Revista espanola de cardiologia最新文献

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Inteligencia artificial (IA): una de arena… 人工智能（AI）：一个沙…

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2026-01-01 Epub Date: 2025-07-05 DOI: 10.1016/j.recesp.2025.07.001

Fernando A. Navarro

引用次数: 0

Acoplamiento entre el ventrículo derecho y la arteria pulmonar como predictor de muerte o ingreso por IC en pacientes con insuficiencia tricuspídea grave 右心室与肺动脉的联接作为严重三联功能不全患者死亡或IC入院的预测因素

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2026-01-01 Epub Date: 2025-06-23 DOI: 10.1016/j.recesp.2025.04.012

Ana Fernández Ruiz , Martín Ruiz Ortiz , Consuelo Fernández-Avilés Irache , Ana María Rodríguez Almodóvar , Mónica Delgado Ortega , Fátima Esteban Martínez , Adriana Resúa Collazo , Gloria Heredia Campos , Rafael González Manzanares , José López Aguilera , Juan Carlos Castillo Domínguez , Manuel Anguita Sánchez , Manuel Pan Álvarez-Ossorio , Dolores Mesa Rubio

Introduction and objectives

The right ventricular-pulmonary arterial coupling, evaluated by tricuspid annular plane systolic excursion and pulmonary artery systolic pressure ratio (TAPSE/PASP), has been studied in the prognostic assessment of severe tricuspid regurgitation only in selected populations and mainly in relation to all-cause mortality.

Methods

We retrospectively included all adult patients with severe tricuspid regurgitation who underwent echocardiography at a tertiary care hospital between January 1, 2008, and December 31, 2017. We investigated the association of TAPSE/PASP, either as a continuous variable or dichotomized at < 0.31 mm/mmHg, with the combined endpoint of mortality and heart failure (HF) admission, as well as its usefulness in several subgroups of interest.

Results

A total of 474 patients (70 ± 13 years; 71% women) were included, with a median follow-up of 5 [p25-75, 2-7] years. During follow-up, 285 patients died and 192 experienced 481 HF admissions. Patients with TAPSE/PASP < 0.31 mm/mmHg had significantly worse HF admission-free survival at median follow-up (25% vs 53%, P < .0005). The discriminative ability of TAPSE/PASP was statistically significant (area under the curve, 0.69; 95%CI, 0.65-0.74; P < .0005). After multivariate adjustment, TAPSE/PASP remained an independent predictor of the combined endpoint (HR, 0.017; 95%CI, 0.004-0.075; P < .0005), with significant incremental prognostic value over clinical variables (P < .0005). The performance of the index was consistent in patients with pacemaker/defibrillator leads or prior cardiac surgery, but not in those with reduced ejection fraction.

Conclusions

In this cohort of patients with severe tricuspid regurgitation, TAPSE/PASP was a strong independent predictor of HF admission or mortality during long-term follow-up.

通过三尖瓣环平面收缩偏移和肺动脉收缩压比（TAPSE/PASP）评估的右心室-肺动脉耦合，仅在选定人群中研究了严重三尖瓣反流的预后评估，主要与全因死亡率有关。方法回顾性纳入2008年1月1日至2017年12月31日在三级医院接受超声心动图检查的所有严重三尖瓣反流成年患者。我们研究了TAPSE/PASP与死亡率和心力衰竭（HF）入院的联合终点的关联，无论是作为一个连续变量还是在0.31 mm/mmHg时进行二分类，以及它在几个感兴趣的亚组中的有效性。结果共纳入474例患者（70±13岁，71%为女性），中位随访时间为5年[p25- 75,2 -7]年。随访期间，285例患者死亡，192例有481例心衰入院。中位随访时，TAPSE/PASP <； 0.31 mm/mmHg的患者心衰无入院生存率明显较差（25% vs 53%, P < 0.0005）。TAPSE/PASP的判别能力有统计学意义（曲线下面积0.69;95%CI, 0.65 ~ 0.74; P < 0.0005）。多因素调整后，TAPSE/PASP仍然是联合终点的独立预测因子（HR, 0.017; 95%CI, 0.004-0.075; P < .0005），与临床变量相比，其预后价值显著增加（P < .0005）。该指数在使用起搏器/除颤器导联或既往心脏手术的患者中表现一致，但在射血分数降低的患者中则不一致。结论：在这组严重三尖瓣反流患者中，TAPSE/PASP是长期随访中心衰入院或死亡的一个强有力的独立预测因子。

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引用次数: 0

Imagen de fusión ecocardiográfica-fluoroscópica con la minisonda transesofágica 3D en cardiopatías congénitas pediátricas 在儿科先天性心脏病中使用经食管微型3D超声心动图-荧光融合成像

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2026-01-01 Epub Date: 2025-05-21 DOI: 10.1016/j.recesp.2025.03.011

Ramona Ghenghea , Khaled Hadeed , Paul Vignaud-Marighetto , Nicolas Combes , Philippe Acar , Clement Karsenty

