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

英文中文

Microaxial flow pump malrotation and cardiogenic shock outcomes 微轴流泵旋转不良与心源性休克结局。

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2026-03-01 Epub Date: 2025-05-17 DOI: 10.1016/j.rec.2025.05.002

Sebastián Aranda-Martínez , Jorge Martínez-Solano , Antonio Portolés-Hernández , Iago Sousa-Casasnovas , Jorge García-Carreño , Manuel Martínez-Sellés

引用次数: 0

Long-term impact of an intensive telemedicine-based strategy for lipid management 基于密集远程医疗的血脂管理策略的长期影响。

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2026-03-01 Epub Date: 2025-06-26 DOI: 10.1016/j.rec.2025.05.013

César Jiménez-Méndez , Rafael Vázquez-García , William Delgado, Daniel Bartolome, Etel Silva

引用次数: 0

Intravascular ultrasound to assess adverse pulmonary vascular remodeling in Fontan circulation 血管内超声评估方坦循环不良肺血管重构。

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2026-03-01 Epub Date: 2025-05-21 DOI: 10.1016/j.rec.2025.05.004

Yassin Belahnech , Gerard Martí-Aguasca , Enric Domingo-Ribas , Eduard Ródenas-Alesina , Antonia Pijuan-Domenech , Laura Dos-Subirà

引用次数: 0

Cumulative resting heart rate load and cardiovascular risk in patients with heart failure in sinus rhythm 窦性心律心力衰竭患者的累积静息心率负荷与心血管风险。

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2026-03-01 Epub Date: 2025-08-13 DOI: 10.1016/j.rec.2025.07.006

Jun Hao , Jingyang Wang , Rui Shi , Qi Wang , Xiaohua Cheng , Jiayu Feng , Yanmin Yang , Yuxiao Hu , Tao Chen , Kangyu Chen

Introduction and objectives

Resting heart rate is a readily available vital sign with important prognostic significance. However, traditional measures overlook both the magnitude and duration of elevated heart rate over time. This study assessed the association between cumulative resting heart rate load and adverse outcomes in patients with chronic heart failure (HF) in sinus rhythm.

Methods

Data from 5 randomized controlled trials (BEST, GUIDE-IT, HF-ACTION, RELAX, and TOPCAT) were analyzed. Cumulative heart rate load was calculated as the area under the curve (AUC) for heart rate ≥70 beats per minute (bpm), relative to the total AUC prior to outcomes. The primary outcome was major adverse cardiac events (MACE), defined as the composite of cardiovascular death and hospitalization for HF. Cox proportional hazards regression models were used to examine associations with outcomes.

Results

A total of 5428 patients were included. Higher cumulative resting heart rate load was significantly associated with increased risk of MACE (hazard ratio [HR], 1.31; 95% CI, 1.24-1.38), cardiovascular death (HR, 1.17; 95% CI, 1.08-1.27), hospitalization for HF (HR, 1.34; 95% CI, 1.26-1.43), all-cause death (HR, 1.20; 95% CI, 1.12-1.29), and any hospitalization (HR, 1.20; 95% CI, 1.15-1.25). Cumulative resting heart rate load demonstrated superior predictive value for all outcomes compared with baseline heart rate, mean heart rate, heart rate standard deviation, and heart rate time in the target range with improvements in C-statistics, net reclassification improvement, and integrated discrimination improvement when added to base models.

Conclusions

Cumulative resting heart rate load provides stronger prognostic value for adverse outcomes in chronic HF. Incorporating this parameter into clinical practice may improve risk stratification and help identify high-risk patients who could benefit from intensive monitoring or therapeutic interventions.

