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Causa infrecuente de obstrucción de la arteria pulmonar 肺动脉阻塞的罕见病因
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2024-06-11 DOI: 10.1016/j.recesp.2024.03.016
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引用次数: 0
Impacto de un modelo integrado cardiología-medicina intensiva en la mortalidad del IAMCEST 综合心脏病学强化护理模式对 ST 段抬高型急性心肌梗死死亡率的影响
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2024-06-11 DOI: 10.1016/j.recesp.2024.05.018
Javier Lorenzo González , Marcos Farráis Villalba , Cristina López Ferraz , Sergio Huertas Nieto , Mar Martín Velasco , Julio Hernández Afonso
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引用次数: 0
Estilo de vida poco saludable y perfil de riesgo cardiovascular: una preocupación en trabajadores adultos jóvenes en España 不健康的生活方式和心血管风险概况:西班牙青年工人的担忧
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2024-06-07 DOI: 10.1016/j.recesp.2024.04.009
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引用次数: 0
Uso de un catéter orientable de ablación para facilitar la valvuloplastia mitral percutánea 使用可转向消融导管促进经皮二尖瓣成形术
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2024-06-06 DOI: 10.1016/j.recesp.2024.04.018
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引用次数: 0
Registro español de trasplante cardiaco. XXXV informe oficial de la Asociación de Insuficiencia Cardiaca de la Sociedad Española de Cardiología 西班牙心脏移植登记处。西班牙心脏病学会心力衰竭协会第三十五次官方报告。
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2024-06-05 DOI: 10.1016/j.recesp.2024.05.016

Introduction and objectives

Our aim was to describe the characteristics and outcomes of heart transplants in Spain.

Methods

We analyzed trends in recipient and donor characteristics, recipient-donor interaction, surgical procedures, immunosuppression, and outcomes of patients included in the Spanish heart transplant registry from 2014 to 2023. Changes in survival were analyzed using the Kaplan-Meier method.

Results

In 2023, 325 cardiac transplants were performed (4.5% more than in the previous year), with a total of 2987 procedures from 2014 to 2023. There was a trend toward performing more transplants in women (29.2%), with etiologies other than cardiomyopathy (32.6%), and with better pretransplant status (less hepatic [12.5%], renal [glomerular filtration rate, 81.5 mL/min/1.73 m2], and respiratory [8.7%] involvement). In 2023, the number of urgent transplants increased (44% of the total), especially those performed after circulatory support with extracorporeal membrane oxygenation (36% of total assistance), and transplants performed with donation after circulatory death (17.9%). Survival improved in the triennium from 2020 to 2022 compared with 2014 to 2016 (83.0% at 1 year from 2020-2022 vs 79.0% from 2014-2016).

Conclusions

The number of transplants performed in Spain showed an upward trend, with recipients with better clinical status and an increasing use of donation after circulatory death. Survival improved in the last triennium.
导言和目标我们的目的是描述西班牙心脏移植手术的特点和结果。方法我们分析了2014年至2023年期间西班牙心脏移植登记处收录的受体和供体特点、受体与供体相互作用、手术过程、免疫抑制和患者结果的趋势。结果2023年共进行了325例心脏移植手术(比上一年增加4.5%),2014年至2023年共进行了2987例手术。女性(29.2%)、心肌病以外的病因(32.6%)和移植前状态较好(肝脏[12.5%]、肾脏[肾小球滤过率,81.5 mL/min/1.73 m2]和呼吸系统[8.7%]受累较少)的患者接受移植的数量呈上升趋势。2023 年,紧急移植数量增加(占总数的 44%),尤其是在体外膜氧合循环支持后进行的移植(占总援助的 36%),以及在循环死亡后通过捐赠进行的移植(17.9%)。与 2014 年至 2016 年相比,2020 年至 2022 年三年期的存活率有所提高(2020 年至 2022 年 1 年存活率为 83.0% vs 2014 年至 2016 年为 79.0%)。结论西班牙进行的移植数量呈上升趋势,受者的临床状况更好,循环死亡后捐献的使用率也在增加。最近三年的存活率有所提高。
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引用次数: 0
Impacto clínico del tratamiento a distancia de la insuficiencia cardiaca con la alerta multiparamétrica del DAI HeartLogic 使用 HeartLogic ICD 多参数预警对心力衰竭进行远程治疗的临床影响
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2024-06-04 DOI: 10.1016/j.recesp.2024.04.007
Javier de Juan Bagudá , Rocío Cózar León , Juan J. Gavira Gómez , Marta Pachón , Josebe Goirigolzarri Artaza , Virgilio Martínez Mateo , Vanessa Escolar Pérez , Ángel Manuel Iniesta Manjavacas , Nuria Rivas Gándara , Jesús Álvarez-García , Jesús Gabriel Sánchez Ramos , Cristina Aguilera Agudo , José Manuel Rubín López , Alfonso Macías Gallego , Silvia López Fernández , Luis González Torres , Juan Gabriel Martínez , Natalia Marrero Negrín , Javier Ramos Maqueda , Mercedes Cabrera Ramos , Rafael Salguero Bodes