引用次数: 0

Síndrome de Sézary como causa inusual de endocarditis de Loeffler 塞扎里综合征作为Loeffler心内膜炎的不寻常病因

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2026-01-01 Epub Date: 2025-07-31 DOI: 10.1016/j.recesp.2025.07.009

Juan Manuel Serrano-Marcos, Miguel Morales-García, Sara Ruiz-Magaña

引用次数: 0

Asociación entre la metilación del ADN en loci relacionados con el tabaco y mortalidad en pacientes con enfermedad arterial periférica 烟草相关位点的DNA甲基化与周围动脉疾病患者死亡率之间的关联

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2026-01-01 Epub Date: 2025-04-25 DOI: 10.1016/j.recesp.2025.02.024

Lidia Marcos-García , Albert Clarà , Sonia Pérez-Cabezón , Manuel Miralles-Hernández , Roberto Elosua , Alina Velescu

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 : 2026-01-01 Epub 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

Precisión diagnóstica del cociente cuantitativo de flujo en lesiones intermedias no culpables de pacientes con infarto agudo de miocardio con elevación del segmento ST ST段升高急性心肌梗死患者非罪过性中间损伤定量流量系数的诊断准确性

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2026-01-01 Epub Date: 2025-07-10 DOI: 10.1016/j.recesp.2025.05.010

Emilio Alfonso Rodríguez , Josep Gómez-Lara , Ramón López-Palop , Enrique Gutiérrez , Luis Renier Goncalves Ramírez , José Valencia , Alfonso Jurado-Román , Juan Gabriel Córdoba Soriano , Antonio Gómez-Menchero , Estefanía Fernández-Peregrina , Carlos Cortés , Paula Tejedor , Raúl Millán , Guillermo Sánchez-Elvira , Tamara García-Camarero , José Antonio Linares Vicente , Eva Rúmiz , Rosa María Cardenal Piris , Irene Elizondo Rua , Jean Paul Vílchez , Joan Antoni Gómez-Hospital

Introduction and objectives

The reliability of quantitative flow ratio (QFR) has been questioned. Our aim was to evaluate the diagnostic accuracy of QFR in intermediate nonculprit lesions during the index ST-segment elevation myocardial infarction (STEMI) procedure compared with positive pressure wire-based fractional flow reserve (FFR ≤ 0.80) in a staged procedure.

Methods

This was a substudy of the multicenter, controlled, and randomized VULNERABLE trial, including 428 intermediate nonculprit lesions from 388 consecutive STEMI patients undergoing FFR assessment in a staged procedure between 1 and 60 days. Off-line QFR analyses were performed during both the index and staged procedures. The primary objective was to assess the diagnostic accuracy of index QFR compared with staged positive FFR.

Results

Angiographic vessel diameter (2.80 ± 0.59 vs 2.91 ± 0.57 mm; P < .01), stenosis severity (51.33 ± 8.04% vs 50.54 ± 7.63%; P = .053), and QFR values (0.85 ± 0.09 vs 0.86 ± 0.09; P = .120) showed minimal changes between the index and staged procedures. Moderate concordance was observed between index QFR and staged FFR (kappa index = 0.629; intraclass correlation coefficient = 0.641). The diagnostic accuracy of index QFR for predicting positive FFR was good (area under the curve = 0.825). An index QFR cutoff ≤ 0.80 showed moderate sensitivity (72%) and excellent specificity (91%). An index QFR ≤ 0.87 achieved a sensitivity of 86% for detecting lesions with positive FFR, with 55% of lesions presenting QFR ≤ 0.87 at the index procedure.

Conclusions

Index QFR demonstrated good diagnostic accuracy for identifying lesions with positive FFR in a staged procedure. However, an index QFR cutoff value of ≤ 0.80 showed moderate sensitivity and may underdiagnose approximately 3 out of 10 lesions with positive FFR. An index QFR ≤ 0.87 provided higher sensitivity and may help avoid invasive (staged) procedures in many patients.

定量流量比（QFR）的可靠性一直受到质疑。我们的目的是评估QFR在st段抬高型心肌梗死（STEMI）过程中对中间非罪魁祸首病变的诊断准确性，并与分期手术中基于正压丝的分数血流储备（FFR≤0.80）进行比较。这是多中心、对照和随机的VULNERABLE试验的一项亚研究，包括388例连续STEMI患者的428个中间非罪魁祸首病变，在1至60天的分期过程中进行FFR评估。离线QFR分析在索引和分级过程中进行。主要目的是评估QFR指数与分期阳性FFR的诊断准确性。结果血管造影血管直径（2.80±0.59 vs 2.91±0.57 mm, P < 01）、狭窄严重程度（51.33±8.04% vs 50.54±7.63%,P = 0.053）和QFR值（0.85±0.09 vs 0.86±0.09,P = 0.120）在指数和分期手术之间变化最小。指标QFR与分期FFR有中等程度的一致性（kappa指数= 0.629，类内相关系数= 0.641）。指标QFR预测FFR阳性的诊断准确率较好（曲线下面积= 0.825）。QFR指数截止值≤0.80，灵敏度中等（72%），特异度极佳（91%）。指数QFR≤0.87对于检测FFR阳性病变的灵敏度为86%，其中55%的病变在指数程序中QFR≤0.87。结论指数QFR在分期诊断FFR阳性病变方面具有良好的准确性。然而，指数QFR截断值≤0.80表示中度敏感性，并且可能在FFR阳性的10个病变中有3个未被诊断。QFR指数≤0.87提供了更高的敏感性，并可能有助于避免许多患者的侵入性（分期）手术。

