Archivos de cardiologia de Mexico最新文献

Objective: To identify principal components that characterize cardiovascular structure across age groups.

Method: Cross-sectional analysis of a secondary database including 3,215 individuals under 18 years. Measurements encompassed left ventricular parameters (diameters, areas, lengths, and wall thicknesses), thoracic aorta (annulus, root, sinotubular junction, ascending aorta, and arch), atrioventricular valves, pulmonary arteries, and coronary arteries. The population was classified into three age strata. Multivariate statistics assessed suitability for factor analysis with KMO and Bartlett tests; principal component analysis using the Kaiser criterion and Varimax rotation identified latent patterns and age-specific sentinel variables.

Results: Sampling adequacy was high in all groups (KMO > 0.86; Bartlett p < 0.001). In children aged 0-5 years, a single component explained > 83% of the variance. In school-age children (6-12 years), five factors explained 71% of the variance. In adolescents (13-17 years), seven independent components accounted for 72%, with high loadings across multiple indicators, indicating progressive complexity and independence among cardiovascular domains with maturation.

Conclusions: The pediatric heart progresses from uniform growth to a differentiated architecture; adolescence marks anatomical specialization of chambers, walls, aorta, pulmonary circulation, and coronary arteries.

Infectious endocarditis is an infection of the endocardium, typically involving the cardiac valves, and that presents with higher incidence in patients with degenerative and congenital valve disorders, prostheses and foreign bodies (e.g. defibrillator and pacemaker leads). Initial assessment include transthoracic echocardiography, however transesophageal echocardiography and other multiplanar imaging modalities may be needed to better delineate the presence of vegetations and other complications. Multidetector computed tomography (MDCT) is particularly useful in detection and assessment of some intracardiac complications including abscesses and pseudoaneurysms. In addition, it also aids in detection of extracardiac complications as a result of pulmonary or systemic embolization, and mycotic aneurysms. In this article, we review the spectrum of MDCT findings observed in patients with infective endocarditis.

Objective: To analyze cardiac dynamics by quantifying heart rate using equiprobable probability theory in order to discriminate between normal and chronic dynamics and to develop predictions of these dynamics.

Method: Fifty 21-hour Holter recordings were evaluated. Based on two prototypes (normal and chronic diagnosis), repetitions of heart rates were taken in a probability space with ranges from 1001 to 2000 and from 2001 to 3000 repetitions. The probability of each repetition was calculated, and the most frequent probabilities in each range were summed. With the remaining tests, a blinded study was conducted, concealing the diagnoses and applying the same methodology; afterwards, the diagnoses were revealed and the probabilities were compared with those obtained in the initial induction. A blinded analysis was performed, calculating sensitivity, specificity, and kappa.

Results: In normal dynamics, the sum of frequent probabilities ranged from 0.35 to 0.46 in the 1001-2000 range and from 0 to 1 in the 2001-3000 range; in chronic dynamics, from 0.35 to 0.48 and from 0.54 to 0.7, respectively. Normal frequencies were located between 55-95 and 65-95; in chronic dynamics, between 65-105 and 65-85. Sensitivity, specificity, and kappa were 1.

Conclusions: The probabilistic analysis of cardiac dynamics made it possible to define probability and frequency ranges that differentiate normal and chronic patterns, are predictive, and constitute an applicable diagnostic support tool.

Coronary flow meter is commonly used in myocardial revascularization surgery since it allows an intraoperative assessment of blood flow through the different bypasses performed, ensuring an optimal result of the surgery. However, in cardiovascular surgery, the measurement of intraoperative arterial flows could be applied in other types of surgery other than coronary surgery. We present the case of a 68 years-old female patient diagnosed with Standford type A dissection who underwent urgent surgery, replacing the ascending aorta and aortic arch with an Evita Open Neo® prosthesis with direct reimplantation of the supra-aortic trunks using the Frozen Elephant Trunk technique. Once the prosthesis was implanted, hemostasis was achieved by reinforcing the end-to-end subclavian artery-prosthesis anastomosis with a circumferential pericardial patch, followed by a decrease in blood pressure observed in the monitorization of the radial artery of the left arm. In this situation, blood flow in the left subclavian artery was measured before and beyond the anastomosis, finding a significant decrease. Given the results of the measurement, the patch wad removed from the anastomosis and a second flow measurement was performed, verifying adequate flow distal from the anastomosis and recovery of blood pressure values in invasive monitoring.

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.