Revista espanola de cardiologia最新文献

英文中文

Revisión sistemática y metanálisis de la mortalidad en la miocardiopatía chagásica crónica frente a otras miocardiopatías: ¿mayor riesgo o ficción? 慢性恰加斯病心肌病与其他心肌病死亡率的系统回顾和荟萃分析：风险增加还是子虚乌有？

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-05-11 DOI: 10.1016/j.recesp.2024.02.022

Introduction and objectives

Although multiple studies suggest that chronic Chagas cardiomyopathy (CCC) has higher mortality than other cardiomyopathies, the absence of meta-analyses supporting this perspective limits the possibility of generating robust conclusions. The aim of this study was to systematically evaluate the current evidence on mortality risk in CCC compared with that of other cardiomyopathies.

Methods

PubMed/Medline and EMBASE were searched for studies comparing mortality risk between patients with CCC and those with other cardiomyopathies, including in the latter nonischemic cardiomyopathy (NICM), ischemic cardiomyopathy, and non-Chagas cardiomyopathy (nonCC). A random-effects meta-analysis was performed to combine the effects of the evaluated studies.

Results

A total of 37 studies evaluating 17 949 patients were included. Patients with CCC had a significantly higher mortality risk compared with patients with NICM (HR, 2.04; 95%CI, 1.60-2.60; I², 47%; 8 studies) and non-CC (HR, 2.26; 95%CI, 1.65-3.10; I², 71%; 11 studies), while no significant association was observed compared with patients with ischemic cardiomyopathy (HR, 1.72; 95%CI, 0.80-3.66; I², 69%; 4 studies) in the adjusted-measures meta-analysis.

Conclusions

Patients with CCC have an almost 2-fold increased mortality risk compared with individuals with heart failure secondary to other etiologies. This finding highlights the need for effective public policies and targeted research initiatives to optimally address the challenges of CCC.

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

引言和目的虽然多项研究表明慢性恰加斯氏心肌病（CCC）的死亡率高于其他心肌病，但由于缺乏支持这一观点的荟萃分析，因此无法得出可靠的结论。本研究的目的是系统评估目前有关 CCC 与其他心肌病死亡率风险比较的证据。研究方法在 PubMed/Medline 和 EMBASE 上搜索了比较 CCC 患者与其他心肌病患者死亡率风险的研究，包括后者中的非缺血性心肌病 (NICM)、缺血性心肌病和非恰加斯心肌病 (nonCC)。结果共纳入了 37 项研究，对 17 949 名患者进行了评估。与 NICM 患者（HR，2.04；95%CI，1.60-2.60；I2，47%；8 项研究）和非 CCC 患者（HR，2.26；95%CI，1.65-3.10；I2，71%；11 项研究）相比，CCC 患者的死亡风险明显更高，而与缺血性心肌病患者（HR，1.结论与继发于其他病因的心力衰竭患者相比，CCC 患者的死亡风险几乎增加了 2 倍。这一发现突出表明，需要有效的公共政策和有针对性的研究措施，以最佳方式应对 CCC 带来的挑战。英文全文可从以下网站获取：www.revespcardiol.org/en。

{"title":"Revisión sistemática y metanálisis de la mortalidad en la miocardiopatía chagásica crónica frente a otras miocardiopatías: ¿mayor riesgo o ficción?","authors":"","doi":"10.1016/j.recesp.2024.02.022","DOIUrl":"10.1016/j.recesp.2024.02.022","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Although multiple studies suggest that chronic Chagas cardiomyopathy (<span>CCC</span>) has higher mortality than other cardiomyopathies, the absence of meta-analyses supporting this perspective limits the possibility of generating robust conclusions. The aim of this study was to systematically evaluate the current evidence on mortality risk in CCC compared with that of other cardiomyopathies.</div></div><div><h3>Methods</h3><div>PubMed/Medline and EMBASE were searched for studies comparing mortality risk between patients with CCC and those with other cardiomyopathies, including in the latter nonischemic cardiomyopathy (NICM), ischemic cardiomyopathy, and non-Chagas cardiomyopathy (nonCC). A random-effects meta-analysis was performed to combine the effects of the evaluated studies.</div></div><div><h3>Results</h3><div>A total of 37 studies evaluating 17 949 patients were included. Patients with CCC had a significantly higher mortality risk compared with patients with NICM (HR, 2.04; 95%CI, 1.60-2.60; I<sup>2</sup>, 47%; 8 studies) and non-CC (HR, 2.26; 95%CI, 1.65-3.10; I<sup>2</sup>, 71%; 11 studies), while no significant association was observed compared with patients with ischemic cardiomyopathy (HR, 1.72; 95%CI, 0.80-3.66; I<sup>2</sup>, 69%; 4 studies) in the adjusted-measures meta-analysis.</div></div><div><h3>Conclusions</h3><div>Patients with CCC have an almost 2-fold increased mortality risk compared with individuals with heart failure secondary to other etiologies. This finding highlights the need for effective public policies and targeted research initiatives to optimally address the challenges of CCC.</div><div><em>Full English text available from</em>:<span><span>www.revespcardiol.org/en</span><svg><path></path></svg></span></div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141041657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Estado nutricional al ingreso y pronóstico en el shock cardiogénico 心源性休克患者入院时的营养状况和预后

