Pub Date : 2025-11-01Epub Date: 2025-05-17DOI: 10.1016/j.recesp.2025.03.006
Mengyue Lin , Xiaocong Chen , Muli Wu , Jiaxin Xiao , Shaobin Li , Haoxian Tang , Xuerui Tan , Yequn Chen
Introduction and objectives
Both abdominal obesity (AO) and insulin resistance (IR) are predictors of cardiometabolic disease (CMD). We aimed to evaluate the temporal relationship between AO and IR and their combined effect on CMD risk.
Methods
A nationally representative cohort of 9234 participants was included, with a maximum follow-up of 9 years. The triglyceride-glucose (TyG) index was calculated as an indicator of IR, and AO was measured by waist circumference (WC). Cox regression was applied to evaluate the combined effect of AO and TyG on CMD risk, including hypertension, diabetes, heart disease, and stroke. A cross-lagged panel model was used to examine the temporal relationship. Multiplicative and additive interactions between AO and insulin resistance, as well as the mediating effect of TyG, were assessed.
Results
Individuals concurrently with AO and higher TyG (≥ 8.6 [median]) had the highest risk of hypertension (HR,1.46; 95%CI, 1.25-1.69), diabetes (HR, 1.99; 95%CI, 1.65-2.41), and stroke (HR, 1.76; 95%CI, 1.22-1.94). A biological interaction between AO and IR on diabetes was observed, with the attributable proportion due to interaction being 29%. There was a bidirectional temporal relationship between WC and TyG, and the effect of WC on TyG was more prominent than vice versa. High TyG had a mediating effect on the association of AO with hypertension (19%), diabetes (25%), and stroke (24%).
Conclusions
The findings reveal a temporal relationship between AO and IR, their combined effect on hypertension, diabetes, and stroke, and the mediating role of IR. Strategies simultaneously targeting both factors should be emphasized for the primary prevention of CMD.
{"title":"Efectos interactivos de la obesidad abdominal y la resistencia a la insulina sobre el riesgo cardiometabólico","authors":"Mengyue Lin , Xiaocong Chen , Muli Wu , Jiaxin Xiao , Shaobin Li , Haoxian Tang , Xuerui Tan , Yequn Chen","doi":"10.1016/j.recesp.2025.03.006","DOIUrl":"10.1016/j.recesp.2025.03.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Both abdominal obesity (AO) and insulin resistance (IR) are predictors of cardiometabolic disease (CMD). We aimed to evaluate the temporal relationship between AO and IR and their combined effect on CMD risk.</div></div><div><h3>Methods</h3><div>A nationally representative cohort of 9234 participants was included, with a maximum follow-up of 9 years. The triglyceride-glucose (TyG) index was calculated as an indicator of IR, and AO was measured by waist circumference (WC). Cox regression was applied to evaluate the combined effect of AO and TyG on CMD risk, including hypertension, diabetes, heart disease, and stroke. A cross-lagged panel model was used to examine the temporal relationship. Multiplicative and additive interactions between AO and insulin resistance, as well as the mediating effect of TyG, were assessed.</div></div><div><h3>Results</h3><div>Individuals concurrently with AO and higher TyG (≥<!--> <!-->8.6 [median]) had the highest risk of hypertension (HR,1.46; 95%CI, 1.25-1.69), diabetes (HR, 1.99; 95%CI, 1.65-2.41), and stroke (HR, 1.76; 95%CI, 1.22-1.94). A biological interaction between AO and IR on diabetes was observed, with the attributable proportion due to interaction being 29%. There was a bidirectional temporal relationship between WC and TyG, and the effect of WC on TyG was more prominent than vice versa. High TyG had a mediating effect on the association of AO with hypertension (19%), diabetes (25%), and stroke (24%).</div></div><div><h3>Conclusions</h3><div>The findings reveal a temporal relationship between AO and IR, their combined effect on hypertension, diabetes, and stroke, and the mediating role of IR. Strategies simultaneously targeting both factors should be emphasized for the primary prevention of CMD.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 11","pages":"Pages 967-976"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369609","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: 2025-06-26DOI: 10.1016/j.recesp.2025.06.009
Rafael de la Espriella
{"title":"Congestión refractaria en la insuficiencia cardiaca: cuando lo convencional no basta","authors":"Rafael de la Espriella","doi":"10.1016/j.recesp.2025.06.009","DOIUrl":"10.1016/j.recesp.2025.06.009","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 11","pages":"Pages 1007-1009"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369613","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: 2025-05-16DOI: 10.1016/j.recesp.2025.03.001
Patricia Palau , Eloy Domínguez , Silvia Mínguez , Gonzalo Núñez , Enrique Santas , Celia García-Conejo , Iván de Amo , Paloma Marín , Cristina Flor , Laura López , Lucía Ortega , Isabel Gabaldón-Sánchez , Rafael de la Espriella , Juan Sanchis , Julio Núñez
Introduction and objectives
In asymptomatic individuals, left bundle branch block (LBBB) is associated with an increased risk of cardiovascular events, but its impact on maximal functional capacity remains unclear. This study aimed to evaluate maximal aerobic capacity (peakVO2) in asymptomatic adults with LBBB without structural heart disease and compare it to an age-, physical activity-, and sex-matched control population.
