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Amat-Santos IJ, Marengo G, Cortés C, Sánchez-Luna JP, Gonzalez-Gutiérrez JC, Gómez Herrero J, Sanz-Sanchez J, Gutiérrez H, Serrador A, Campo A, Blasco-Turrión S, Gasparini G, San Román JA. Response by Amat-Santos et al to Letter Regarding Article, "Laser Coronary Atherectomy and Polymeric Coronary Wires in Uncrossable Lesions: a Word of Caution". Circ Cardiovasc Interv 2024; 17:e013996. [PMID: 38502724 DOI: 10.1161/circinterventions.124.013996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Ignacio J Amat-Santos
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
| | - Giorgio Marengo
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
| | - Carlos Cortés
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
| | - Juan Pablo Sánchez-Luna
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
| | - Jose Carlos Gonzalez-Gutiérrez
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
| | - Javier Gómez Herrero
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
| | - Jorge Sanz-Sanchez
- Cardiology Department, Hospital Universitari i Politécnic La Fe, Valencia, Spain (J.S.-S.)
| | - Hipólito Gutiérrez
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
| | - Ana Serrador
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
| | - Alberto Campo
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
| | - Sara Blasco-Turrión
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
| | - Gabriele Gasparini
- Cardiology Department, Istituto Clinico Humanitas (IRCCS) Humanitas Research Hospital, Milan, Italy (G.G.)
| | - J Alberto San Román
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (I.J.A.-S., G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R.)
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Marengo G, Cortés C, Sánchez-Luna JP, Gonzalez-Gutiérrez JC, Gómez Herrero J, Sanz-Sanchez J, Gutiérrez H, Serrador-Frutos AM, Campo A, Blasco-Turrión S, Gasparini G, San Román JA, Amat-Santos IJ. Laser Coronary Atherectomy and Polymeric Coronary Wires in Uncrossable Lesions: A Word of Caution. Circ Cardiovasc Interv 2024; 17:e013427. [PMID: 38227700 DOI: 10.1161/circinterventions.123.013427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Affiliation(s)
- Giorgio Marengo
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
| | - Carlos Cortés
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
| | - Juan Pablo Sánchez-Luna
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
| | - Jose Carlos Gonzalez-Gutiérrez
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
| | - Javier Gómez Herrero
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
| | - Jorge Sanz-Sanchez
- Cardiology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain (J.S.-S.)
| | - Hipólito Gutiérrez
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
| | - Ana M Serrador-Frutos
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
| | - Alberto Campo
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
| | - Sara Blasco-Turrión
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
| | - Gabriele Gasparini
- Cardiology Department, Istituto Clinico Humanitas Cancer Center Humanitas Research Hospital, Milan, Italy (G.G.)
| | - J Alberto San Román
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
| | - Ignacio J Amat-Santos
- Cardiology Department, Hospital Clinico Universitario de Valladolid, Spain (G.M., C.C., J.P.S.-L., J.C.G.-G., J.G.H., H.G., A.S., A.C., S.B.-T., J.A.S.R., I.J.A.-S)
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3
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Cortés C, Fernández-Corredoira PM, Liu L, López-Palop R, Rivero F, Jiménez O, Freites A, Goncalves-Ramirez LR, Minguito C, Concepción R, Pérez A, Del Val D, Leithod G, Oberhuber-Kurth J, Amat-Santos IJ, Diarte JA, San Román JA, Ortas Nadal MR, Gutiérrez-Chico JL. Long-term prognostic value of quantitative-flow-ratio-concordant revascularization in stable coronary artery disease. Int J Cardiol 2023; 389:131176. [PMID: 37442350 DOI: 10.1016/j.ijcard.2023.131176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/28/2023] [Accepted: 07/10/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES Confirming the prognostic value of global QFR and evaluating the long-term prognosis of QFR-concordant therapy in stable coronary artery disease. BACKGROUND Wire-based functional evaluation of coronary disease is linked to patient's prognosis. Quantitative Flow Ratio (QFR) is a newer index of computational physiology, linked to clinical outcomes and prognosis at 1 year follow-up. Long-term prognosis of QFR-concordant revascularization in stable coronary artery disease is however unknown hitherto. METHODS Consecutive patients with stable coronary disease undergoing coronary angiography were included. Centralized and blinded QFR analysis of three coronary territories was performed. Three vessel QFR (3vQFR) was defined as the sum of the basal QFR of each coronary territory. QFR-concordant revascularization was met if all significant lesions (QFR ≤ 0.80) were revascularized and all non-significant lesions (QFR > 0.80) were not; otherwise, the case was defined as QFR-discordant revascularization. Patient-oriented composite end-point (POCE) of cardiac death, myocardial infarction and unscheduled revascularization was the primary endpoint. RESULTS A total of 803 patients from six high-volume centers were included. Canadian Cardiovascular Society (CCS) class II angina was the most frequent (48.9%) clinical presentation. Median of follow-up was 68.8 months. 3vQFR was an independent predictor of POCE (HR 1.79 CI95% 1.01-3.18), with 2.75 as optimal cut-off value, irrespective of the therapy received. QFR-discordant revascularization (QFR+/Revascularization- or QFR-/Revascularization+) was an independent predictor of POCE in multivariate analysis (HR 1.65, CI 95% 1.03-2.64). CONCLUSION Global burden of epicardial coronary atherosclerosis, as evaluated by 3vQFR, as well as QFR-discordant therapy are independent predictors of adverse clinical outcome at long-term follow-up in stable coronary artery disease.