简介和目的：静息心率是一种容易获得的生命体征，具有重要的预后意义。然而，传统的测量方法忽略了心率随时间升高的幅度和持续时间。本研究评估了窦性心律慢性心力衰竭（HF）患者的累积静息心率负荷与不良结局之间的关系。方法：对5项随机对照试验（BEST、GUIDE-IT、HF-ACTION、RELAX、TOPCAT）的数据进行分析。累积心率负荷计算为心率≥70次/分钟（bpm）时的曲线下面积（AUC），相对于结果前的总AUC。主要终点是主要心脏不良事件（MACE），定义为心血管死亡和HF住院的综合。Cox比例风险回归模型用于检验与结果的关联。结果：共纳入5428例患者。较高的累积静息心率负荷与MACE风险增加显著相关(危险比[HR]， 1.31；95% CI, 1.24-1.38)，心血管死亡(HR, 1.17；95% CI, 1.08-1.27)，心衰住院(HR, 1.34；95% CI, 1.26-1.43)，全因死亡(HR, 1.20；95% CI, 1.12-1.29)，以及任何住院治疗(HR, 1.20；95% ci, 1.15-1.25)。与基线心率、平均心率、心率标准差和心率在目标范围内的时间相比，累积静息心率负荷对所有结局的预测价值都更高(P)。结论：累积静息心率负荷对慢性心衰不良结局的预测价值更强。将这一参数纳入临床实践可以改善风险分层，并有助于识别高危患者，这些患者可以从强化监测或治疗干预中受益。

{"title":"Cumulative resting heart rate load and cardiovascular risk in patients with heart failure in sinus rhythm","authors":"Jun Hao , Jingyang Wang , Rui Shi , Qi Wang , Xiaohua Cheng , Jiayu Feng , Yanmin Yang , Yuxiao Hu , Tao Chen , Kangyu Chen","doi":"10.1016/j.rec.2025.07.006","DOIUrl":"10.1016/j.rec.2025.07.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Resting heart rate is a readily available vital sign with important prognostic significance. However, traditional measures overlook both the magnitude and duration of elevated heart rate over time. This study assessed the association between cumulative resting heart rate load and adverse outcomes in patients with chronic heart failure (HF) in sinus rhythm.</div></div><div><h3>Methods</h3><div>Data from 5 randomized controlled trials (BEST, GUIDE-IT, HF-ACTION, RELAX, and TOPCAT) were analyzed. Cumulative heart rate load was calculated as the area under the curve (AUC) for heart rate ≥70 beats per minute (bpm), relative to the total AUC prior to outcomes. The primary outcome was major adverse cardiac events (MACE), defined as the composite of cardiovascular death and hospitalization for HF. Cox proportional hazards regression models were used to examine associations with outcomes.</div></div><div><h3>Results</h3><div>A total of 5428 patients were included. Higher cumulative resting heart rate load was significantly associated with increased risk of MACE (hazard ratio [HR], 1.31; 95% CI, 1.24-1.38), cardiovascular death (HR, 1.17; 95% CI, 1.08-1.27), hospitalization for HF (HR, 1.34; 95% CI, 1.26-1.43), all-cause death (HR, 1.20; 95% CI, 1.12-1.29), and any hospitalization (HR, 1.20; 95% CI, 1.15-1.25). Cumulative resting heart rate load demonstrated superior predictive value for all outcomes compared with baseline heart rate, mean heart rate, heart rate standard deviation, and heart rate time in the target range with improvements in C-statistics, net reclassification improvement, and integrated discrimination improvement when added to base models.</div></div><div><h3>Conclusions</h3><div>Cumulative resting heart rate load provides stronger prognostic value for adverse outcomes in chronic HF. Incorporating this parameter into clinical practice may improve risk stratification and help identify high-risk patients who could benefit from intensive monitoring or therapeutic interventions.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 3","pages":"Pages 204-214"},"PeriodicalIF":4.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859746","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}

引用次数: 0

Clinical outcomes, health care resource utilization and costs by renal function in patients with heart failure 心衰患者肾功能的临床结局、医疗资源利用及费用。

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2026-03-01 Epub Date: 2025-09-19 DOI: 10.1016/j.rec.2025.08.005

Martín Romo , Claudia Yuste , Jorge Vélez , Miguel Hernández , Beatriz Palacios , Raquel Pita , Margarita Capel , Sandra Fernández Fernández , Nicolás Rosillo , Guillermo Moreno , Manuel del Oro , Carmen Ortega , José L. Bernal , Héctor Bueno

Introduction and objectives

Chronic kidney disease is highly prevalent in patients with heart failure (HF), increases clinical complexity, and worsens prognosis. This study quantitatively assessed the impact of renal dysfunction severity, including dialysis, on clinical outcomes, resource utilization, and costs in patients with HF.

