Pub Date : 2025-06-23DOI: 10.1016/j.recesp.2025.04.006
Carlos Ortiz-Bautista , Luis Almenar-Bonet , David Couto-Mallón , José González-Costello , Javier Segovia-Cubero , Diego Rangel-Sousa , Joan Guzmán-Bofarull , Antonia Pomares-Varó , Juan F. Delgado-Jiménez , Beatriz Díaz-Molina , Iris P. Garrido-Bravo , Teresa Blasco-Peiró , María del Val Groba Marco , Javier Muñiz-García , Francisco González-Vílchez
Introduction and objectives
Severe primary graft dysfunction (PGD) is the leading cause of early mortality following heart transplant (HT). This study analyzed the temporal trends and mortality associated with severe PGD, identified risk factors, and developed a predictive model based on a contemporary cohort.
Methods
A total of 2029 HT performed between 2010 and 2020 in 14 Spanish centers were retrospectively analyzed. Patients with and without severe PGD were compared. Logistic regression was used to identify predictors of severe PGD and to generate a risk score. Model performance was assessed in terms of calibration and discrimination.
Results
The incidence of severe PGD was 10%, with an increase observed over the last 5 years (8% vs 11%). However, 30-day and 1-year mortality declined significantly (59.1% vs 38.8% and 69.7% vs 58.8%, respectively). Independent predictors of severe PGD included extracorporeal membrane oxygenation (OR, 2.79), pretransplant ventricular assist devices (OR, 2.11), donor-to-recipient weight ratio < 0.8 (OR, 2.11), and congenital heart disease (OR, 2.11). A risk score was created, showing good calibration but limited discriminative ability.
Conclusions
Despite a rising incidence of severe PGD, mortality showed a marked decrease. Predictors of severe PGD included congenital heart disease, a donor-to-recipient weight ratio < 0.8, and the use of extracorporeal membrane oxygenation or pretransplant ventricular assist devices. The predictive model showed good calibration but only moderate discriminative performance.
{"title":"Fracaso primario del injerto grave tras el trasplante cardiaco: tendencias y resultados en una cohorte española contemporánea","authors":"Carlos Ortiz-Bautista , Luis Almenar-Bonet , David Couto-Mallón , José González-Costello , Javier Segovia-Cubero , Diego Rangel-Sousa , Joan Guzmán-Bofarull , Antonia Pomares-Varó , Juan F. Delgado-Jiménez , Beatriz Díaz-Molina , Iris P. Garrido-Bravo , Teresa Blasco-Peiró , María del Val Groba Marco , Javier Muñiz-García , Francisco González-Vílchez","doi":"10.1016/j.recesp.2025.04.006","DOIUrl":"10.1016/j.recesp.2025.04.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Severe primary graft dysfunction (PGD) is the leading cause of early mortality following heart transplant (HT). This study analyzed the temporal trends and mortality associated with severe PGD, identified risk factors, and developed a predictive model based on a contemporary cohort.</div></div><div><h3>Methods</h3><div>A total of 2029 HT performed between 2010 and 2020 in 14 Spanish centers were retrospectively analyzed. Patients with and without severe PGD were compared. Logistic regression was used to identify predictors of severe PGD and to generate a risk score. Model performance was assessed in terms of calibration and discrimination.</div></div><div><h3>Results</h3><div>The incidence of severe PGD was 10%, with an increase observed over the last 5 years (8% vs 11%). However, 30-day and 1-year mortality declined significantly (59.1% vs 38.8% and 69.7% vs 58.8%, respectively). Independent predictors of severe PGD included extracorporeal membrane oxygenation (OR, 2.79), pretransplant ventricular assist devices (OR, 2.11), donor-to-recipient weight ratio <<!--> <!-->0.8 (OR, 2.11), and congenital heart disease (OR, 2.11). A risk score was created, showing good calibration but limited discriminative ability.</div></div><div><h3>Conclusions</h3><div>Despite a rising incidence of severe PGD, mortality showed a marked decrease. Predictors of severe PGD included congenital heart disease, a donor-to-recipient weight ratio <<!--> <!-->0.8, and the use of extracorporeal membrane oxygenation or pretransplant ventricular assist devices. The predictive model showed good calibration but only moderate discriminative performance.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1054-1063"},"PeriodicalIF":5.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-23DOI: 10.1016/j.recesp.2025.04.007