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Affiliation(s)
- Carlos Cortés
- Hospital Clínico Universitario de Valladolid, Valladolid, CIBERCV, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain.
| | | | - Lili Liu
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Fernando Rivero
- Department of Cardiology, Hospital Universitario de La Princesa, IIS-IP. Madrid, Spain
| | | | - Alfonso Freites
- Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | | | | | - Ainhoa Pérez
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - David Del Val
- Department of Cardiology, Hospital Universitario de La Princesa, IIS-IP. Madrid, Spain
| | - Gunnar Leithod
- Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | | | - José A Diarte
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - Juan Luis Gutiérrez-Chico
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Bundeswehrzentralkrankenhaus, Koblenz, Germany
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4
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Krasowska D, Gambichler T, Cortés C, Horev A, Compagno N, Dahale SS, Papanastasiou P, Keefe D. Long‐term efficacy, safety, and tolerability of secukinumab in children and adolescents with severe chronic plaque psoriasis: Two‐year results from a Phase
III
double‐blind, randomised controlled trial. J Eur Acad Dermatol Venereol 2023. [PMID: 36971771 DOI: 10.1111/jdv.19063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/08/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Secukinumab has previously demonstrated sustained efficacy and favourable safety for up to 52 weeks in paediatric patients (children and adolescents aged 6 to <18 years) with severe chronic plaque psoriasis (NCT02471144). OBJECTIVE To investigate the long-term (104 weeks) efficacy and safety of secukinumab. METHODS After 52 weeks, patients continued to receive secukinumab low dose (LD [75/150 mg]) or high dose (HD [75/150/300 mg]). Patients on etanercept (0.8 mg/kg) until Week 52 entered follow-up. Data for patients receiving secukinumab LD from the beginning and those switching to secukinumab LD from placebo ('Any secukinumab' LD) and patients receiving secukinumab HD from the beginning and those switching to secukinumab HD from placebo ('Any secukinumab' HD) are presented. ASSESSMENTS Psoriasis Area and Severity Index (PASI) score, PASI (75/90/100) responses, Investigator's Global Assessment modified 2011 (IGA mod 2011) 0/1 response, Children's Dermatology Life Quality Index (CDLQI) score and CDLQI 0/1 response up to Week 104, and, safety up to Week 104 for all patients and up to 4 years for some patients (~320 patient-years [PY] of treatment). RESULTS Secukinumab-treated patients showed sustained PASI 75/90/100 and IGA mod 2011 0/1 responses up to Week 104. Throughout the second year of treatment, efficacy was similar for the 'Any secukinumab' LD and HD groups for PASI 75 and IGA mod 2011 0/1 responses. PASI 90/100 responses were mostly comparable between the dose groups up to Week 88, but higher in the 'Any secukinumab' HD than the 'Any secukinumab' LD group at Week 104. Patients achieved a sustained CDLQI 0/1 response that was similar between the 'Any secukinumab' LD (61.1%) and HD (65.0%) groups. Safety data were consistent with the established safety profile of secukinumab. CONCLUSION Secukinumab demonstrated sustained long-term efficacy (up to 2 years) and a favourable safety profile (~320 PY of treatment) in paediatric patients with severe chronic plaque psoriasis.