Methods

Retrospective cohort study in adult patients with 1 emergency department visit or hospitalization with an HF diagnosis in a university hospital in 2018. One-year clinical outcomes, resources, and costs were compared with the COHERENT (Clinical outcomes, healthcare resource utilization and related costs) model according to estimated glomerular filtration rate (eGFR) ≥ 60, 30 to 59, 15 to 29, and < 15 (including patients on dialysis) mL/min/1.73 m².

Results

Of 3274 patients with HF (median age, 84 years; 56% women), 1453 (44.4%) had eGFR ≥ 60. Lower eGFR levels were associated with higher 1-year mortality (20.4% in eGFR ≥ 60 vs 45.4% in eGFR 15 to 29; P < .001 for trend), rehospitalization, and new emergency department visits. Patients with eGFR < 15 had the highest readmission rate (50.8%; P < .001 for trend). Days out of hospital without dialysis decreased from 292 (80.0%) in eGFR ≥ 60 to 184 (50.3%) in eGFR < 15. Median cost per patient journey increased from €3960 (Q1-Q3, €1750 to €8410) with eGFR ≥ 60 to €9590 (Q1-Q3, €4140 to €28 520; P < .001) with eGFR < 15, driven mainly by hospitalizations (84%-90% of total, except for eGFR < 15, 59.0%).

Conclusions

Renal dysfunction severity was associated with progressively worse clinical outcomes, increased health resource utilization, and higher costs in patients with HF. Strategies are needed to improve outcomes and reduce costs in patients with HF and severe chronic kidney disease.

简介和目的：慢性肾脏疾病在心力衰竭（HF）患者中非常普遍，增加了临床复杂性，并恶化了预后。本研究定量评估了肾功能不全严重程度（包括透析）对心衰患者临床结局、资源利用和成本的影响。方法：回顾性队列研究2018年某大学医院1例急诊就诊或住院诊断为HF的成年患者。根据估计肾小球滤过率(eGFR)≥60、30 ~ 59、15 ~ 29和< 15（包括透析患者）mL/min/1.73 m²，将一年的临床结果、资源和成本与临床结果、医疗资源利用率和相关成本（COHERENT）模型进行比较。结果：在3274例HF患者（中位年龄84岁，56%为女性）中，1453例（44.4%）的eGFR≥60。较低的eGFR水平与较高的1年死亡率（eGFR≥60组为20.4%，eGFR 15 ~ 29组为45.4%；趋势P < 0.001）、再住院和急诊新就诊相关。eGFR < 15的患者再入院率最高（50.8%，趋势P < 0.001）。未透析的出院天数从eGFR≥60组的292天（80.0%）减少到eGFR < 15组的184天（50.3%）。eGFR≥60时，每位患者就诊的中位费用从3960欧元（Q1-Q3, 1750欧元至8410欧元）增加到eGFR < 15时的9590欧元（Q1-Q3, 4140欧元至28520欧元，P < 0.001），主要由住院费用驱动（占总费用的84%-90%，eGFR < 15除外，59.0%）。结论：肾功能不全严重程度与心衰患者逐渐恶化的临床结果、增加的卫生资源利用率和更高的费用相关。需要制定策略来改善心衰合并严重慢性肾脏疾病患者的预后并降低费用。

