Revista española de cardiología (English ed.)最新文献

英文中文

Prognostic significance of right ventriculoarterial coupling in patients undergoing isolated tricuspid valve surgery 接受孤立三尖瓣手术患者右心室-动脉耦合的预后意义。

IF 7.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2025-03-01 DOI: 10.1016/j.rec.2024.08.011

Marcelo Luque , Isidre Vilacosta , Manuel Carnero , Julián Pérez-Villacastín , Alberto de Agustín , Eduardo Pozo Osinalde

引用次数: 0

Lumenless versus stylet-driven leads in left bundle branch pacing 左束支起搏中的无腔导联与支架驱动导联的比较

IF 7.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2025-03-01 DOI: 10.1016/j.rec.2024.08.014

Álvaro Marco del Castillo, Javier Ramos Jiménez, Luis Borrego Bernabé, Fernando Arribas Ynsaurriaga, Daniel Rodríguez Muñoz, Rafael Salguero Bodes

引用次数: 0

Comments on the ESC 2024 guidelines for the management of chronic coronary syndromes 对ESC 2024慢性冠状动脉综合征管理指南的评论。

IF 7.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2025-03-01 DOI: 10.1016/j.rec.2024.10.007

SEC Working Group for the 2024 ESC guidelines for the management of chronic coronary syndromes and SEC Guidelines Committee

引用次数: 0

Transgastric views: an adjunct in left atrial appendage evaluation 经胃镜：左心耳评价的辅助手段。

IF 7.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2025-03-01 DOI: 10.1016/j.rec.2024.10.012

Lucía Fernández Gassó , Esther Pérez David , Raúl Moreno

引用次数: 0

Impact of natriuresis on worsening renal function during episodes of acute heart failure 急性心力衰竭发作时，利尿对肾功能恶化的影响。

IF 7.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2025-03-01 DOI: 10.1016/j.rec.2024.07.006

Pedro Caravaca Pérez , Ignacio Fernández-Herrero , José Jesús Broseta , Nikein Ibarra-Márquez , Zorba Blázquez-Bermejo , Juan Carlos López-Azor , César Del Castillo Gordillo , Marta Cobo Marcos , Javier de Juan Bagudá , María Dolores García Cosío , Ana García-Álvarez , Marta Farrero , Juan F. Delgado

Introduction and objectives

Worsening renal function (WRF) is a frequent complication in acute heart failure (AHF) with a controversial prognostic value. We aimed to study the usefulness of natriuresis to evaluate WRF.

Methods

We conducted an observational, prospective, multicenter study of patients with AHF who underwent a furosemide stress test. The patients were classified according to whether WRF was present or absent and according to the median natriuretic response. The main endpoint was the combination of mortality, rehospitalization due to HF, and heart transplant at 6 months of follow-up.

Results

One hundred and fifty-six patients were enrolled, and WRF occurred in 60 (38.5%). The patients were divided into 4 groups: a) 47 (30.1%) no WRF/low UNa (UNa ≤ 109 mEq/L); b) 49 (31.4%) no WRF/high UNa (UNa > 109 mEq/L); c) 31 (19.9%) WRF/low UNa and d) 29 (18.6%) WRF/high UNa. The parameters of the WRF/low UNa group showed higher clinical severity and worse diuretic and decongestive response. The development of WRF was associated with a higher risk of the combined event (HR, 1.88; 95%CI, 1.01-3.50; P = .046). When stratified by natriuretic response, WRF was associated with an increased risk of adverse events in patients with low natriuresis (HR, 2.28; 95%CI, 1.15-4.53; P = .019), but not in those with high natriuresis (HR, 1.18; 95%CI, 0.26-5.29; P = .826).

Conclusions

Natriuresis could be a useful biomarker for interpreting and prognosticating WRF in AHF. WRF is associated with a higher risk of adverse events only in the context of low natriuresis.

引言和目的：肾功能恶化（WRF）是急性心力衰竭（AHF）的常见并发症，其预后价值尚存争议。我们旨在研究钠尿症对评估 WRF 的作用：我们对接受呋塞米负荷试验的 AHF 患者进行了一项观察性、前瞻性、多中心研究。根据 WRF 是否存在以及利钠反应的中位数对患者进行分类。主要终点是随访6个月时的死亡率、因心房颤动再次住院和心脏移植的综合情况：共有 156 名患者入选，其中 60 人（38.5%）发生了 WRF。患者分为 4 组：a) 47 例（30.1%）无 WRF/低 UNa（UNa ≤ 109 mEq/L）；b) 49 例（31.4%）无 WRF/高 UNa（UNa > 109 mEq/L）；c) 31 例（19.9%）WRF/低 UNa；d) 29 例（18.6%）WRF/高 UNa。WRF/ 低 UNa 组的参数显示临床严重程度更高，利尿和减充血反应更差。WRF 的发生与较高的合并事件风险相关（HR，1.88；95%CI，1.01-3.50；P = .046）。按钠尿反应分层时，低钠尿患者发生 WRF 与不良事件的风险增加有关（HR，2.28；95%CI，1.15-4.53；P = .019），而高钠尿患者则无关（HR，1.18；95%CI，0.26-5.29；P = .826）：钠尿症可能是解释和预后AHF中WRF的有用生物标志物。只有在低钠血症的情况下，WRF才与较高的不良事件风险相关。