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Affiliation(s)
- D Krasowska
- Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - T Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C Cortés
- Department of Dermatology, La Samaritana University Hospital, Dermatology Program National University of Colombia, Pontificia Universidad Javeriana and Los Andes University, Bogotá, Colombia
| | - A Horev
- Pediatric Dermatology Service, Soroka University Medical Centre, Beer Sheva, Israel
| | | | | | | | - D Keefe
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
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5
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García-Guimarães M, Sanz-Ruiz R, Sabaté M, Velázquez-Martín M, Veiga G, Ojeda S, Avanzas P, Cortés C, Trillo-Nouche R, Pérez-Guerrero A, Gutiérrez-Barrios A, Becerra-Muñoz V, Lozano-Ruiz-Poveda F, Pérez de Prado A, Del Val D, Bastante T, Alfonso F. Spontaneous coronary artery dissection and ST-segment elevation myocardial infarction: Does clinical presentation matter? Int J Cardiol 2023; 373:1-6. [PMID: 36435331 DOI: 10.1016/j.ijcard.2022.11.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Some patients with spontaneous coronary artery dissection (SCAD) present as ST-segment-elevation myocardial infarction (STEMI). This study evaluates the characteristics, management and outcomes of SCAD patients presenting as STEMI compared to non-ST-segment elevation myocardial infarction (NSTEMI). METHODS We analysed data from consecutive patients included in the prospective Spanish Registry on SCAD. All coronary angiograms were centrally reviewed. All adverse events were adjudicated by an independent Clinical Events Committee. RESULTS Between June 2015 to December 2020, 389 patients were included. Forty-two percent presented with STEMI and 56% with NSTEMI. STEMI patients showed a worse distal flow (TIMI flow 0-1 38% vs 19%, p < 0.001) and more severe (% diameter stenosis 85 ± 18 vs 75 ± 21, p < 0.001) and longer (42 ± 23 mm vs 35 ± 24 mm, p = 0.006) lesions. Patients with STEMI were more frequently treated with percutaneous coronary intervention (PCI) (31% vs 16%, p < 0.001) and developed more frequently left ventricular systolic dysfunction (21% vs 8%, p < 0.001). No differences were found in combined major adverse events during admission (7% vs 5%, p = 0.463), but in-hospital reinfarctions (5% vs 1.4%, p = 0.039) and cardiogenic shock (2.6% vs 0%, p = 0.019) were more frequently seen in the STEMI group. At late follow-up (median 29 months) no differences were found in the incidence of major adverse cardiac and cerebrovascular events (13% vs 13%, p-value = 0.882) between groups. CONCLUSIONS Patients with SCAD and STEMI had a worse angiographic profile and were more frequently referred to PCI compared to NSTEMI patients. Despite these disparities, both short and long-term prognosis were similar in STEMI and NSTEMI SCAD patients.
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Affiliation(s)
- Marcos García-Guimarães
- Department of Cardiology, Hospital Universitario Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Ricardo Sanz-Ruiz
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Manel Sabaté
- Department of Cardiology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Maite Velázquez-Martín
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Cardiology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Gabriela Veiga
- Department of Cardiology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Soledad Ojeda
- Department of Cardiology, Hospital Universitario Reina Sofía, Córdoba. University of Córdoba, Maimonides Institute for Research in Biomedicine of Córdoba (IMIBIC), Córdoba, Spain
| | - Pablo Avanzas
- Department of Cardiology, Hospital Universitario Central de Asturias, Health Research Institute of Asturias, ISPA, University of Oviedo, Oviedo, Spain
| | - Carlos Cortés
- Department of Cardiology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Ramiro Trillo-Nouche
- Department of Cardiology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - Ainhoa Pérez-Guerrero
- Department of Cardiology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Víctor Becerra-Muñoz
- Department of Cardiology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | | | - David Del Val
- Department of Cardiology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital de la Princesa (IIS-IP), Madrid, Spain
| | - Teresa Bastante
- Department of Cardiology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital de la Princesa (IIS-IP), Madrid, Spain
| | - Fernando Alfonso
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Cardiology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital de la Princesa (IIS-IP), Madrid, Spain.