{"title":"Clinical outcomes, health care resource utilization and costs by renal function in patients with heart failure","authors":"Martín Romo , Claudia Yuste , Jorge Vélez , Miguel Hernández , Beatriz Palacios , Raquel Pita , Margarita Capel , Sandra Fernández Fernández , Nicolás Rosillo , Guillermo Moreno , Manuel del Oro , Carmen Ortega , José L. Bernal , Héctor Bueno","doi":"10.1016/j.rec.2025.08.005","DOIUrl":"10.1016/j.rec.2025.08.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Chronic kidney disease is highly prevalent in patients with heart failure (HF), increases clinical complexity, and worsens prognosis. This study quantitatively assessed the impact of renal dysfunction severity, including dialysis, on clinical outcomes, resource utilization, and costs in patients with HF.</div></div><div><h3>Methods</h3><div>Retrospective cohort study in adult patients with 1 emergency department visit or hospitalization with an HF diagnosis in a university hospital in 2018. One-year clinical outcomes, resources, and costs were compared with the COHERENT (Clinical outcomes, healthcare resource utilization and related costs) model according to estimated glomerular filtration rate (eGFR) ≥ 60, 30 to 59, 15 to 29, and <15 (including patients on dialysis) mL/min/1.73 m<sup>2</sup>.</div></div><div><h3>Results</h3><div>Of 3274 patients with HF (median age, 84 years; 56% women), 1453 (44.4%) had eGFR ≥ 60. Lower eGFR levels were associated with higher 1-year mortality (20.4% in eGFR ≥ 60 vs 45.4% in eGFR 15 to 29; <em>P</em>   <.001 for trend). Days out of hospital without dialysis decreased from 292 (80.0%) in eGFR ≥ 60 to 184 (50.3%) in eGFR <15. Median cost per patient journey increased from €3960 (Q1-Q3, €1750 to €8410) with eGFR ≥ 60 to €9590 (Q1-Q3, €4140 to €28 520; <em>P</em>    <!-->15, 59.0%).</div></div><div><h3>Conclusions</h3><div>Renal dysfunction severity was associated with progressively worse clinical outcomes, increased health resource utilization, and higher costs in patients with HF. Strategies are needed to improve outcomes and reduce costs in patients with HF and severe chronic kidney disease.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 3","pages":"Pages 247-256"},"PeriodicalIF":4.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114343","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}

引用次数: 0

Commissural alignment with the Allegra transcatheter aortic bioprosthesis Allegra经导管主动脉生物假体的联合对准。

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2026-03-01 Epub Date: 2025-06-04 DOI: 10.1016/j.rec.2025.05.011

Jorge Sanz Sánchez , José Antonio Sorolla Romero , Jean Paul Vílchez Tschischke , Carles Fonfria , Ignacio J. Amat Santos , José Luis Díez Gil

引用次数: 0

Sudden death due to pulmonary embolism in young adults in Spain. Retrospective multicenter study of 128 forensic autopsy cases 西班牙年轻人肺栓塞猝死的研究128例法医尸检病例的回顾性多中心研究。

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2026-03-01 Epub Date: 2025-09-05 DOI: 10.1016/j.rec.2025.04.013

Pilar Molina , Benito Morentin , Paloma Hevia , Ana Monzó , Joaquín S. Lucena

Introduction and objectives

Pulmonary embolism (PE) may debut as sudden death (SD) in young and middle-aged adults. This study aims to determine the epidemiological and clinicopathological characteristics involved in SD due to PE in this age group and the underlying risk factors.

Methods

Multicenter retrospective noncontrolled study based on forensic autopsies performed in individuals aged 12 to 49 years at 3 forensic pathology services in Spain (Valencia, Biscay, and Seville) over an 8-year period (2010-2017).

Results

A total of 1344 cardiac SD cases were recorded, of which 128 (9.5%) were due to PE (57% male, median age 42 years). The annual incidence was 0.56/100 000 inhabitants/y. The main risk factor was obesity (62%; 18.5% morbid obesity). The mean body mass index was 34.9 ± 13.1. Psychiatric disorders were highly prevalent (44%). Immobilization (26%) and prior trauma (11%) were other relevant antecedents. Among women, 22% were receiving oral contraceptive therapy. Premortem symptoms were reported in 52% of cases, mainly dyspnea (56%). Although 22 individuals sought medical attention, only one was correctly diagnosed. Toxicological analysis was performed in 67% of cases, with positive results for psychotropic drugs (20%) and substances of abuse/alcohol (9%).

Conclusions

PE is a common cause of SD in individuals younger than 50 years and is frequently clinically underdiagnosed. This study provides evidence supporting a strong association with obesity and psychiatric disorders, which facilitate immobilization, venous stasis, and a prothrombotic state. Forensic studies of SD due to PE offer complementary data to clinical research, revealing risk factors that are underrepresented in clinical cohorts.