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引用次数: 0

Role of spot urinary sodium in outpatients with heart failure 定点尿钠在门诊心力衰竭患者中的作用。

IF 7.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2025-03-01 DOI: 10.1016/j.rec.2024.07.002

Miguel Lorenzo , Rafael de la Espriella , Gema Miñana , Gonzalo Núñez , Arturo Carratalá , Enrique Rodríguez , Enrique Santas , Neus Valls , Sandra Villar , Víctor Donoso , Antoni Bayés-Genís , Juan Sanchis , Julio Núñez

Introduction and objectives

Spot determination of urinary sodium (UNa+) has emerged as a useful tool for monitoring diuretic response in patients with acute heart failure (AHF). However, the evidence in outpatients is scarce. We aimed to examine the relationship between spot UNa+ levels and the risk of mortality and worsening heart failure (WHF) events in individuals with chronic HF.

Methods

This observational and ambispective study included 1145 outpatients with chronic HF followed in a single center specialized HF clinic. UNa+ assessment was carried out 1-5 days before each visit. The endpoints of the study were the association between UNa+ and risk of a) long-term death and b) AHF-hospitalization and total WHF events (including AHF-hospitalization, emergency department visits or parenteral loop-diuretic administration in HF clinic), assessed by multivariate Cox and negative binomial regressions.

Results

The mean ± standard deviation of age was 73 ± 11 years, 670 (58.5%) were men, 902 (78.8%) were on stable NYHA class II, and 595 (52%) had LFEF ≥ 50%. The median (interquartile range) UNa+ was 72 (51-94) mmol/L. Over a median follow-up of 2.63 (1.70-3.36) years, there were 293 (25.6%) deaths and 382 WHF events (244 AHF-admissions) in 233 (20.3%) patients. After multivariate adjustment, baseline UNa+ was inverse and linearly associated with the risk of total WHF (IRR, 1.07; 95%CI, 1.02-1.12; P = .007) and AHF-admissions (IRR, 1.08; 95%CI, 1.02-1.14; P = .012) and borderline associated with all-cause mortality (HR, 1.04; 95%CI, 0.99-1.09; P = .068).

Conclusions

In outpatients with chronic HF, lower UNa+ was associated with a higher risk of recurrent WHF events.

引言和目的：尿钠（UNa+）定点测定已成为监测急性心力衰竭（AHF）患者利尿剂反应的有用工具。然而，门诊患者的相关证据却很少。我们的目的是研究慢性心力衰竭患者的尿钠浓度与死亡率和心力衰竭（WHF）恶化风险之间的关系：这项观察性和前瞻性研究纳入了 1145 名慢性心力衰竭门诊患者，他们均在一家中心的心力衰竭专科门诊接受随访。每次就诊前 1-5 天进行 UNa+ 评估。研究终点为UNa+与以下风险之间的关系：a）长期死亡；b）AHF-住院和总WHF事件（包括AHF-住院、急诊就诊或在HF门诊使用肠外环利尿剂），通过多变量Cox和负二项回归进行评估：平均年龄（标准差）为 73 ± 11 岁，670 例（58.5%）为男性，902 例（78.8%）处于稳定的 NYHA II 级，595 例（52%）LFEF ≥ 50%。UNa+ 的中位数（四分位数间距）为 72 (51-94) mmol/L。在中位 2.63（1.70-3.36）年的随访期间，293 名患者（25.6%）死亡，233 名患者（20.3%）发生 382 例 WHF 事件（244 例 AHF-入院）。经过多变量调整后，基线 UNa+ 与总 WHF（IRR，1.07；95%CI，1.02-1.12；P = .007）和 AHF-入院（IRR，1.08；95%CI，1.02-1.14；P = .012）风险呈反向线性相关，与全因死亡率呈边缘相关（HR，1.04；95%CI，0.99-1.09；P = .068）：结论：在慢性心房颤动门诊患者中，较低的 UNa+ 与较高的复发性 WHF 事件风险相关。

