REC: CardioClinics最新文献

英文中文

Implementación de un algoritmo diagnóstico-terapéutico para hipoflujo pulmonar tras cirugía de fístula sistémico-pulmonar 实施全身性肺瘘手术后肺下流的诊断治疗算法

Q4 Medicine

REC: CardioClinics

Pub Date : 2026-01-01 DOI: 10.1016/j.rccl.2025.08.002

Amaranta López-Santiago , Antonio Juanico-Enríquez , Theo Y. Contreras-Alvarado , Kenneth G.A. Magaña , Yuriria E. Olivares-Fernández , Jocelyn Castro-Pineda , Martín A. Saldaña-Becerra , Chantale Gilles-Herrera , Carlos Zabal-Cerdeira , Sofía de la Cruz-Pérez , Joan S. Celis-Jasso

Introduction and objectives

The systemic-to-pulmonary shunt (SPS) is a high-risk procedure with significant mortality in developing countries.

Methods

A retrospective, observational and analytical multicenter study was conducted. Medical records of patients with congenital heart disease who underwent SPS surgery between January 2016 and December 2020 were reviewed. Two high-specialty cardiology centers participated, and patients were divided into 2 groups (control group vs. algorithm group).

Results

A total of 94 patients were identified: 47 in the control group and 47 in the algorithm group. Emergency surgery was required in 35.1% of cases. The most common SPS size was 4 mm. Thrombosis and shunt reintervention were more frequent in the control group (23.4 vs. 2.1%; P < .001; 10.6 vs. 2.1%; P < .164). A reduced risk was observed for postoperative desaturation (oxygen saturation < 75%) (OR, 0.16; 95%CI 0.03-0.54; P = .006), thrombosis (OR, 0.07; 95%CI 0.00-0.39; P = .013), emergency postoperative surgery (OR, 0.16; 95%CI 0.03-0.54; P = .006), length of stay in the intensive care unit (mean = 3-9 days, OR, 0.38; 95%CI 0.15-0.90; P = .032), and mortality (OR, 0.31; 95%CI 0.11-0.81; P = .021) in the algorithm group.

Conclusions

The resulting algorithm provides valuable information for the early identification of pulmonary hypoperfusion. The initiation and maintenance of appropriate medical approach lead to improved clinical outcomes and reduced mortality in these patients.

在发展中国家，系统-肺分流术（SPS）是一种死亡率很高的高风险手术。方法采用回顾性、观察性和分析性多中心研究。回顾了2016年1月至2020年12月期间接受SPS手术的先天性心脏病患者的医疗记录。两家高专科心脏病中心参与，患者分为两组（对照组与算法组）。结果共鉴定94例患者，对照组47例，算法组47例。35.1%的病例需要紧急手术。最常见的SPS尺寸为4毫米。对照组血栓形成和再介入发生率更高（23.4 vs. 2.1%; P < .001; 10.6 vs. 2.1%; P < .164）。术后去饱和（血氧饱和度<； 75%）（OR, 0.16; 95%CI 0.03-0.54; P = 0.006）、血栓形成（OR, 0.07; 95%CI 0.003 -0.39; P = 0.013）、术后急诊手术（OR, 0.16; 95%CI 0.03-0.54; P = 0.006）、重症监护病房住院时间（平均= 3-9天，OR, 0.38; 95%CI 0.15-0.90; P = 0.032）和死亡率（OR, 0.31; 95%CI 0.11-0.81; P = 0.021）的风险降低。结论该算法为肺灌注不足的早期识别提供了有价值的信息。开始和维持适当的医疗方法可以改善这些患者的临床结果并降低死亡率。

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引用次数: 0

La electroporación en la vida real, ¿solo cuestión de tiempo? 现实生活中的电穿孔只是时间问题吗？

Q4 Medicine

REC: CardioClinics

Pub Date : 2026-01-01 DOI: 10.1016/j.rccl.2025.08.003

Concepción Alonso-Martín , Bieito Campos García , Francisco Javier Méndez Zurita

引用次数: 0

Rol mediador de la gamma-glutamil transferasa en el vínculo entre disfunción ventricular y función sistólica γ -谷氨酰胺转移酶在心室功能障碍与收缩压之间的作用

Q4 Medicine

REC: CardioClinics

Pub Date : 2026-01-01 DOI: 10.1016/j.rccl.2025.08.006

Alberto Guevara Tirado

Introduction and objectives

Heart failure involves multiorgan dysfunction; the heart–liver axis underlies the concept of the cardiohepatic syndrome. This study evaluated gamma-glutamyl transferase (GGT) as a mediator between left ventricular dysfunction and systolic function.

