Methods

Multicenter data from ventricular overdrive pacing during atrial tachycardia (from 6 centers) and during AVRT and AVNRT (from 2 centers) were retrospectively and consecutively collected. The correct diagnosis was established using conventional criteria. The SA-VA difference was calculated for each case. The optimal SA-VA cut-off point for the diagnosis of atrial tachycardia was determined.

Results

Out of 240 tachycardias analyzed, ventricular overdrive pacing succeeded in accelerating the atria to the pacing rate without tachycardia termination in 106 cases: 38 (36%) AVNRT, 33 (31%) AVRT, and 35 (33%) atrial tachycardias (all exhibiting long VA intervals). All atrial tachycardias had a negative SA-VA value, while all AVNRT and AVRT cases had positive SA-VA values. A SA-VA value lower than 0 ms was the best cutoff, with an area under the curve of 1 and 100% sensitivity and specificity for the diagnosis of atrial tachycardia.

Conclusions

A negative SA-VA difference is a novel and accurate criterion for the diagnosis of atrial tachycardia with long VA intervals.

介绍和目的室上性心动过速的心室超速起搏时刺激-心房负室房间期（SA-VA）差值可用于区分房室往复式心动过速（AVRT）和房室结型再入性心动过速（AVNRT），但一直有阳性值的报道。在房性心动过速中，SA传导与心动过速机制无关，允许SA- va值为负。我们假设SA-VA阴性可作为室上性心动过速和右心室心尖过度起搏患者房性心动过速的标准。方法回顾性、连续收集6个中心的房性心动过速和2个中心的AVRT、AVNRT期间的心室超速起搏数据。采用常规标准建立正确诊断。计算每个病例的SA-VA差异。确定最佳SA-VA分界点诊断房性心动过速。结果在分析的240例心动过速患者中，106例室性超速起搏成功地将心房加速至起搏速率而无心动过速终止，其中AVNRT 38例（36%），AVRT 33例（31%），房性心动过速35例（33%）（均表现为长室性心动过速间隔）。所有房性心动过速SA-VA值均为阴性，而AVNRT和AVRT病例SA-VA值均为阳性。SA-VA值小于0 ms为最佳临界值，曲线下面积为1，诊断房性心动过速的敏感性和特异性均为100%。结论sa阴性SA-VA差是诊断房性心动过速长房性心动过速的一种新颖、准确的判据。

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引用次数: 0

¿Séptum o septo?

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-06-11 DOI: 10.1016/j.recesp.2025.05.016

引用次数: 0

Picadura de escorpión sin síndrome de Kounis ni miocardiopatía de tako-tsubo 无Kounis综合征或tako-tsubo心肌病的蝎子咬伤

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-06-06 DOI: 10.1016/j.recesp.2025.04.013

Regina Wilson , Halil Tekiner , Steven H. Yale , Eileen S. Yale

引用次数: 0

Prueba sistemática de expansión de tripletes en pacientes con síndrome de Brugada genéticamente negativo 基因阴性布鲁加达综合征患者三联扩张的系统试验

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-06-06 DOI: 10.1016/j.recesp.2025.04.011

Alexis Hermida , Guillaume Jedraszak , Flavie Ader , Philippe Maury , Philippe Charron , Estelle Gandjbakhch

引用次数: 0

Recurrencia rápida de reestenosis coronaria inexplicada en el stent (RECUR): una nueva enfermedad inflamatoria coronaria con evidencia patológica 支架中原因不明的冠状动脉再狭窄迅速复发（RECUR）：一种具有病理证据的新型炎症性冠状动脉疾病

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-06-04 DOI: 10.1016/j.recesp.2025.04.014

Zhangyu Lin , Xuejing Duan , Yuetang Wang , Qian Wang , Lei Jia , Kefei Dou

引用次数: 0

Impacto de la exclusión de accesos transapicales en los resultados por sexos del implante percutáneo de válvula aórtica: ¿una limitación metodológica? 排除经脊柱进入对经皮主动脉瓣植入的性别结果的影响：方法论上的限制？

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-06-04 DOI: 10.1016/j.recesp.2025.05.017

Lorenzo Fácila , Jezabel Pendás , Vicente Montagud , Miguel Benedito

引用次数: 0

Asociación de la discapacidad con la mortalidad cardiovascular en la población adulta española no institucionalizada 残疾与西班牙非住院成人心血管死亡率的关联

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-05-31 DOI: 10.1016/j.recesp.2025.03.010

Roberto Pastor-Barriuso , Alicia Padrón-Monedero , Fernando J. García López , Javier Almazán-Isla , Jesús de Pedro-Cuesta , Javier Damián

Introduction and objectives

Adults with disability have higher risk of all-cause mortality, but evidence on their risk of cardiovascular mortality is scarce. This study aimed to evaluate the association between disability severity and mortality from cardiovascular causes among community-dwelling adults.