简介和目的：肺栓塞（PE）可能在中青年中以猝死（SD）的形式出现。本研究旨在确定该年龄组PE所致SD的流行病学和临床病理特征及其潜在危险因素。方法：多中心回顾性非对照研究，基于西班牙（瓦伦西亚、比斯开和塞维利亚）3家法医病理学服务机构在8年（2010-2017年）期间对12至49岁的个体进行的法医尸检。结果：共记录1344例心脏性SD病例，其中128例（9.5%）由PE引起，其中57%为男性，中位年龄42岁。年发病率为0.56/10万居民/年。主要危险因素为肥胖（62%；病态肥胖18.5%）。平均体重指数为34.9±13.1。精神疾病非常普遍（44%）。固定（26%）和既往创伤（11%）是其他相关的前因。在妇女中，22%正在接受口服避孕药治疗。52%的病例报告有死前症状，主要是呼吸困难（56%）。虽然有22人求医，但只有一人得到了正确诊断。对67%的病例进行了毒理学分析，对精神药物（20%）和滥用物质/酒精（9%）的检测结果呈阳性。结论：PE是50岁以下人群SD的常见病因，临床上常被误诊。这项研究提供了证据支持肥胖和精神疾病之间的密切联系，这促进了固定、静脉停滞和血栓形成前状态。PE猝死的法医研究为临床研究提供了补充数据，揭示了在临床队列中未被充分代表的风险因素。

{"title":"Sudden death due to pulmonary embolism in young adults in Spain. Retrospective multicenter study of 128 forensic autopsy cases","authors":"Pilar Molina , Benito Morentin , Paloma Hevia , Ana Monzó , Joaquín S. Lucena","doi":"10.1016/j.rec.2025.04.013","DOIUrl":"10.1016/j.rec.2025.04.013","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Pulmonary embolism (PE) may debut as sudden death (SD) in young and middle-aged adults. This study aims to determine the epidemiological and clinicopathological characteristics involved in SD due to PE in this age group and the underlying risk factors.</div></div><div><h3>Methods</h3><div>Multicenter retrospective noncontrolled study based on forensic autopsies performed in individuals aged 12 to 49 years at 3 forensic pathology services in Spain (Valencia, Biscay, and Seville) over an 8-year period (2010-2017).</div></div><div><h3>Results</h3><div>A total of 1344 cardiac SD cases were recorded, of which 128 (9.5%) were due to PE (57% male, median age 42 years). The annual incidence was 0.56/100 000 inhabitants/y. The main risk factor was obesity (62%; 18.5% morbid obesity). The mean body mass index was 34.9±13.1. Psychiatric disorders were highly prevalent (44%). Immobilization (26%) and prior trauma (11%) were other relevant antecedents. Among women, 22% were receiving oral contraceptive therapy. Premortem symptoms were reported in 52% of cases, mainly dyspnea (56%). Although 22 individuals sought medical attention, only one was correctly diagnosed. Toxicological analysis was performed in 67% of cases, with positive results for psychotropic drugs (20%) and substances of abuse/alcohol (9%).</div></div><div><h3>Conclusions</h3><div>PE is a common cause of SD in individuals younger than 50 years and is frequently clinically underdiagnosed. This study provides evidence supporting a strong association with obesity and psychiatric disorders, which facilitate immobilization, venous stasis, and a prothrombotic state. Forensic studies of SD due to PE offer complementary data to clinical research, revealing risk factors that are underrepresented in clinical cohorts.</div><div>.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 3","pages":"Pages 237-246"},"PeriodicalIF":4.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016421","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}

引用次数: 0

Characterization of hepatic, portal, and renal venous flow patterns by Doppler ultrasound across tricuspid regurgitation grades 多普勒超声在三尖瓣反流等级上对肝脏、门静脉和肾静脉血流模式的表征。

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2026-03-01 Epub Date: 2025-09-02 DOI: 10.1016/j.rec.2025.08.002

Álvaro Rodríguez-Pérez , Carlos Moliner-Abos , David Viladés-Medel , Juan Fernández-Martínez , Josep Mayol-Domingo , Adrián Ruíz-López , Mario Salido , Martín Descalzo , Sandra Pujadas-Olano , Irene Menduiña , Lidia Bos-Real , José A. Parada-Barcia , Manuel Barreiro-Pérez , Ilana Forado-Benatar , Andrea Arenas-Loriente , Rubén Leta-Petracca , Dabit Arzamendi , Chi Hion Pedro Li

Introduction and objectives

Hepatic, portal, and intrarenal venous flows are impaired in significant tricuspid regurgitation (TR), but the impact of massive and torrential TR remains unclear. This study assessed these venous flow patterns across the 5-grade TR classification and their potential as grading markers.