Methods

A cross-sectional analysis was performed using secondary data from 567 patients hospitalized for heart failure. The relationships between left ventricular end-diastolic diameter (LVEDD), GGT, and left ventricular ejection fraction (LVEF) were assessed using Hayes’ PROCESS mediation model 4. Multiple linear regressions were adjusted for comorbidities and clinical variables. The indirect effect was estimated through bootstrap resampling with 5000 iterations. A directed acyclic graph was used to represent the causal hypothesis.

Results

A significant association was observed between LVEDD and GGT (B = 5.13; P=.044), suggesting a direct link between cardiac impairment and increased hepatic marker levels. GGT was inversely associated with LVEF (B = −0.021; P=.009), and LVEDD also showed a negative association with LVEF (B = −2.40; P<.001). Mediation analysis revealed a significant indirect effect of LVEDD on LVEF through GGT (−0.11; 95%CI: −0.23 to −0.005), supporting the mediating role of this enzyme in the cardiohepatic axis.

Conclusions

GGT may act as a mediator between ventricular dysfunction and reduced LVEF in patients hospitalized with heart failure, reflecting a clinically relevant cardiohepatic interaction.

心衰涉及多器官功能障碍；心肝轴是心肝综合征概念的基础。本研究评估了γ -谷氨酰转移酶（GGT）在左心室功能障碍和收缩功能之间的中介作用。方法对567例心力衰竭住院患者的二次资料进行横断面分析。采用Hayes ' PROCESS中介模型4评估左室舒张末期内径（LVEDD）、GGT和左室射血分数（LVEF）之间的关系。多重线性回归对合并症和临床变量进行调整。通过5000次迭代的自举重采样来估计间接效应。用有向无环图表示因果假设。结果LVEDD与GGT之间存在显著相关性（B = 5.13； P= 0.044），提示心脏损害与肝脏标志物水平升高有直接关系。GGT与LVEF呈负相关（B = - 0.021； P= 0.009）， LVEDD与LVEF呈负相关（B = - 2.40； P= 0.009）。中介分析显示，LVEDD通过GGT间接影响LVEF(−0.11;95%CI:−0.23 ~−0.005)，支持该酶在心肝轴中的中介作用。结论ggt可能在心衰住院患者心室功能障碍和LVEF降低之间起中介作用，反映了临床相关的心肝相互作用。

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引用次数: 0

Risk of complications in pregnant patients with cardiac implantable electronic devices 植入心脏电子装置的孕妇并发症风险分析

Q4 Medicine

REC: CardioClinics

Pub Date : 2026-01-01 DOI: 10.1016/j.rccl.2025.01.009

Javier Cantalapiedra-Romero , Laura Galian-Gay , Jaume Francisco-Pascual , Berta Serrano-Sánchez , Nerea Maíz , Antònia Pijuan-Domènech

引用次数: 0

Características y evolución de la concesión de patentes en el área cardiovascular en España 西班牙心血管领域专利授予的特点和演变

Q4 Medicine

REC: CardioClinics

Pub Date : 2026-01-01 DOI: 10.1016/j.rccl.2025.08.004

Francisco J. Chorro , Adolfo Alonso-Arroyo , Cristina I. Font-Julián , Yiming Liu , Rafael Aleixandre-Benavent

Introduction and objectives

Updated analysis of patent grants related to cardiovascular diseases (CVD) in Spain.

Methods

Development of a search process for patents related to CVD in the Global Patent Index, review of those granted in Spain, and standardization. Analysis of their evolution over time, origin, collaborations, types, and thematic distribution.

Results

Identification of 1870 patents (1909-2023), whose growth has been exponential (n = 1.687 exp [0.066*years; P<.001). They come from 1107 applicants from 39 countries, 616 from Spain who have originated 923 patents, followed by Germany (293), Switzerland (177), France (92) and the Netherlands (81). Collaborations are present in 15.2%. Seven networks have involved ≥ 3 applicants with ≥ 2 collaborations. The most frequent subject has been “pharmacological treatments” (38%), and in this group “antihypertensives”. Since 1992, translations of European patents have increased, and are currently the most common type. The proportions by thematic group have varied significantly (P<.001), with more recent increases in those related to “catheters/devices” and “diagnostic/monitoring techniques” and decreases in “pharmacological treatments” and “biochemistry/molecular biology”.

Conclusions

Patents related to CVD in Spain originate mainly in Europe. 15.2% are requested in collaboration. The highest number corresponds to Spain, followed by Germany, Switzerland, France, and the Netherlands. The most frequent subject has been “antihypertensive treatments”. Overall, the largest increase in grants (close to 40%) occurred in the decade 2010-2020, especially related to the translation of European patents. The subjects that are growing the most in the 21st century are those related to “catheters/devices” and “diagnostic/monitoring techniques”.