Methods

A representative cohort of 105 743 community-dwelling Spanish adults aged 40 years or older was screened for disability severity within the framework of the international classification of functioning, disability, and health from 2007 to 2008 and was followed up for cardiovascular mortality until 2017. Five- and 10-year cardiovascular mortality risks in each disability category were standardized by sociodemographic characteristics using inverse probability weighting and corrected for competing causes of death. Bias analyses were performed to quantify residual confounding by unmeasured baseline cardiovascular conditions.

Results

The baseline prevalence of disability was 16.2% (95%CI, 15.9-16.4), including 11.5% with mild, 3.5% with moderate, and 1.1% with severe/complete disability. Compared with no disability, the standardized 5-year risk ratios for cardiovascular mortality (95%CI) were 1.70 (1.49-1.93), 3.92 (3.23-4.76), and 4.77 (3.42-6.66) for mild, moderate, and severe/complete disability, respectively, corresponding to 11.7 (8.4-15.0), 49.0 (37.0-60.9), and 63.1 (37.0-89.3) excess cardiovascular deaths per 1000 persons. The positive confounding in these risk ratios by unmeasured prevalent cardiovascular conditions was 5.9%. Results were similar for ischemic heart disease and cerebrovascular mortality and were sustained after 10 years of follow-up.

Conclusions

Adults with disability have higher mortality from cardiovascular causes. Conditions that increase cardiovascular risk in people with disability should be investigated. Preventive measures and health promotion initiatives are needed to reduce the risk of cardiovascular mortality in this population.

成人残疾有更高的全因死亡风险，但关于他们心血管死亡风险的证据很少。本研究旨在评估社区居住成人心血管疾病致残严重程度与死亡率之间的关系。方法在2007年至2008年的国际功能、残疾和健康分类框架内，对105743名40岁或以上的西班牙社区成年人进行残疾严重程度筛查，并随访心血管死亡率至2017年。每种残疾类别的5年和10年心血管死亡风险采用逆概率加权，根据社会人口学特征进行标准化，并对相互竞争的死亡原因进行校正。进行偏倚分析以量化未测量基线心血管状况的残留混杂。结果基线残疾率为16.2% (95%CI, 15.9-16.4)，其中轻度残疾率为11.5%，中度残疾率为3.5%，重度/完全残疾率为1.1%。与无残疾相比，轻度、中度和重度/完全残疾的心血管死亡率标准化5年风险比（95%CI）分别为1.70（1.49-1.93）、3.92（3.23-4.76）和4.77(3.42-6.66)，对应于每1000人心血管死亡率增加11.7（8.4-15.0）、49.0（37.0-60.9）和63.1（37.0-89.3）。未测量的心血管疾病在这些风险比中的正混淆率为5.9%。缺血性心脏病和脑血管疾病死亡率的结果相似，并在随访10年后持续存在。结论成人残疾患者心血管疾病死亡率较高。应调查增加残疾人心血管风险的情况。需要采取预防措施和健康促进举措，以降低这一人群中心血管疾病死亡的风险。

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引用次数: 0

Resonancia magnética cardiovascular feature-tracking para predecir eventos cardiovasculares adversos mayores en pacientes con amiloidosis cardiaca 心血管磁共振特征跟踪，以预测心脏淀粉样蛋白血症患者的主要不良心血管事件

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-05-27 DOI: 10.1016/j.recesp.2025.04.002

Ilaria Dentamaro , Andrea Igoren Guaricci , Yassin Belahnech , Paolo Basile , Gianluca Pontone , José Fernando Rodríguez Palomares

引用次数: 0

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Revista espanola de cardiologia

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