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引用次数: 0

Management of heart disease in renal transplant recipients: a national Delphi survey-based SET/SEC/SEN consensus document 肾移植受者心脏病的管理：基于德尔菲调查的 SET/SEC/SEN 全国共识文件。

IF 7.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2025-03-01 DOI: 10.1016/j.rec.2024.09.008

María Dolores García-Cosío , Josep María Cruzado , Marta Farrero , María Teresa Blasco Peiró , Marta Crespo , Juan Francisco Delgado Jiménez , Beatriz Díaz Molina , Constantino Fernández Rivera , Iris Paula Garrido Bravo , Verónica López Jiménez , Edoardo Melilli , Sonia Mirabet Pérez , María Lourdes Pérez Tamajón , Diego Rangel Sousa , Emilio Rodrigo Calabia , Domingo Hernández Marrero

Renal transplantation improves the survival and quality of life of patients with end-stage renal disease. Cardiovascular disease is the leading cause of morbidity and mortality in renal transplant recipients. The bidirectional relationship between renal and heart disease creates a unique clinical scenario that demands a comprehensive and personalized approach. This expert consensus, drafted by the Spanish Society of Transplantation, the Spanish Society of Cardiology, and the Spanish Society of Nephrology, aims to assess current practices and propose strategies for the management of heart disease in renal transplant recipients. A panel of Spanish nephrologists and cardiologists with expertise in renal and heart transplantation reviewed the scientific evidence concerning the current management of heart disease in renal transplant recipients. Subsequently, consensus statements were created through a 2-round Delphi methodology, resulting in 30 statements covering key topics such as the identification of renal transplant candidates, the management of heart disease in renal transplant recipients, and eligibility for combined heart-kidney transplantation in patients with both end-stage renal disease and cardiac disease. These consensus statements provide expert guidance for the management of heart disease in renal transplant recipients, an area where published clinical evidence remains limited.

肾移植可提高终末期肾病患者的生存率和生活质量。心血管疾病是肾移植受者发病和死亡的主要原因。肾病和心脏病之间的双向关系造成了一种独特的临床情况，需要采取全面和个性化的治疗方法。这份由西班牙移植学会、西班牙心脏病学会和西班牙肾脏病学会共同起草的专家共识旨在评估目前的做法，并提出肾移植受者心脏病的治疗策略。一个由西班牙肾脏病学家和心脏病学家组成的肾脏移植和心脏移植专家小组对目前肾移植受者心脏病治疗的科学证据进行了审查。随后，通过两轮德尔菲法形成了 30 份共识声明，涵盖了肾移植候选者的确定、肾移植受者心脏病的管理以及终末期肾病和心脏病患者接受心肾联合移植的资格等关键主题。这些共识声明为肾移植受者心脏病的管理提供了专家指导，而这一领域已发表的临床证据仍然有限。

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引用次数: 0

Comments on the 2024 ESC guidelines for the management of peripheral arterial and aortic diseases 对2024年ESC外周动脉和主动脉疾病管理指南的评论。

IF 7.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2025-03-01 DOI: 10.1016/j.rec.2024.10.002

SEC Working Group for the 2024 ESC guidelines for the management of peripheral arterial and aortic diseases and SEC Guidelines Committee

引用次数: 0

María de los Ángeles Alonso García

IF 7.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2025-03-01 DOI: 10.1016/j.rec.2024.11.012

José R. González-Juanatey , Mar Moreno Yangüela

引用次数: 0

Heart transplant as treatment for cardiogenic shock: an effective strategy or a "Spanish exception"?

IF 7.2 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2025-02-27 DOI: 10.1016/j.rec.2024.11.021

Francisco José Hernández-Pérez, Alba Martín-Centellas, Mercedes Rivas-Lasarte, Cristina Mitroi, Manuel Gómez-Bueno, Javier Segovia-Cubero

Cardiogenic shock remains one of the main challenges in modern cardiovascular medicine. In Spain, urgent cardiac transplantation is the most widely used heart replacement therapy fin eligible patients who do not achieve cardiac recovery. However, this approach has significant implications related to the principle of equity, influenced by the characteristics of the recipient, the donor, and organ access. When selecting a recipient, multiorgan failure must first be addressed before considering transplantation. At the same time, it is essential to expand the donor pool through various strategies to meet the growing demand, even if it involves using suboptimal organs. Given the scarcity of donors and favorable outcomes, long-term left ventricular assist devices should be considered as an alternative to transplantation. Finally, designing organ distribution criteria remains a constantly evolving challenge, as there is no universal system that can address all the issues involved. Allocating organs to the most critically ill patients can provide substantial individual benefits, as long as it does not significantly compromise the common good.

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Revista española de cardiología (English ed.)

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