西班牙心血管疾病（CVD）相关专利授权的最新分析。方法开发全球专利索引中CVD相关专利的检索流程，对西班牙授予的专利进行审查，并进行标准化。分析它们随时间的演变，起源，合作，类型和主题分布。结果发现1870项专利（1909-2023），呈指数增长（n = 1.687 exp[0.066*年；P<.001）。这些专利来自39个国家的1107名申请人，其中616名来自西班牙，他们提出了923项专利，其次是德国（293项）、瑞士（177项）、法国（92项）和荷兰（81项）。15.2%的人有合作关系。7个网络有3个以上的申请者和2个以上的合作。最常见的主题是“药物治疗”（38%），在这一组中是“抗高血压药物”。自1992年以来，欧洲专利的翻译有所增加，目前是最常见的类型。不同主题组的比例差异很大（P<.001），最近与“导管/设备”和“诊断/监测技术”相关的比例增加，而与“药物治疗”和“生物化学/分子生物学”相关的比例减少。结论西班牙CVD相关专利主要来源于欧洲，15.2%为合作申请。人数最多的是西班牙，其次是德国、瑞士、法国和荷兰。最常见的主题是“降压治疗”。总体而言，补助金的最大增长（接近40%）发生在2010-2020年，特别是与欧洲专利的翻译有关。21世纪增长最快的学科是与“导管/装置”和“诊断/监测技术”相关的学科。

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引用次数: 0

Purulent pericarditis in the 21st century. Causes, clinical presentation, and prognostic factors at a referral center 21世纪的化脓性心包炎。病因、临床表现和转诊中心的预后因素

Q4 Medicine

REC: CardioClinics

Pub Date : 2026-01-01 DOI: 10.1016/j.rccl.2025.02.001

Maria Calvo-Barceló , Maria Vidal-Burdeus , José A. Barrabés , Ignacio Ferreira-González , Núria Fernández-Hidalgo , Pau Rello

引用次数: 0

Desenmascarando el gradiente oculto: el papel de la ecocardiografía de esfuerzo en la miocardiopatía hipertrófica 揭开隐藏的梯度：用力超声心动图在肥厚性心肌病中的作用

Q4 Medicine

REC: CardioClinics

Pub Date : 2026-01-01 DOI: 10.1016/j.rccl.2025.10.004

Noemí Ramos López , Jesús González Mirelis , Esther González-López

引用次数: 0

Embolia paradójica inminente por foramen oval permeable 可穿孔的椭圆形孔即将形成矛盾栓塞

Q4 Medicine

REC: CardioClinics

Pub Date : 2026-01-01 DOI: 10.1016/j.rccl.2025.07.003

Juan Manuel Serrano-Marcos, Miguel Morales-García, Juan Emilio Alcalá-López

引用次数: 0

Utilidad del ecocardiograma de esfuerzo en la valoración de pacientes con miocardiopatía hipertrófica 超声心动图在评估肥厚性心肌病患者中的作用

Q4 Medicine

REC: CardioClinics

Pub Date : 2026-01-01 DOI: 10.1016/j.rccl.2025.07.006

Juan Geraldo-Martínez , Alba Corralejo-del-Peso , Virginia Ruiz-Pizarro , Marta Alamar-Cervera , Jorge Álvarez-Rubio , Joan Torres-Marqués , Esther Moranta-Ribas , David Crémer-Luengos , Carlos Veras-Burgos , María Monserrat-Companys , Tomás Ripoll-Vera

Introduction and objectives

One-third of patients with hypertrophic cardiomyopathy (HCM) present left ventricular outflow tract obstruction at rest. However, a significant percentage of patients show latent obstruction. Exercise echocardiography is valuable for detecting this hidden gradient. The aim of this study is to analyze predictors of latent left ventricular outflow tract obstruction and its prognostic implications.

Methods

We conducted a single-center retrospective study in 150 patients diagnosed with HCM according to European Society of Cardiology criteria, all of whom underwent exercise echocardiography. Demographic, clinical, echocardiographic, and long-term adverse event data were collected. Characteristics of patients with and without latent obstruction were compared, and prognostic factors associated with severe events were examined.

Results

Resting obstruction was present in 9% of the cohort, while 24% exhibited latent obstruction. Absence of atrial fibrillation, the use of beta-blockers or disopyramide, and an elevated baseline or post-Valsalva gradient were associated with latent obstruction. Neither latent obstruction nor gradient magnitude correlated with adverse events. Worse prognosis was linked to older age, increased ventricular wall thickness, New York Heart Association functional class III or IV, and use of beta-blockers or disopyramide.

Conclusions

Exercise echocardiography is a safe and useful method for detecting latent obstruction in HCM patients. Although the induced gradient did not correlate with prognosis, identifying it could enhance overall patient assessment.