Methods

Patients with TR were prospectively included from 3 centers. Exclusion criteria were admission for heart failure, cirrhosis, and stage V renal disease. TR severity was classified using biplane vena contracta width and 2-dimensional effective regurgitant orifice area. Venous flow patterns (hepatic vein reverse systolic flow, portal pulsatility fraction, monophasic intrarenal flow, and reverse portal and intrarenal systolic flows) were analyzed for each TR grade.

Results

Of the 143 patients (52 grade III, 30 grade IV, 17 grade V TR), worsening TR was associated with progressively abnormal venous flow. Hepatic vein reverse flow had high sensitivity (96%) but lower specificity (73%) for grade III TR and was less useful for grades IV-V. Monophasic intrarenal flow had high specificity (97%) for grade III TR. Portal pulsatility fraction worsened with severity, with cutoffs of ≥ 40% for grade III, ≥ 80% for grade IV, and > 100% for grade V. Reverse portal and intrarenal systolic flows were highly specific for grade V (94% and 97%, respectively).

Conclusions

Increasing TR severity correlates with abnormal hepatic, portal, and intrarenal venous flow patterns, which can be assessed through routine echocardiography.

简介和目的：肝、门静脉和肾内静脉流动在明显的三尖瓣反流（TR）中受损，但大量和剧烈的TR的影响尚不清楚。本研究通过5级TR分类评估了这些静脉流动模式及其作为分级标记的潜力。方法：前瞻性纳入来自3个中心的TR患者。排除标准为心力衰竭、肝硬化和V期肾病。根据双平面静脉收缩宽度和二维有效返流孔面积对TR的严重程度进行分类。分析各TR分级的静脉血流模式（肝静脉收缩反流、门静脉搏动分数、单相肾内血流、门静脉和肾内收缩反流）。结果：143例患者（52例III级TR， 30例IV级TR， 17例V级TR）中，TR恶化与进行性静脉血流异常相关。肝静脉逆流对III级TR的敏感性高（96%），但特异性较低（73%），对IV-V级TR的作用较小。III级TR的单相肾内血流具有高特异性（97%）。门脉搏动分数随严重程度而恶化，III级临界值≥40%，IV级临界值≥80%，V级临界值为100%。V级的门脉反向和肾内收缩血流具有高特异性（分别为94%和97%）。结论：TR严重程度的增加与肝脏、门静脉和肾内静脉血流模式异常相关，可通过常规超声心动图评估。

{"title":"Characterization of hepatic, portal, and renal venous flow patterns by Doppler ultrasound across tricuspid regurgitation grades","authors":"Álvaro Rodríguez-Pérez , Carlos Moliner-Abos , David Viladés-Medel , Juan Fernández-Martínez , Josep Mayol-Domingo , Adrián Ruíz-López , Mario Salido , Martín Descalzo , Sandra Pujadas-Olano , Irene Menduiña , Lidia Bos-Real , José A. Parada-Barcia , Manuel Barreiro-Pérez , Ilana Forado-Benatar , Andrea Arenas-Loriente , Rubén Leta-Petracca , Dabit Arzamendi , Chi Hion Pedro Li","doi":"10.1016/j.rec.2025.08.002","DOIUrl":"10.1016/j.rec.2025.08.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Hepatic, portal, and intrarenal venous flows are impaired in significant tricuspid regurgitation (TR), but the impact of massive and torrential TR remains unclear. This study assessed these venous flow patterns across the 5-grade TR classification and their potential as grading markers.</div></div><div><h3>Methods</h3><div>Patients with TR were prospectively included from 3 centers. Exclusion criteria were admission for heart failure, cirrhosis, and stage V renal disease. TR severity was classified using biplane vena contracta width and 2-dimensional effective regurgitant orifice area. Venous flow patterns (hepatic vein reverse systolic flow, portal pulsatility fraction, monophasic intrarenal flow, and reverse portal and intrarenal systolic flows) were analyzed for each TR grade.</div></div><div><h3>Results</h3><div>Of the 143 patients (52 grade III, 30 grade IV, 17 grade V TR), worsening TR was associated with progressively abnormal venous flow. Hepatic vein reverse flow had high sensitivity (96%) but lower specificity (73%) for grade III TR and was less useful for grades IV-V. Monophasic intrarenal flow had high specificity (97%) for grade III TR. Portal pulsatility fraction worsened with severity, with cutoffs of ≥ 40% for grade III, ≥ 80% for grade IV, and> 100% for grade V. Reverse portal and intrarenal systolic flows were highly specific for grade V (94% and 97%, respectively).</div></div><div><h3>Conclusions</h3><div>Increasing TR severity correlates with abnormal hepatic, portal, and intrarenal venous flow patterns, which can be assessed through routine echocardiography.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 3","pages":"Pages 226-236"},"PeriodicalIF":4.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001549","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}