Methods
This prospective case-control study included asymptomatic adults with isolated LBBB and matched controls. All participants underwent maximal cardiopulmonary exercise testing and echocardiography. The primary outcome was to compare peakVO2 and percent predicted peakVO2 (pp-peakVO2) between LBBB and matched controls. Secondary outcomes included differences in left ventricular indexed end-diastolic volumes (iLVEDV) and left ventricular ejection fraction (LVEF). Multivariate linear mixed models were used to analyze primary and secondary outcomes.
Results
A total of 162 participants (81 with LBBB and 81 controls) were included. The mean age was 65.7 ± 10.2 years, and 106 participants (65.4%) were women. The mean pp-peakVO2 and peakVO2 were 93.6 ± 16.9% and 19.9 ± 6.4 mL/kg/min, respectively. There were no significant differences in cardiovascular risk factors, NT-proBNP, or hemoglobin values between groups. Multivariate analysis showed that the presence of LBBB was associated with lower peakVO2 (−3.3 mL/kg/min, 95%CI, − 4.6 to − 2.1; P < .001) and pp-peakVO2 (−17.2%; 95%CI, −22.1 to −11.9; P < .001). Regarding secondary endpoints, individuals with LBBB showed higher iLVEDV (+4.4 mL/m2, 95%CI, 1.3 to 7.6; P = .006) and lower LVEF (−2.8%, 95%CI, −4.3 to −1.2; P < .001) compared with controls.
Conclusions
In this study, adults with isolated LBBB showed reduced maximal functional capacity compared with controls.
{"title":"Efecto del bloqueo de rama izquierda sobre la capacidad funcional máxima en individuos asintomáticos sin enfermedad estructural cardiaca","authors":"Patricia Palau , Eloy Domínguez , Silvia Mínguez , Gonzalo Núñez , Enrique Santas , Celia García-Conejo , Iván de Amo , Paloma Marín , Cristina Flor , Laura López , Lucía Ortega , Isabel Gabaldón-Sánchez , Rafael de la Espriella , Juan Sanchis , Julio Núñez","doi":"10.1016/j.recesp.2025.03.001","DOIUrl":"10.1016/j.recesp.2025.03.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>In asymptomatic individuals, left bundle branch block (LBBB) is associated with an increased risk of cardiovascular events, but its impact on maximal functional capacity remains unclear. This study aimed to evaluate maximal aerobic capacity (peakVO<sub>2</sub>) in asymptomatic adults with LBBB without structural heart disease and compare it to an age-, physical activity-, and sex-matched control population.</div></div><div><h3>Methods</h3><div>This prospective case-control study included asymptomatic adults with isolated LBBB and matched controls. All participants underwent maximal cardiopulmonary exercise testing and echocardiography. The primary outcome was to compare peakVO<sub>2</sub> and percent predicted peakVO<sub>2</sub> (pp-peakVO<sub>2</sub>) between LBBB and matched controls. Secondary outcomes included differences in left ventricular indexed end-diastolic volumes (iLVEDV) and left ventricular ejection fraction (LVEF). Multivariate linear mixed models were used to analyze primary and secondary outcomes.</div></div><div><h3>Results</h3><div>A total of 162 participants (81 with LBBB and 81 controls) were included. The mean age was 65.7<!--> <!-->±<!--> <!-->10.2 years, and 106 participants (65.4%) were women. The mean pp-peakVO<sub>2</sub> and peakVO<sub>2</sub> were 93.6<!--> <!