三分之一的肥厚性心肌病（HCM）患者静息时出现左心室流出道梗阻。然而，相当比例的患者表现为潜伏性梗阻。运动超声心动图对检测这种隐藏梯度很有价值。本研究的目的是分析潜伏性左心室流出道梗阻的预测因素及其预后意义。方法我们对150例根据欧洲心脏病学会标准诊断为HCM的患者进行了单中心回顾性研究，所有患者均接受了运动超声心动图检查。收集了人口统计学、临床、超声心动图和长期不良事件数据。比较有和无潜伏性梗阻患者的特征，并检查与严重事件相关的预后因素。结果静息性梗阻发生率为9%，潜伏性梗阻发生率为24%。无房颤、使用β受体阻滞剂或双酰胺、基线升高或valsalva后梯度升高与潜伏性梗阻相关。潜伏性梗阻和梯度大小均与不良事件无关。较差的预后与年龄较大、心室壁厚度增加、纽约心脏协会功能等级为III或IV级以及使用-受体阻滞剂或双酰胺有关。结论运动超声心动图是检测HCM患者潜伏性梗阻的一种安全有效的方法。虽然诱导梯度与预后无关，但识别它可以提高患者的整体评估。

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引用次数: 0

Aislamiento de venas pulmonares en fibrilación auricular paroxística y persistente. Electroporación o radiofrecuencia 在突发和持续性耳纤颤中肺静脉的隔离。电或射频

Q4 Medicine

REC: CardioClinics

Pub Date : 2026-01-01 DOI: 10.1016/j.rccl.2025.06.002

Joaquín Osca Asensi , Josep Navarro-Manchón , María Teresa Izquierdo de Francisco , Óscar Cano Pérez , Javier Navarrete Navarro , Carmen Arveras Martínez , Francisco Javier Chorro Gascó , Luis Martínez-Dolz

Introduction and objectives

Pulsed-field ablation (PFA) has emerged as an alternative to radiofrequency and cryoablation for pulmonary vein isolation (PVI). The effectiveness and safety of PFA versus radiofrequency for PVI is not sufficiently studied.

Methods

Unicentric and retrospective study. Consecutive patients with paroxysmal or persistent atrial fibrillation undergoing PVI with PFA or radiofrequency in 2 historical cohorts were included. The primary outcome was recurrence of any atrial arrhythmia after a 90-day blanking period. Patients underwent usual clinical follow-up.

Results

A total of 374 patients were remitted to PVI (198 to PFA and 176 to radiofrequency). At 1 year 82,3% were free of auricular arrhythmias in PFA versus 82,4% in radiofrequency (P = .862). Looking at the type of atrial fibrillation (paroxysmal/persistent) the long-term outcomes were also similar. Median procedure time was significantly shorter in PFA (73 vs 141 minutes; P = .001). However, fluoroscopy time was significantly longer in PFA (13 vs 5 minutes; P = .001). Adverse events were similar in both cohorts. Organized atrial arrhythmias after PVI were similar in both groups (26% of recurrence). Recurrences were related to different factors in univariate buy were only related to early recurrence (blanking period) in multivariate analysis (OR, 4,24; 95%CI, 2,46-7,33; P = .0001).

Conclusions

PFA compared with radiofrequency PVI shows a similar procedural effectiveness but is associated with shorter procedure time and longer fluoroscopy. Organized atrial arrhythmias after PVI were similar.

简介和目的脉冲场消融（PFA）已成为射频和冷冻消融治疗肺静脉隔离（PVI）的替代方法。PFA与射频治疗PVI的有效性和安全性尚未得到充分研究。方法采用单中心回顾性研究。连续的阵发性或持续性心房颤动患者接受PVI与PFA或射频纳入2个历史队列。主要终点是在90天的空白期后房性心律失常的复发。患者接受常规临床随访。结果374例患者接受PVI治疗，其中PFA治疗198例，射频治疗176例。1年后，PFA组中有3%的患者无耳廓心律失常，而射频组中有89.4% （P = 0.862）。观察房颤的类型（阵发性/持续性），长期结果也相似。PFA的中位手术时间显著缩短（73分钟vs 141分钟；P = .001）。然而，PFA患者的透视时间明显更长（13分钟vs 5分钟；P = 0.001）。两组的不良事件相似。两组PVI后有组织性心房心律失常相似（26%复发率）。在单因素分析中，复发与不同因素有关；在多因素分析中，复发仅与早期复发（空白期）有关（OR, 4,24; 95%CI, 2,46-7,33; P = 0.0001）。结论与射频PVI相比，spfa具有相似的手术效果，但手术时间较短，透视时间较长。PVI后的有组织性心房心律失常相似。

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