Pub Date : 2025-12-01Epub 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":"2025-12-01","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 : 2025-12-01Epub Date: 2025-09-16DOI: 10.1016/j.recesp.2025.08.005
Joaquín Osca Asensi , Ignacio Fernández-Lozano , David Calvo , en representación de los colaboradores del Registro español de desfibrilador automático implantable
Introduction
This report presents data on implantable cardioverter-defibrillator (ICD) implants performed in Spain in 2024.
Methods
The registry is based on information submitted by centers after device implantation to the Heart Rhythm Association of the Spanish Society of Cardiology through the online national registry platform (CardioDispositivos). Additional data sources included: a) submissions from manufacturing and marketing companies; b) local databases provided by ICD-implanting centers; and c) the ICD Technical Report. Implantation rates were calculated using population data from the National Institute of Statistics.
Results
In 2024, 203 hospitals participated in the registry. A total of 8793 devices were reported, compared with 8975 reported by Eucomed (European Confederation of Medical Suppliers Associations). The overall rate was 186 implants/million population, representing an increase compared with previous years. Marked differences among the autonomous communities persisted, and Spain continued to have the lowest implantation rate of all European countries participating in Eucomed.
Conclusions
The 2024 registry reflects virtually all ICD implants performed in Spain. Despite the improvement observed in implantation rates, Spain's position in Europe remains unchanged, as do the large differences among its autonomous communities.
Full English text available from:www.revespcardiol.org/en
{"title":"Registro español de desfibrilador automático implantable. XXI informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2024)","authors":"Joaquín Osca Asensi , Ignacio Fernández-Lozano , David Calvo , en representación de los colaboradores del Registro español de desfibrilador automático implantable","doi":"10.1016/j.recesp.2025.08.005","DOIUrl":"10.1016/j.recesp.2025.08.005","url":null,"abstract":"<div><h3>Introduction</h3><div>This report presents data on implantable cardioverter-defibrillator (ICD) implants performed in Spain in 2024.</div></div><div><h3>Methods</h3><div>The registry is based on information submitted by centers after device implantation to the Heart Rhythm Association of the Spanish Society of Cardiology through the online national registry platform (<em>CardioDispositivos</em>). Additional data sources included: <em>a)</em> submissions from manufacturing and marketing companies; <em>b)</em> local databases provided by ICD-implanting centers; and <em>c)</em> the ICD Technical Report. Implantation rates were calculated using population data from the National Institute of Statistics.</div></div><div><h3>Results</h3><div>In 2024, 203 hospitals participated in the registry. A total of 8793 devices were reported, compared with 8975 reported by Eucomed (European Confederation of Medical Suppliers Associations). The overall rate was 186 implants/million population, representing an increase compared with previous years. Marked differences among the autonomous communities persisted, and Spain continued to have the lowest implantation rate of all European countries participating in Eucomed.</div></div><div><h3>Conclusions</h3><div>The 2024 registry reflects virtually all ICD implants performed in Spain. Despite the improvement observed in implantation rates, Spain's position in Europe remains unchanged, as do the large differences among its autonomous communities.</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":"78 12","pages":"Pages 1100-1112"},"PeriodicalIF":5.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579132","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 : 2025-12-01Epub Date: 2025-04-08DOI: 10.1016/j.recesp.2025.02.018