Alejandro Carta-Bergaz , Ángel Arenal-Maíz
{"title":"Puente epicárdico de aleteo auricular. Al alcance del catéter","authors":"Alejandro Carta-Bergaz , Ángel Arenal-Maíz","doi":"10.1016/j.recesp.2025.04.007","DOIUrl":"10.1016/j.recesp.2025.04.007","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1127-1129"},"PeriodicalIF":5.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-11DOI: 10.1016/j.recesp.2025.06.001
Alejandro Gullón de la Roza , María Salgado Barquinero , María Fernández García , Beatriz Nieves Ureña , Fernando López Iglesias , María Martín Fernández
{"title":"Miocarditis por vasculitis de vaso pequeño: una etiología infrecuente","authors":"Alejandro Gullón de la Roza , María Salgado Barquinero , María Fernández García , Beatriz Nieves Ureña , Fernando López Iglesias , María Martín Fernández","doi":"10.1016/j.recesp.2025.06.001","DOIUrl":"10.1016/j.recesp.2025.06.001","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1115-1117"},"PeriodicalIF":5.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-11DOI: 10.1016/j.recesp.2025.05.011
{"title":"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","authors":"","doi":"10.1016/j.recesp.2025.05.011","DOIUrl":"10.1016/j.recesp.2025.05.011","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 8","pages":"Page 752"},"PeriodicalIF":5.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-11DOI: 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.
{"title":"Abordaje y consumo de recursos sanitarios en la miocardiopatía hipertrófica obstructiva en España: un estudio de la vida real","authors":"Roberto Barriales-Villa , Luis Escobar-López , David Vilanova Larena , Joel Salazar-Mendiguchía , Ainara Echeto , Ignacio Hernández , Elena Rebollo-Gómez , Juan Ramón Gimeno","doi":"10.1016/j.recesp.2025.04.004","DOIUrl":"10.1016/j.recesp.2025.04.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1041-1053"},"PeriodicalIF":5.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-11DOI: 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.
{"title":"Diferencia SA-VA negativa para el diagnóstico de taquicardia auricular durante la sobreestimulación ventricular de la taquicardia supraventricular","authors":"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","doi":"10.1016/j.recesp.2025.03.008","DOIUrl":"10.1016/j.recesp.2025.03.008","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>A negative SA-VA difference is a novel and accurate criterion for the diagnosis of atrial tachycardia with long VA intervals.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1024-1032"},"PeriodicalIF":5.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-11DOI: 10.1016/j.recesp.2025.05.016
{"title":"¿Séptum o septo?","authors":"","doi":"10.1016/j.recesp.2025.05.016","DOIUrl":"10.1016/j.recesp.2025.05.016","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Page 1023"},"PeriodicalIF":5.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-06DOI: 10.1016/j.recesp.2025.04.013
Regina Wilson , Halil Tekiner , Steven H. Yale , Eileen S. Yale
{"title":"Picadura de escorpión sin síndrome de Kounis ni miocardiopatía de tako-tsubo","authors":"Regina Wilson , Halil Tekiner , Steven H. Yale , Eileen S. Yale","doi":"10.1016/j.recesp.2025.04.013","DOIUrl":"10.1016/j.recesp.2025.04.013","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 9","pages":"Pages 835-836"},"PeriodicalIF":5.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-04DOI: 10.1016/j.recesp.2025.05.017
Lorenzo Fácila , Jezabel Pendás , Vicente Montagud , Miguel Benedito
{"title":"Impacto de la exclusión de accesos transapicales en los resultados por sexos del implante percutáneo de válvula aórtica: ¿una limitación metodológica?","authors":"Lorenzo Fácila , Jezabel Pendás , Vicente Montagud , Miguel Benedito","doi":"10.1016/j.recesp.2025.05.017","DOIUrl":"10.1016/j.recesp.2025.05.017","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 930-931"},"PeriodicalIF":5.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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