-->±<!--> <!-->16.9% and 19.9<!--> <!-->±<!--> <!-->6.4<!--> <!-->mL/kg/min, respectively. There were no significant differences in cardiovascular risk factors, NT-proBNP, or hemoglobin values between groups. Multivariate analysis showed that the presence of LBBB was associated with lower peakVO<sub>2</sub> (−3.3<!--> <!-->mL/kg/min, 95%CI,<!--> <!-->−<!--> <!-->4.6 to<!--> <!-->−<!--> <!-->2.1; <em>P</em> <!--><<!--> <!-->.001) and pp-peakVO<sub>2</sub> (−17.2%; 95%CI, −22.1 to −11.9; <em>P</em> <!--><<!--> <!-->.001). Regarding secondary endpoints, individuals with LBBB showed higher iLVEDV (+4.4<!--> <!-->mL/m<sup>2</sup>, 95%CI, 1.3 to 7.6; <em>P</em> <!-->=<!--> <!-->.006) and lower LVEF (−2.8%, 95%CI, −4.3 to −1.2; <em>P</em> <!--><<!--> <!-->.001) compared with controls.</div></div><div><h3>Conclusions</h3><div>In this study, adults with isolated LBBB showed reduced maximal functional capacity compared with controls.</div><div>Registered at ClinicalTrials.gov (<span><span>NCT05643404</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 11","pages":"Pages 957-966"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369677","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: 2025-05-17DOI: 10.1016/j.recesp.2025.03.003
Clara Fernández-Cordón , Emmanouil S. Brilakis , Mario García-Gómez , Akash Jain , Marcelo Rodríguez , Carlos Cortés-Villar , Alberto Campo-Prieto , Ana Serrador , Hipólito Gutiérrez , Sara Blasco-Turrión , Luca Scorpiglione , Luis Llamas-Fernández , J. Alberto San Román , Ignacio Jesús Amat Santos
Introduction and objectives
Calcified nodules (CN) have been associated with higher complexity and worse outcomes after percutaneous coronary intervention (PCI) in both stable and unstable coronary disease. The aim of this systematic review was to summarize the current evidence on CN.
Methods
Systematic review of published studies on the prevalence, clinical associations, and impact of CN on outcomes after PCI up to November 2024.
Results
We identified 474 publications, of which 87 were included (all observational). CN were divided into 2 types: noneruptive CN (NECN), with an intact fibrous cap; and eruptive CN (ECN), with disruption of the fibrous cap with or without thrombus. The most common location was the right coronary artery (28%-71%). Angiography-based diagnostic sensitivity was low (18%-38%). Optical coherence tomography was preferred for type differentiation. The main clinical factors associated with CN were older age, diabetes mellitus, and chronic kidney disease. CN were considered the culprit lesion in 3% to 18% of acute coronary syndromes but were also present in up to 30% of nonculprit arteries. ECN were associated with more events at follow-up than NECN (20% vs 3.3% at 1 year). Post-PCI, CN were associated with lower minimum lumen area (MLA), higher rates of stent-edge dissection (44%-73%), malapposition (71%-96%), and underexpansion (60%-77%). ECN were associated with better acute results but worse long-term outcomes compared with NECN.
Conclusions
CN are often present in acute coronary syndrome culprit and stable coronary lesions. Intracoronary imaging is essential for the diagnosis and differentiation of CN. CN are associated with worse outcomes after PCI, acutely and during follow-up.