引用次数: 0

Key messages on subclinical atrial fibrillation from the ARTESiA and NOAH trials ARTESiA和NOAH试验对亚临床心房颤动的关键信息。

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2026-03-01 Epub Date: 2025-09-04 DOI: 10.1016/j.rec.2025.07.010

Juan Benezet-Mazuecos , Jeff S. Healey

引用次数: 0

In-hospital platelet count dynamics in patients with acute coronary syndrome 急性冠状动脉综合征患者住院血小板计数动态。

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista española de cardiología (English ed.)

Pub Date : 2026-03-01 Epub Date: 2025-09-16 DOI: 10.1016/j.rec.2025.09.002

Andrea Zito , Antonio Landi , Andrea Milzi , Enrico Frigoli , Sergio Leonardi , Pascal Vranckx , Arnoud W.J. Vant’Hof , José M. de la Torre Hernández , Gianluca Campo , Ferdinando Varbella , Paolo Calabrò , Giuseppe Andò , Giacomo Boccuzzi , Filippo Russo , Marco Valgimigli

Introduction and objectives

The prognostic role of platelet count dynamics in patients hospitalized with acute coronary syndromes (ACS) remains unclear. This study investigated the implications of platelet counts and their changes in ACS patients, using MATRIX trial data.

Methods

In-hospital relative changes in platelet count were analyzed continuously and were categorized into groups. Associations with 1-year risks of mortality and major or clinically relevant nonmajor bleeding were modelled using Cox regression.

Results

Among 7722 ACS patients, a platelet count drop > 10% occurred in 47.5% of the patients and a platelet count increase > 10% in 6.4%. Platelet count changes showed a U-shaped association with mortality and an L-shaped association with bleeding. Compared with the reference group (from 10% drop to 10% increase; rates: mortality 2.6%, bleeding 6.2%), platelet count drops were associated with an incremental mortality risk of approximately 30% (30%-50% drop: 9.5%; HR, 2.86; 95%CI, 1.93-4.23]; > 50% drop: 21.4% HR, 3.86; 95%CI, 2.21-6.74) and a bleeding risk of approximately 10% (10%-30% drop: 8.2%, HR, 1.34; 95%CI, 1.11-1.61; 30%-50% drop: 13.8%, HR, 2.01; 95%CI, 1.48-2.72; > 50% drop: 32.1%; HR, 4.59; 95%CI, 3.01-6.99). Platelet count increases were associated with an incremental mortality risk of approximately 10% (10%-30% increase: 5.8%; HR, 1.87; 95%CI, 1.18-2.98; 30%-50% increase: 8.5%; HR, 2.61; 95%CI, 1.05-6.44; > 50% increase: 9.7%; HR, 3.51; 95%CI, 1.10-11.22) but not with bleeding.

Conclusion

In ACS patients, platelet count drops were associated with incremental risks of mortality and bleeding, whereas platelet count increases were associated with an incremental risk of mortality but not bleeding.