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-05-10 DOI: 10.1016/j.recesp.2024.05.001

引用次数: 0

Desafíos en el avance de la sonda de ecocardiografía transesofágica: identificación de causas y soluciones 推进经食道超声心动图探头的挑战：找出原因和解决方案

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-05-08 DOI: 10.1016/j.recesp.2024.04.016

引用次数: 0

Valvulitis: un nuevo criterio ecocardiográfico para el diagnóstico de endocarditis infecciosa de bioprótesis de válvula aórtica 瓣膜炎：诊断主动脉瓣生物假体感染性心内膜炎的新超声心动图标准

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-05-07 DOI: 10.1016/j.recesp.2024.03.001

Introduction and objectives

Diffuse homogeneous hypoechoic leaflet thickening, with a wavy leaflet motion documented by transesophageal echocardiography (TEE), has been described in some cases of prosthetic valve endocarditis (PVE) involving aortic bioprosthesis (AoBio-PVE). This echocardiographic finding has been termed valvulitis. We aimed to estimate the prevalence of valvulitis, precisely describe its echocardiographic characteristics, and determine their clinical significance in patients with AoBio-PVE.

Methods

From 2011 to 2022, 388 consecutive patients with infective endocarditis (IE) admitted to a tertiary care hospital were prospectively included in a multipurpose database. For this study, all patients with AoBio-PVE (n = 86) were selected, and their TEE images were thoroughly evaluated by 3 independent cardiologists to identify all cases of valvulitis.

Results

The prevalence of isolated valvulitis was 12.8%, and 20.9% of patients had valvulitis accompanied by other classic echocardiographic findings of IE. A total of 9 out of 11 patients with isolated valvulitis had significant valve stenosis, whereas significant aortic valve regurgitation was documented in only 1 patient. Compared with the other patients with AoBio-PVE, cardiac surgery was less frequently performed in patients with isolated valvulitis (27.3% vs 62.7%, P = .017). In 4 out of 5 patients with valve stenosis who did not undergo surgery but underwent follow-up TEE, valve gradients significantly improved with appropriate antibiotic therapy.

Conclusions

Valvulitis can be the only echocardiographic finding in infected AoBio and needs to be identified by imaging specialists for early diagnosis. However, this entity is a diagnostic challenge and additional imaging techniques might be required to confirm the diagnosis. Larger series are needed.

导言和目的经食道超声心动图（TEE）显示，一些涉及主动脉生物假体（AoBio-PVE）的人工瓣膜心内膜炎（PVE）病例出现弥漫性同质低回声瓣叶增厚，并伴有波浪形瓣叶运动。这种超声心动图检查结果被称为瓣膜炎。我们旨在估算瓣膜炎的患病率，精确描述其超声心动图特征，并确定其在 AoBio-PVE 患者中的临床意义。结果孤立性瓣膜炎的发病率为12.8%，20.9%的患者瓣膜炎伴有其他典型的IE超声心动图检查结果。在11名孤立性瓣膜炎患者中，共有9名患者有明显的瓣膜狭窄，而只有1名患者有明显的主动脉瓣反流。与其他患有 AoBio-PVE 的患者相比，孤立性瓣膜炎患者接受心脏手术的比例较低（27.3% 对 62.7%，P = .017）。结论瓣膜炎可能是感染性 AoBio 的唯一超声心动图检查结果，需要由影像学专家识别以进行早期诊断。然而，这种疾病在诊断上是一个挑战，可能需要额外的成像技术来确诊。需要更大规模的系列研究。

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引用次数: 0

Hipertensión arterial pulmonar asociada a cortocircuitos pretricuspídeos: perfil de riesgo y supervivencia 与前三尖瓣分流相关的肺动脉高压：风险和存活概况

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-05-07 DOI: 10.1016/j.recesp.2024.04.014

引用次数: 0

Tomografía computarizada espectral en el abordaje del MINOCA MINOCA 方法中的光谱计算机断层扫描