Introduction and objectives

The multiparametric implantable cardioverter-defibrillator HeartLogic index has proven to be a sensitive and timely predictor of impending heart failure (HF) decompensation. We evaluated the impact of a standardized follow-up protocol implemented by nursing staff and based on remote management of alerts.

Methods

The algorithm was activated in HF patients at 19 Spanish centers. Transmitted data were analyzed remotely, and patients were contacted by telephone if alerts were issued. Clinical actions were implemented remotely or through outpatient visits. The primary endpoint consisted of HF hospitalizations or death. Secondary endpoints were HF outpatient visits. We compared the 12-month periods before and after the adoption of the protocol.

Results

We analyzed 392 patients (aged 69 ± 10 years, 76% male, 50% ischemic cardiomyopathy) with implantable cardioverter-defibrillators (20%) or cardiac resynchronization therapy defibrillators (80%). The primary endpoint occurred 151 times in 86 (22%) patients during the 12 months before the adoption of the protocol, and 69 times in 45 (11%) patients (P < .001) during the 12 months after its adoption. The mean number of hospitalizations per patient was 0.39 ± 0.89 pre- and 0.18 ± 0.57 postadoption (P < .001). There were 185 outpatient visits for HF in 96 (24%) patients before adoption and 64 in 48 (12%) patients after adoption (P < .001). The mean number of visits per patient was 0.47 ± 1.11 pre- and 0.16 ± 0.51 postadoption (P < .001).

Conclusions

A standardized follow-up protocol based on remote management of HeartLogic alerts enabled effective remote management of HF patients. After its adoption, we observed a significant reduction in HF hospitalizations and outpatient visits.
导言和目的事实证明,多参数植入式心律转复除颤器 HeartLogic 指数能敏感、及时地预测即将发生的心衰(HF)失代偿。我们评估了护理人员在远程管理警报的基础上实施标准化随访方案的影响。对传输的数据进行远程分析,如果发出警报,则通过电话联系患者。临床行动通过远程或门诊实施。主要终点包括高血压住院或死亡。次要终点为高血压门诊量。我们对采用该方案前后 12 个月的情况进行了比较。结果我们分析了 392 名患者(年龄 69 ± 10 岁,76% 为男性,50% 为缺血性心肌病患者),其中 20% 使用了植入式心律转复除颤器,80% 使用了心脏再同步治疗除颤器。在采用该方案前的 12 个月内,86 名患者(22%)中有 151 次出现主要终点;在采用该方案后的 12 个月内,45 名患者(11%)中有 69 次出现主要终点(P < .001)。每位患者的平均住院次数在采用前为 0.39 ± 0.89 次,采用后为 0.18 ± 0.57 次(P < .001)。采用前,96 名(24%)患者因高血压就诊 185 次,采用后,48 名(12%)患者因高血压就诊 64 次(P < .001)。每位患者的平均就诊次数在采用前为 0.47 ± 1.11 次,采用后为 0.16 ± 0.51 次(P <.001)。结论基于远程管理 HeartLogic 警报的标准化随访方案能够对高血压患者进行有效的远程管理。采用该方案后,我们发现心房颤动住院和门诊就诊人数明显减少。
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引用次数: 0
Pericarditis aguda: ¿cuándo es necesaria una búsqueda exhaustiva de las causas? 急性心包炎:何时需要彻底查找病因?
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2024-06-04 DOI: 10.1016/j.recesp.2024.05.014
José Rozado
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引用次数: 0
Disfunción del ventrículo derecho: fisiopatología, modelos experimentales, evaluación y tratamiento 右心室功能障碍:病理生理学、实验模型、评估和管理
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2024-06-04 DOI: 10.1016/j.recesp.2024.05.017
Interest in the right ventricle has substantially increased due to advances in knowledge of its pathophysiology and prognostic implications across a wide spectrum of diseases. However, we are still far from understanding the multiple mechanisms that influence right ventricular dysfunction, its evaluation continues to be challenging, and there is a shortage of specific treatments in most scenarios. This review article aims to update knowledge about the physiology of the right ventricle, its transition to dysfunction, diagnostic tools, and available treatments from a translational perspective.
由于对右心室的病理生理学和对多种疾病的预后影响的认识不断进步,人们对右心室的关注度大幅提高。然而,我们对影响右心室功能障碍的多种机制的了解还远远不够,对其进行评估仍然具有挑战性,而且在大多数情况下缺乏特定的治疗方法。这篇综述文章旨在从转化的角度更新有关右心室生理学、右心室向功能障碍的转变、诊断工具和现有治疗方法的知识。
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引用次数: 0
Vena pulmonar superior derecha que cruza la línea media 穿越中线的右上肺静脉
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.recesp.2024.03.015
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引用次数: 0
Estilo de vida y riesgo cardiovascular de jóvenes trabajadores: hallazgos en una cohorte de toda España 青年工人的生活方式与心血管风险:西班牙全境队列研究结果
IF 5.9 2区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.recesp.2024.02.006