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引用次数: 0

Pequeñas dimensiones telediastólicas del ventrículo izquierdo identifican a pacientes con insuficiencia cardiaca y fracción de eyección supranormal 左心室的小远心室尺寸可识别心脏衰竭和超常射精部分患者

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2026-01-01 Epub Date: 2025-05-16 DOI: 10.1016/j.recesp.2025.03.002

Enrique Santas , Rafael de la Espriella , Gema Miñana , Anna Mollar , Patricia Palau , Julio Núñez

引用次数: 0

Abordaje del tratamiento antitrombótico durante el perioperatorio y el periprocedimiento: documento de consenso 2025 de SEC, SEDAR, SEACV, SECCE, AEC, SECOM CYC, SECPRE, SEPD, SEGG, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEN, S.E.N., SENEC, SEPAR, SEO, SEORL-CCC, SEPA, SERVEI, SECOT y AEU 术后和手术期间的抗血栓治疗：SEC、SEDAR、SEACV、SECCE、AEC、SECOM CYC、SECPRE、SEPD、SEGG、SEGO、SEHH、SETH、SEMERGEN、SEMFYC、SEMG、SEMICYUC、SEMI、SEMES、SEN、SEE.N.、SENEC、SEPAR、SEO、SEORL-CCC、SEPA、SERVEI、SECOT和AEU共识文件2025

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2026-01-01 Epub Date: 2025-07-29 DOI: 10.1016/j.recesp.2025.07.008

David Vivas , Raquel Ferrandis , Manuel Anguita-Sánchez , María Anguita-Gámez , Juan Ignacio Arcelus , Marysol Echeverri , Isabel Egocheaga , María Asunción Esteve-Pastor , José Luis Ferreiro , Juan Vicente Llau , Vanessa Roldán , Juan Miguel Ruiz-Nodar , David González-Casal , Mónica Torres-Fonseca , José López-Menéndez , Míriam Ciria , Francisco Leyva , Enrique Rodríguez de Santiago , María Teresa Vidán , Loida Pamplona , Nora Palomo-López

In recent years, the use of anticoagulant and antiplatelet medications has significantly increased, along with rising life expectancy. As a result, many patients on antithrombotic therapy will eventually require invasive procedures. This necessitates decisions on the appropriateness and timing of discontinuing anticoagulation and/or antiplatelet therapy in each case. Although a key multidisciplinary consensus document was published in 2018 to guide this process, its practical application has been limited. Furthermore, adherence to its recommendations has been low, leading to a higher incidence of both thrombotic and hemorrhagic adverse events. To address these issues and reflect advances in knowledge, it has been decided to update the previous consensus document to include developments since 2018. The aim is to simplify clinical decision-making and gain support from a broader range of scientific societies. Ultimately, the goal is to improve the dissemination and practical application of these recommendations to optimize the safety and effectiveness of antithrombotic treatment in patients requiring invasive procedures, reduce complications associated with inappropriate treatment, and enhance clinical outcomes in this increasingly complex scenario.

Full English text available from:www.revespcardiol.org/en

近年来，抗凝血和抗血小板药物的使用随着预期寿命的延长而显著增加。因此，许多接受抗血栓治疗的患者最终将需要侵入性手术。这就需要在每个病例中决定停止抗凝和/或抗血小板治疗的适当性和时机。尽管2018年发表了一份重要的多学科共识文件来指导这一过程，但其实际应用有限。此外，对其建议的依从性很低，导致血栓和出血性不良事件的发生率较高。为了解决这些问题并反映知识的进步，决定更新以前的共识文件，纳入2018年以来的发展情况。其目的是简化临床决策，并获得更广泛的科学学会的支持。最终，目标是提高这些建议的传播和实际应用，以优化需要侵入性手术的患者抗血栓治疗的安全性和有效性，减少与不适当治疗相关的并发症，并在这种日益复杂的情况下提高临床结果。完整的英文文本可从：www.revespcardiol.org/en

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引用次数: 0

Modelando el pronóstico en la insuficiencia tricuspídea grave a través del acoplamiento entre el ventrículo derecho y la arteria pulmonar 通过右心室与肺动脉的连接，模拟严重三叉肌功能不全的预后

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2026-01-01 Epub Date: 2025-08-14 DOI: 10.1016/j.recesp.2025.06.012

Dalila Nappa , Rocío Hinojar , Covadonga Fernández-Golfín

引用次数: 0

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