{"title":"Nódulos calcificados en las arterias coronarias: revisión sistemática sobre incidencia y resultados del intervencionismo coronario percutáneo","authors":"Clara Fernández-Cordón , Emmanouil S. Brilakis , Mario García-Gómez , Akash Jain , Marcelo Rodríguez , Carlos Cortés-Villar , Alberto Campo-Prieto , Ana Serrador , Hipólito Gutiérrez , Sara Blasco-Turrión , Luca Scorpiglione , Luis Llamas-Fernández , J. Alberto San Román , Ignacio Jesús Amat Santos","doi":"10.1016/j.recesp.2025.03.003","DOIUrl":"10.1016/j.recesp.2025.03.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Calcified nodules (CN) have been associated with higher complexity and worse outcomes after percutaneous coronary intervention (PCI) in both stable and unstable coronary disease. The aim of this systematic review was to summarize the current evidence on CN.</div></div><div><h3>Methods</h3><div>Systematic review of published studies on the prevalence, clinical associations, and impact of CN on outcomes after PCI up to November 2024.</div></div><div><h3>Results</h3><div>We identified 474 publications, of which 87 were included (all observational). CN were divided into 2 types: noneruptive CN (NECN), with an intact fibrous cap; and eruptive CN (ECN), with disruption of the fibrous cap with or without thrombus. The most common location was the right coronary artery (28%-71%). Angiography-based diagnostic sensitivity was low (18%-38%). Optical coherence tomography was preferred for type differentiation. The main clinical factors associated with CN were older age, diabetes mellitus, and chronic kidney disease. CN were considered the culprit lesion in 3% to 18% of acute coronary syndromes but were also present in up to 30% of nonculprit arteries. ECN were associated with more events at follow-up than NECN (20% vs 3.3% at 1 year). Post-PCI, CN were associated with lower minimum lumen area (MLA), higher rates of stent-edge dissection (44%-73%), malapposition (71%-96%), and underexpansion (60%-77%). ECN were associated with better acute results but worse long-term outcomes compared with NECN.</div></div><div><h3>Conclusions</h3><div>CN are often present in acute coronary syndrome culprit and stable coronary lesions. Intracoronary imaging is essential for the diagnosis and differentiation of CN. CN are associated with worse outcomes after PCI, acutely and during follow-up.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 11","pages":"Pages 977-991"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369610","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: 2025-02-26DOI: 10.1016/j.recesp.2025.02.014
Leticia Fernández-Friera , Milagros Pedreira Pérez , Raquel Campuzano Ruiz , José M. Gámez , Luis Rodríguez Padial , Carolina Ortiz Cortés , en representación del Comité Científico del proyecto «Mujer y Corazón» de la SEC , Clara Bonanad , Lorenzo Fácila , Samantha Wasniewski , Manuel Anguita , Antonia Sambola
{"title":"Percepción y conocimiento de la ECV en la mujer en España: encuesta nacional sobre concienciación, riesgo y estilo de vida","authors":"Leticia Fernández-Friera , Milagros Pedreira Pérez , Raquel Campuzano Ruiz , José M. Gámez , Luis Rodríguez Padial , Carolina Ortiz Cortés , en representación del Comité Científico del proyecto «Mujer y Corazón» de la SEC , Clara Bonanad , Lorenzo Fácila , Samantha Wasniewski , Manuel Anguita , Antonia Sambola","doi":"10.1016/j.recesp.2025.02.014","DOIUrl":"10.1016/j.recesp.2025.02.014","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 11","pages":"Pages 1014-1017"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369842","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: 2025-04-17DOI: 10.1016/j.recesp.2025.02.020
Ismael Arco Adamuz, Torcuato Garrido-Arroquia Jurado, Rocío García Orta
{"title":"Entre la fibrilación auricular y la ablación: un hallazgo inesperado","authors":"Ismael Arco Adamuz, Torcuato Garrido-Arroquia Jurado, Rocío García Orta","doi":"10.1016/j.recesp.2025.02.020","DOIUrl":"10.1016/j.recesp.2025.02.020","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 11","pages":"Pages 1018-1019"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369843","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: 2025-05-05DOI: 10.1016/j.recesp.2025.04.005
Álvaro Montes Muñiz , Alberto Cecconi , Luis Jesús Jiménez-Borreguero
{"title":"Afinando en la valoración del exceso de trabeculación del ventrículo izquierdo","authors":"Álvaro Montes Muñiz , Alberto Cecconi , Luis Jesús Jiménez-Borreguero","doi":"10.1016/j.recesp.2025.04.005","DOIUrl":"10.1016/j.recesp.2025.04.005","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 11","pages":"Pages 945-946"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369675","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: 2025-05-05DOI: 10.1016/j.recesp.2025.02.015
Raymond N. Haddad , Ali Houeijeh , Ender Odemis , Jean-Benoit Thambo , Turkay Saritas , Ibrahim Ece , Clement Karsenty , Kaan Yildiz , Mete Han Kizilkaya , Sébastien Hascoet , Hojat Mortezaeian , Harun Terin , Mohammed Kasem , Zakhia Saliba , Nazmi Narin
Introduction and objectives
The Lifetech KONAR-MF ventricular septal defect occluder (MFO) is increasingly used for transcatheter perimembranous ventricular septal defect (pmVSD) closure. We aim to collect real-world data on patient outcomes and MFO performance in pmVSD cases.