Introduction and objectives

This study aimed to describe the cardiovascular risk profile of working young adults from Spain and its association with lifestyle.

Methods

Participants (18-30 years) were recruited from a nationwide cohort of economically active adults insured by a large occupational risk prevention company, with data obtained from routine medical assessments. The participants were categorized as having an “unhealthy” cardiovascular risk profile based on the presence of prediabetes/diabetes, prehypertension/hypertension, or hypercholesterolemia, or a “healthy” profile if these conditions were completely absent. The association with lifestyle factors (weight, physical activity, sleeping characteristics, alcohol consumption, smoking) was assessed.

Results

A total of 78 421 young adults (27 ± 2 years, 36% female) were evaluated at baseline. The “unhealthy” cardiovascular risk profile was prevalent (18%) and inversely associated (OR, 0.64; 95%CI, 0.57-0.80) with an optimal lifestyle (normal weight, regular physical activity, no drinking/smoking, and good sleep). The latter condition was found in only 3.5% of the participants. On the other hand, prospective analyses in 44 776 participants (median follow-up = 2 [range 2-5] years) showed that 2.0% transitioned from a “healthy” to an “unhealthy” profile. Being physically active (OR, 0.95; 95%CI, 0.81-0.99) and having a normal weight (OR, 0.61; 95%CI, 0.51-0.70) were associated with a lower likelihood of this transition. No consistent associations were found for other lifestyle factors.

Conclusions

The prevalence of cardiovascular risk factors is high in economically active young Spanish adults. An unhealthy cardiovascular risk profile is inversely associated with an optimal lifestyle, but the latter is highly infrequent in this population.
Full English text available from:www.revespcardiol.org/en
这项研究旨在描述西班牙在职青壮年的心血管风险状况及其与生活方式的关系。方法从一家大型职业风险预防公司投保的全国经济活跃成年人队列中招募参与者(18-30 岁),并从常规医疗评估中获取数据。根据参与者是否存在糖尿病前期/糖尿病、高血压前期/高血压或高胆固醇血症,将其归类为心血管风险状况 "不健康 "的人群;如果完全不存在这些情况,则归类为心血管风险状况 "健康 "的人群。结果 共有 78 421 名年轻成年人(27 ± 2 岁,36% 为女性)接受了基线评估。不健康 "的心血管风险状况普遍存在(18%),且与最佳生活方式(体重正常、经常运动、不饮酒/吸烟、睡眠良好)成反比(OR,0.64;95%CI,0.57-0.80)。只有 3.5%的参与者具备后一种条件。另一方面,对 44 776 名参与者进行的前瞻性分析(中位数随访时间=2[2-5]年)显示,有 2.0% 的人从 "健康 "状态转变为 "不健康 "状态。身体活跃(OR,0.95;95%CI,0.81-0.99)和体重正常(OR,0.61;95%CI,0.51-0.70)与这种转变的可能性较低有关。结论 在西班牙从事经济活动的年轻人中,心血管风险因素的发生率很高。不健康的心血管风险状况与最佳生活方式成反比,但后者在这一人群中并不常见。英文全文见:www.revespcardiol.org/en。
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Revista espanola de cardiologia
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