Juan Alfonso Zamorano-Vargas , Mikel Izquierdo , Robinson Ramírez-Vélez
{"title":"La cinética del consumo de oxígeno durante la recuperación posterior al ejercicio se ve afectada en pacientes con COVID-19 prolongada: un estudio transversal","authors":"Juan Alfonso Zamorano-Vargas , Mikel Izquierdo , Robinson Ramírez-Vélez","doi":"10.1016/j.recesp.2025.02.018","DOIUrl":"10.1016/j.recesp.2025.02.018","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1120-1122"},"PeriodicalIF":5.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579135","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 : 2025-12-01Epub 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":"2025-12-01","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 : 2025-12-01Epub Date: 2025-04-25DOI: 10.1016/j.recesp.2025.02.022
Miguel Morales-García , María Belén García-Ortega , José Pérez del Palacio , Eduardo Moreno-Escobar , Diego Segura-Rodríguez , Rocío García-Orta
{"title":"Identificación de nuevos biomarcadores en enfermedades de la aorta torácica ascendente mediante metabolómica basada en espectrometría de masas de alta resolución no dirigida","authors":"Miguel Morales-García , María Belén García-Ortega , José Pérez del Palacio , Eduardo Moreno-Escobar , Diego Segura-Rodríguez , Rocío García-Orta","doi":"10.1016/j.recesp.2025.02.022","DOIUrl":"10.1016/j.recesp.2025.02.022","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1123-1124"},"PeriodicalIF":5.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579136","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 : 2025-12-01Epub Date: 2025-05-27DOI: 10.1016/j.recesp.2025.05.012
David Calvo
{"title":"Registros de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología: valor actual y perspectivas de futuro","authors":"David Calvo","doi":"10.1016/j.recesp.2025.05.012","DOIUrl":"10.1016/j.recesp.2025.05.012","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1113-1114"},"PeriodicalIF":5.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579133","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 : 2025-12-01Epub 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":"2025-12-01","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 : 2025-12-01Epub Date: 2025-03-28DOI: 10.1016/j.recesp.2025.03.009
Sergio Cinza-Sanjurjo , Pilar Mazón-Ramos , Daniel Rey-Aldana , Alfonso Varela-Román , Manuel Portela-Romero , José R. González-Juanatey
Introduction and objectives
To analyze the relationship between continuity of care in primary care and hospitalizations and mortality among patients referred from primary care to a cardiology service.
Methods
Continuity of care was assessed using 3 measures: a) whether the referral was made by the patient's regular family medicine physician (FMP) or a different FMP, b) FMP turnover within a patient panel, and c) turnover of the referring FMP among different patient panels. The association between continuity of care and hospitalizations and mortality was assessed using a multivariate analysis, with adjustment for potential confounding variables. The results are expressed as odds ratios (OR) with 95% confidence intervals (95%CI).
Results
A total of 67 889 patients, referred from 2010 to 2023, were included, of whom 80.5% were referred by their FMP. Patients referred by an FMP other than their own had a higher annual referral rate (2.3 [2.9]) vs 1.5 [0.6]); P < .001) and were assigned to panels with a higher referral rate (10.5 [12.7] vs 1.6 (1.1]; P < .001). Patients referred by their FMP had a lower risk of overall hospitalizations (OR, 0.90; 95%CI, 0.86-0.94), hospitalizations for cardiovascular causes (OR, 0.88; 95%IC, 0.82-0.95), all-cause mortality (OR, 0.84; 95%CI, 0.80-0.89), cardiovascular-related mortality (OR, 0.86; 95%CI, 0.78-0.96), and heart failure-related mortality (OR, 0.77; 95%CI, 0.66-0.89).
Conclusions
Continuity of care, measured by the persistence of the FMP within the same patient panel, improves health outcomes by reducing hospitalizations and mortality, as well as the number of cardiology service referrals.