简介和目的：血小板计数动态在急性冠脉综合征（ACS）住院患者中的预后作用尚不清楚。本研究利用MATRIX试验数据探讨了血小板计数及其在ACS患者中的变化。方法：连续分析住院患者血小板计数的相对变化并进行分组。使用Cox回归对1年死亡风险和重大或临床相关的非重大出血的相关性进行建模。结果：7722例ACS患者中，血小板计数下降10%的占47.5%，血小板计数升高10%的占6.4%。血小板计数变化与死亡率呈u型关系，与出血呈l型关系。与对照组（从10%下降到10%增加；死亡率：2.6%，出血6.2%）相比，血小板计数下降与死亡风险增加约30%相关（30%-50%下降：9.5%；HR, 2.86; 95%CI, 1.93-4.23）； > 50%下降：21.4% HR, 3.86; 95%CI, 2.21-6.74)，出血风险约为10%（10%-30%下降：8.2%，HR, 1.34; 95%CI, 1.11-1.61； 30%-50%下降：13.8%，HR, 2.01; 95%CI, 1.48-2.72; > 50%下降：32.1%；HR, 4.59; 95%CI, 3.01-6.99）。血小板计数增加与死亡风险增加约10%相关（10%-30%增加：5.8%；HR, 1.87; 95%CI, 1.18-2.98； 30%-50%增加：8.5%；HR, 2.61; 95%CI, 1.05-6.44； 50%增加：9.7%；HR, 3.51; 95%CI, 1.10-11.22），但与出血无关。结论：在ACS患者中，血小板计数下降与死亡和出血风险增加相关，而血小板计数增加与死亡风险增加相关，但与出血风险无关。

{"title":"In-hospital platelet count dynamics in patients with acute coronary syndrome","authors":"Andrea Zito , Antonio Landi , Andrea Milzi , Enrico Frigoli , Sergio Leonardi , Pascal Vranckx , Arnoud W.J. Vant’Hof , José M. de la Torre Hernández , Gianluca Campo , Ferdinando Varbella , Paolo Calabrò , Giuseppe Andò , Giacomo Boccuzzi , Filippo Russo , Marco Valgimigli","doi":"10.1016/j.rec.2025.09.002","DOIUrl":"10.1016/j.rec.2025.09.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The prognostic role of platelet count dynamics in patients hospitalized with acute coronary syndromes (ACS) remains unclear. This study investigated the implications of platelet counts and their changes in ACS patients, using MATRIX trial data.</div></div><div><h3>Methods</h3><div>In-hospital relative changes in platelet count were analyzed continuously and were categorized into groups. Associations with 1-year risks of mortality and major or clinically relevant nonmajor bleeding were modelled using Cox regression.</div></div><div><h3>Results</h3><div>Among 7722 ACS patients, a platelet count drop >10% occurred in 47.5% of the patients and a platelet count increase >10% in 6.4%. Platelet count changes showed a U-shaped association with mortality and an L-shaped association with bleeding. Compared with the reference group (from 10% drop to 10% increase; rates: mortality 2.6%, bleeding 6.2%), platelet count drops were associated with an incremental mortality risk of approximately 30% (30%-50% drop: 9.5%; HR, 2.86; 95%CI, 1.93-4.23]; >50% drop: 21.4% HR, 3.86; 95%CI, 2.21-6.74) and a bleeding risk of approximately 10% (10%-30% drop: 8.2%, HR, 1.34; 95%CI, 1.11-1.61; 30%-50% drop: 13.8%, HR, 2.01; 95%CI, 1.48-2.72; >50% drop: 32.1%; HR, 4.59; 95%CI, 3.01-6.99). Platelet count increases were associated with an incremental mortality risk of approximately 10% (10%-30% increase: 5.8%; HR, 1.87; 95%CI, 1.18-2.98; 30%-50% increase: 8.5%; HR, 2.61; 95%CI, 1.05-6.44; >50% increase: 9.7%; HR, 3.51; 95%CI, 1.10-11.22) but not with bleeding.</div></div><div><h3>Conclusion</h3><div>In ACS patients, platelet count drops were associated with incremental risks of mortality and bleeding, whereas platelet count increases were associated with an incremental risk of mortality but not bleeding.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 3","pages":"Pages 257-269"},"PeriodicalIF":4.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087620","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Revista española de cardiología (English ed.)

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