Archivos de cardiologia de Mexico最新文献

Objective: To estimate the incidence of postoperative delirium (POD) and identify associated factors in adults ≥ 60 years with severe aortic stenosis undergoing surgical (SAVR) or transcatheter (TAVI) aortic valve replacement.

Method: Consecutive, single-center retrospective cohort conducted at a tertiary hospital in Mexico (December 2023-May 2025). POD was defined as a positive Confusion Assessment Method (CAM) documented in the electronic health record, without formal blinding. Descriptive analyses, nonparametric tests, and univariable logistic regression were performed; given the low event frequency, an exploratory parsimonious multivariable model was fitted. Limitations: retrospective design, low number of events-particularly in TAVI-and lack of formal blinding for CAM assessment.

Results: Seventy patients were included (58 SAVR and 12 TAVI). Overall POD incidence was 17.1% (95% CI: 10.1-27.6); SAVR 15.5% (9/58; 95% CI: 8.4-26.9) and TAVI 25.0% (3/12; 95% CI: 8.9-53.2) (p = 0.42). In the penalized (Firth) adjusted model, atrial fibrillation (OR: 11.17; 95% CI: 1.58-79.66; p = 0.038) and infections (OR: 5.03; 95% CI: 1.06-23.11; p = 0.042) were associated with POD. Hyponatremia occurred only among patients with POD.

Conclusions: POD was frequent after SAVR and TAVI. In exploratory penalized analyses, atrial fibrillation and infections were associated with POD, while hyponatremia was observed only among POD cases. These findings support focusing on feasible in-hospital preventive measures.

Cardiogenic shock refers to the reduction in cardiac output caused by myocardial dysfunction, which results in biochemical and clinical manifestations of hypoperfusion. It is mostly due to acute coronary syndromes and less frequently to heart failure. Cardiogenic shock is the most critical state in cardiovascular patients, making timely recognition essential for initiating appropriate treatment. This involves identifying three phases of treatment: rescue, optimization, and weaning off support. The current treatment paradigm involves unloading the left ventricle and providing hemodynamic support, either through medications or ventricular or circulatory assist devices. However, none of these therapies have demonstrated short-term benefits in outcomes. Despite advancements in cardiovascular disease treatment, cardiogenic shock remains highly lethal, so understanding its pathophysiology and current therapeutic options is vital.

Objective: To determine the usefulness of home blood pressure (BP) and heart rhythm monitoring strategies in the detection of subclinical atrial fibrillation (AF) to build a predictive risk score through deep learning.

Methods: Observational, cohort, prospective, multicenter study involving 25 researchers from six Latin American countries. Home BP monitoring and single-lead electrocardiogram (ECG) recording will be performed in a population at moderate-to-high risk of developing AF.

Results: A minimum of twenty 30-s electrocardiographic and BP recordings over 7 days using an Omron Complete Hem-7530 T ECG device will be uploaded from a mobile phone app and then sent to a database for analysis.

Conclusions: The results of this study can provide a simple and accessible home monitoring system for detecting subclinical AF and for optimizing the predictive capacity of arrhythmia risk scores through deep learning. ClinicalTrials.gov identifier: NCT07058831.