{"title":"La continuidad asistencial en atención primaria se asocia a un mejor pronóstico de los pacientes remitidos a un servicio de cardiología","authors":"Sergio Cinza-Sanjurjo , Pilar Mazón-Ramos , Daniel Rey-Aldana , Alfonso Varela-Román , Manuel Portela-Romero , José R. González-Juanatey","doi":"10.1016/j.recesp.2025.03.009","DOIUrl":"10.1016/j.recesp.2025.03.009","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To analyze the relationship between continuity of care in primary care and hospitalizations and mortality among patients referred from primary care to a cardiology service.</div></div><div><h3>Methods</h3><div>Continuity of care was assessed using 3 measures: <em>a)</em> whether the referral was made by the patient's regular family medicine physician (FMP) or a different FMP, <em>b)</em> FMP turnover within a patient panel, and <em>c)</em> turnover of the referring FMP among different patient panels. The association between continuity of care and hospitalizations and mortality was assessed using a multivariate analysis, with adjustment for potential confounding variables. The results are expressed as odds ratios (OR) with 95% confidence intervals (95%<span>C</span>I).</div></div><div><h3>Results</h3><div>A total of 67 889 patients, referred from 2010 to 2023, were included, of whom 80.5% were referred by their FMP. Patients referred by an FMP other than their own had a higher annual referral rate (2.3 [2.9]) vs 1.5 [0.6]); <em>P</em> <!--><<!--> <!-->.001) and were assigned to panels with a higher referral rate (10.5 [12.7] vs 1.6 (1.1]; <em>P</em> <!--><<!--> <!-->.001). Patients referred by their FMP had a lower risk of overall hospitalizations (OR, 0.90; 95%CI, 0.86-0.94), hospitalizations for cardiovascular causes (OR, 0.88; 95%IC, 0.82-0.95), all-cause mortality (OR, 0.84; 95%CI, 0.80-0.89), cardiovascular-related mortality (OR, 0.86; 95%CI, 0.78-0.96), and heart failure-related mortality (OR, 0.77; 95%CI, 0.66-0.89).</div></div><div><h3>Conclusions</h3><div>Continuity of care, measured by the persistence of the FMP within the same patient panel, improves health outcomes by reducing hospitalizations and mortality, as well as the number of cardiology service referrals.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1033-1040"},"PeriodicalIF":5.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579123","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 : 2025-11-01Epub Date: 2025-03-17DOI: 10.1016/j.recesp.2025.01.005
Guillem Casas , Eduard Ródenas-Alesina , Javier Limeres , Clara Badia-Molins , José M. Larrañaga-Moreira , Jesús G. Mirelis , Javier Navarrete-Navarro , Jesús Martín-Jiménez , Juan E. Alcalá-López , Josefa González-Carrillo , Albert Teis , Rafaela Soler-Fernández , Gisela Teixidó-Turà , Laura Gutiérrez-García , Paula Fernández-Álvarez , Patricia Muñoz-Cabello , José A. Barrabés , Coloma Tirón , Julián Palomino-Doza , José Manuel García-Pinilla , José F. Rodríguez-Palomares
Introduction and objectives
Defining the probability of cardiomyopathy in individuals with excessive trabeculation of the left ventricle (ETLV) is an unmet clinical need. Our aims were: a) to describe the incidence and predictors of left ventricular ejection fraction (LVEF) decline and its correlation with major adverse cardiovascular events (MACE); and b) to identify prognostic factors in low-risk individuals.
Methods
Retrospective multicenter study in patients with ETLV and suspected cardiomyopathy. Two endpoints were analyzed: a) LVEF decline (> 10% absolute decrease in LVEF with LVEF < 50% at follow-up); and b) MACE, a composite of heart failure, ventricular arrhythmias, systemic embolisms, or cardiovascular mortality. Cardiovascular magnetic resonance core-lab analysis was performed in low-risk individuals (LVEF ≥ 50% and negative late gadolinium enhancement).
Results
A total of 530 patients were included, with a mean age of 44 ± 19 years and 44% were women. The mean LVEF was 49 ± 16%. Over a median echocardiographic follow-up of 4.2 years, 29 patients (6%) showed a decline in LVEF. Late gadolinium enhancement (P = .004) and baseline atrial fibrillation (P = .006) were independently associated with LVEF decline. During a subsequent clinical follow-up of 3.8 years, 106 patients (20%) experienced MACE. Factors that remained associated with MACE after adjustment were baseline LVEF (P < .001), LVEF decline (P = .022), baseline atrial fibrillation (P = .001), and QRS ≥ 120 ms (P = .009). Among low-risk individuals, left atrial strain correlated with outcomes and distinguished subclinical cardiomyopathy from physiological excessive trabeculation.