Methods
This was a nonrandomized, retrospective, multicenter, postmarketing clinical follow-up study of pmVSD patients implanted with the MFO device between 2018 and 2023. The primary endpoint was 6-month composite clinical success, defined as technical success (successful implantation and device retention at the end of the procedure), closure success (trivial or no residual shunt), absence of serious adverse events at 30 days, and no device removal or reintervention. Secondary endpoints consisted of technical success, procedural success (technical success and less than moderate residual shunt), closure success (clinically insignificant or absent residual shunt), and safety.
Results
Our cohort comprised 333 patients (51.4% male, 10.2% adults), with a median age of 4.6 [IQR, 2-10] years and a median weight of 17 [IQR, 11-32] kg. Baseline defect characteristics consisted of a left ventricular defect diameter of 8 [IQR, 7-10] mm, with 13.8% of patients having aortic valve regurgitation, 9.9% having an indirect Gerbode shunt, 10.5% having mild aortic valve prolapse, and 32.2% having subaortic rim deficiency. Closure via a retrograde approach was performed in 183 patients (55%). Technical success at procedure completion was 97.6%, and procedural success was 94.6%. Closure success at 6 months was 97.1%, while composite clinical success was 90.1%. Freedom from serious adverse events was 95.2% at 30 days. Freedom from device-related events was 96.8% at 6 months and 93.8% at 24 months. Risk factors for 6-month composite clinical failure were aortic valve prolapse (OR, 4.85; 95%CI, 2.07-11.39) and right ventricular defect diameter (OR, 1.41; 95%CI, 1.01-1.98).
Conclusions
Transcatheter closure of pmVSD with the MFO device demonstrated feasibility, effectiveness, and safety in real-world settings.
{"title":"MIOS-MFO, un estudio observacional internacional multicéntrico del oclusor KONAR-MF de Lifetech en el tratamiento de defectos septales ventriculares perimembranosos","authors":"Raymond N. Haddad , Ali Houeijeh , Ender Odemis , Jean-Benoit Thambo , Turkay Saritas , Ibrahim Ece , Clement Karsenty , Kaan Yildiz , Mete Han Kizilkaya , Sébastien Hascoet , Hojat Mortezaeian , Harun Terin , Mohammed Kasem , Zakhia Saliba , Nazmi Narin","doi":"10.1016/j.recesp.2025.02.015","DOIUrl":"10.1016/j.recesp.2025.02.015","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The Lifetech KONAR-MF ventricular septal defect occluder (MFO) is increasingly used for transcatheter perimembranous ventricular septal defect (pmVSD) closure. We aim to collect real-world data on patient outcomes and MFO performance in pmVSD cases.</div></div><div><h3>Methods</h3><div>This was a nonrandomized, retrospective, multicenter, postmarketing clinical follow-up study of pmVSD patients implanted with the MFO device between 2018 and 2023. The primary endpoint was 6-month composite clinical success, defined as technical success (successful implantation and device retention at the end of the procedure), closure success (trivial or no residual shunt), absence of serious adverse events at 30 days, and no device removal or reintervention. Secondary endpoints consisted of technical success, procedural success (technical success and less than moderate residual shunt), closure success (clinically insignificant or absent residual shunt), and safety.</div></div><div><h3>Results</h3><div>Our cohort comprised 333 patients (51.4% male, 10.2% adults), with a median age of 4.6 [IQR, 2-10] years and a median weight of 17 [IQR, 11-32] kg. Baseline defect characteristics consisted of a left ventricular defect diameter of 8 [IQR, 7-10] mm, with 13.8% of patients having aortic valve regurgitation, 9.9% having an indirect Gerbode shunt, 10.5% having mild aortic valve prolapse, and 32.2% having subaortic rim deficiency. Closure via a retrograde approach was performed in 183 patients (55%). Technical success at procedure completion was 97.6%, and procedural success was 94.6%. Closure success at 6 months was 97.1%, while composite clinical success was 90.1%. Freedom from serious adverse events was 95.2% at 30 days. Freedom from device-related events was 96.8% at 6 months and 93.8% at 24 months. Risk factors for 6-month composite clinical failure were aortic valve prolapse (OR, 4.85; 95%<span>C</span>I, 2.07-11.39) and right ventricular defect diameter (OR, 1.41; 95%CI, 1.01-1.98).</div></div><div><h3>Conclusions</h3><div>Transcatheter closure of pmVSD with the MFO device demonstrated feasibility, effectiveness, and safety in real-world settings.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 11","pages":"Pages 947-956"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369676","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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