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-05-01 DOI: 10.1016/j.recesp.2024.03.006

引用次数: 0

Situación de la rehabilitación cardiaca en España. Resultados del registro AULARC 西班牙心脏康复情况。AULARC 登记结果

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-04-27 DOI: 10.1016/j.recesp.2024.04.011

引用次数: 0

Evaluación dinámica de las escalas CHA2DS2-VASc y HAS-BLED para predecir ictus isquémico y hemorragia mayor en pacientes con fibrilación auricular 对 CHA2DS2-VASc 和 HAS-BLED 量表预测心房颤动患者缺血性中风和大出血的动态评估

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-04-24 DOI: 10.1016/j.recesp.2024.02.013

Introduction and objectives

Stroke and bleeding risks in atrial fibrillation (AF) are often assessed at baseline to predict outcomes years later. We investigated whether dynamic changes in CHA₂DS₂-VASc and HAS-BLED scores over time modify risk prediction.

Methods

We included patients with AF who were stable while taking vitamin K antagonists. During a 6-year follow-up, all ischemic strokes/transient ischemic attacks (TIAs) and major bleeding events were recorded. CHA₂DS₂-VASc and HAS-BLED were recalculated every 2-years and tested for clinical outcomes at 2-year periods.

Results

We included 1361 patients (mean CHA₂DS₂-VASc and HAS-BLED 4.0 ± 1.7 and 2.9 ± 1.2). During the follow-up, 156 (11.5%) patients had an ischemic stroke/TIA and 269 (19.8%) had a major bleeding event. Compared with the baseline CHA₂DS₂-VASc, the CHA₂DS₂-VASc recalculated at 2 years had higher predictive ability for ischemic stroke/TIA during the period from 2 to 4 years. Integrated discrimination improvement (IDI) and net reclassification improvement (NRI) showed improvements in sensitivity and better reclassification. The CHA₂DS₂-VASc recalculated at 4 years had better predictive performance than the baseline CHA₂DS₂-VASc during the period from 4 to 6 years, with an improvement in IDI and an enhancement of the reclassification. The recalculated HAS-BLED at 2-years had higher predictive ability than the baseline score for major bleeding during the period from 2 to 4 years, with significant improvements in sensitivity and reclassification. A slight enhancement in sensitivity was observed with the HAS-BLED score recalculated at 4 years compared with the baseline score.

Conclusions

In AF patients, stroke and bleeding risks are dynamic and change over time. The CHA₂DS₂-VASc and HAS-BLED scores should be regularly reassessed, particularly for accurate stroke risk prediction.

导言和目的心房颤动（AF）的卒中和出血风险通常在基线时进行评估，以预测数年后的结果。我们研究了 CHA2DS2-VASc 和 HAS-BLED 评分随着时间推移的动态变化是否会改变风险预测。在为期 6 年的随访中，记录了所有缺血性脑卒中/短暂性脑缺血发作（TIA）和大出血事件。每两年重新计算一次 CHA2DS2-VASc 和 HAS-BLED，并在两年期间检测临床结果。随访期间，156 名患者（11.5%）发生了缺血性中风/TIA，269 名患者（19.8%）发生了大出血。与基线 CHA2DS2-VASc 相比，在 2 年时重新计算的 CHA2DS2-VASc 对 2 至 4 年期间缺血性中风/TIA 的预测能力更高。综合辨别改进（IDI）和净再分类改进（NRI）显示灵敏度有所提高，再分类效果更好。与基线 CHA2DS2-VASc 相比，4 年后重新计算的 CHA2DS2-VASc 在 4 至 6 年期间具有更好的预测性能，IDI 有所提高，重新分类能力也有所增强。在 2 至 4 年期间，重新计算的 2 年期 HAS-BLED 对大出血的预测能力高于基线评分，灵敏度和再分类能力显著提高。与基线评分相比，4 年后重新计算的 HAS-BLED 评分的灵敏度略有提高。应定期重新评估 CHA2DS2-VASc 和 HAS-BLED 评分，尤其是为了准确预测卒中风险。

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引用次数: 0

Stents autoexpandibles SINUS XL para implante previo en el recambio valvular pulmonar 用于肺动脉瓣置换术前植入的 SINUS XL 自扩张支架

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-04-16 DOI: 10.1016/j.recesp.2024.02.021

引用次数: 0

Uso de los nuevos vasodilatadores pulmonares en pacientes con cortocircuitos sistémico-pulmonares: estrategia «tratar y reparar» 在全身-肺分流患者中使用新型肺血管扩张剂："治疗和修复 "策略

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2024-04-16 DOI: 10.1016/j.recesp.2024.04.005

引用次数: 0

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