Conclusions
In ETLV, a decline in LVEF predicts cardiovascular events beyond baseline LVEF. In low-risk individuals, left atrial strain defines the probability of cardiomyopathy. A comprehensive assessment might provide valuable insights for differential diagnosis and risk stratification in this population.
{"title":"Deterioro de la fracción de eyección del ventrículo izquierdo y eventos cardiovasculares en la miocardiopatía con excesiva trabeculación: hacia la medicina de precisión","authors":"Guillem Casas , Eduard Ródenas-Alesina , Javier Limeres , Clara Badia-Molins , José M. Larrañaga-Moreira , Jesús G. Mirelis , Javier Navarrete-Navarro , Jesús Martín-Jiménez , Juan E. Alcalá-López , Josefa González-Carrillo , Albert Teis , Rafaela Soler-Fernández , Gisela Teixidó-Turà , Laura Gutiérrez-García , Paula Fernández-Álvarez , Patricia Muñoz-Cabello , José A. Barrabés , Coloma Tirón , Julián Palomino-Doza , José Manuel García-Pinilla , José F. Rodríguez-Palomares","doi":"10.1016/j.recesp.2025.01.005","DOIUrl":"10.1016/j.recesp.2025.01.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Defining the probability of cardiomyopathy in individuals with excessive trabeculation of the left ventricle (ETLV) is an unmet clinical need. Our aims were: <em>a)</em> to describe the incidence and predictors of left ventricular ejection fraction (LVEF) decline and its correlation with major adverse cardiovascular events (MACE); and <em>b)</em> to identify prognostic factors in low-risk individuals.</div></div><div><h3>Methods</h3><div>Retrospective multicenter study in patients with ETLV and suspected cardiomyopathy. Two endpoints were analyzed: <em>a)</em> LVEF decline (> 10% absolute decrease in LVEF with LVEF <<!--> <!-->50% at follow-up); and <em>b)</em> MACE, a composite of heart failure, ventricular arrhythmias, systemic embolisms, or cardiovascular mortality. Cardiovascular magnetic resonance core-lab analysis was performed in low-risk individuals (LVEF ≥<!--> <!-->50% and negative late gadolinium enhancement).</div></div><div><h3>Results</h3><div>A total of 530 patients were included, with a mean age of 44<!--> <!-->±<!--> <!-->19 years and 44% were women. The mean LVEF was 49<!--> <!-->±<!--> <!-->16%. Over a median echocardiographic follow-up of 4.2 years, 29 patients (6%) showed a decline in LVEF. Late gadolinium enhancement (<em>P<!--> </em>=<!--> <!-->.004) and baseline atrial fibrillation (<em>P<!--> </em>=<!--> <!-->.006) were independently associated with LVEF decline. During a subsequent clinical follow-up of 3.8 years, 106 patients (20%) experienced MACE. Factors that remained associated with MACE after adjustment were baseline LVEF (<em>P<!--> </em><<!--> <!-->.001), LVEF decline (<em>P</em> <!-->=<!--> <!-->.022), baseline atrial fibrillation (<em>P</em> <!-->=<!--> <!-->.001), and QRS ≥<!--> <!-->120<!--> <!-->ms (<em>P</em> <!-->=<!--> <!-->.009). Among low-risk individuals, left atrial strain correlated with outcomes and distinguished subclinical cardiomyopathy from physiological excessive trabeculation.</div></div><div><h3>Conclusions</h3><div>In ETLV, a decline in LVEF predicts cardiovascular events beyond baseline LVEF. In low-risk individuals, left atrial strain defines the probability of cardiomyopathy. A comprehensive assessment might provide valuable insights for differential diagnosis and risk stratification in this population.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 11","pages":"Pages 934-944"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369674","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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