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Grigorian-Shamagian L, Oteo JF, Gutiérrez-Barrios A, Abdul-Jawad Altisent O, Amat-Santos I, Cisnal AF, Roa J, Arellano Serrano C, Fadeuilhe E, Cortés C, Sanz-Ruiz R, Vázquez-Alvarez ME, Díez Delhoyo F, Tamargo M, Soriano J, Elízaga J, Fernández-Avilés F, Gutiérrez E. Endothelial dysfunction in patients with angina and non-obstructed coronary arteries is associated with an increased risk of mayor cardiovascular events. Results of the Spanish ENDOCOR registry. Int J Cardiol 2023; 370:18-25. [PMID: 36328111 DOI: 10.1016/j.ijcard.2022.10.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/16/2022] [Accepted: 10/28/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Coronary endothelial dysfunction and vasospasm are potential causes of ischemia in patients without obstructive coronary stenoses (INOCA). OBJECTIVE To evaluate the prevalence of endothelial dysfunction and the clinical profile of patients with INOCA in Spain, as well as to identify the predictors and the prognostic impact of endothelial dysfunction in this scenario. METHODS A total of 438 consecutive patients with INOCA in whom the acetylcholine test was performed were prospectively enrolled. Patients were followed up at 1 and 2 years. RESULTS Mean age was 62 ± 11 years with 60% female. Clinical presentation comprised 52.6% angina at rest, 61.2% exertional angina, and 31.7% dyspnea. There were no major complications of the acetylcholine test. Endothelial dysfunction was observed in 198 (45%) of patients, with severe vasoconstriction (defined as over 70% constriction), being observed in 101 (23%). Multivariable regression analysis showed that endothelial dysfunction was predicted by the presence of exertional angina (OR 2.2; CI95%1.01-2.55; p = 0.02), prior coronary disease (OR 2.46; CI95% 1.57-3.89; p < 0.01), and coronary intramyocardial bridging (2.35; CI95% 1.02-5.60; p = 0.04). Patients with endothelial dysfunction presented with worsening angina compared to those without endothelial dysfunction (25.6% vs. 12.8%) and also presented with increased levels of minimal effort angina (40% vs. 26,7%, p = 0.03) more frequently during the follow up than those without endothelial dysfunction. Endothelial dysfunction was also an independent predictor of the occurrence of myocardial infarction or unstable angina at one year (OR 2.85, CI 95% 1.01-9.25; p = 0.03). CONCLUSIONS Endothelial dysfunction is present in almost half of patients with INOCA and is associated with worsening symptoms, as well as with a higher rate of adverse events.
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Affiliation(s)
- Lilian Grigorian-Shamagian
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Spain; Universidad Complutense de Madrid, Spain; Centro de investigación biomédica en red - Enfermedades cardiovasculares (CIBERCV, Instituto de Salud Carlos III, Madrid), Spain
| | | | | | | | - Ignacio Amat-Santos
- Departamento de Cardiología, Hospital Clínico Universitario, Valladolid, Spain
| | | | - Jessica Roa
- Hospital Juan Ramón Jiménez de Huelva, Spain
| | | | | | - Carlos Cortés
- Departamento de Cardiología, Hospital Clínico Universitario, Valladolid, Spain
| | - Ricardo Sanz-Ruiz
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Spain; Universidad Complutense de Madrid, Spain; Centro de investigación biomédica en red - Enfermedades cardiovasculares (CIBERCV, Instituto de Salud Carlos III, Madrid), Spain
| | - María Eugenia Vázquez-Alvarez
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Spain; Universidad Complutense de Madrid, Spain; Centro de investigación biomédica en red - Enfermedades cardiovasculares (CIBERCV, Instituto de Salud Carlos III, Madrid), Spain
| | - Felipe Díez Delhoyo
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Spain; Universidad Complutense de Madrid, Spain; Centro de investigación biomédica en red - Enfermedades cardiovasculares (CIBERCV, Instituto de Salud Carlos III, Madrid), Spain
| | - María Tamargo
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Spain; Universidad Complutense de Madrid, Spain; Centro de investigación biomédica en red - Enfermedades cardiovasculares (CIBERCV, Instituto de Salud Carlos III, Madrid), Spain
| | - Javier Soriano
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Spain; Universidad Complutense de Madrid, Spain; Centro de investigación biomédica en red - Enfermedades cardiovasculares (CIBERCV, Instituto de Salud Carlos III, Madrid), Spain
| | - Jaime Elízaga
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Spain; Universidad Complutense de Madrid, Spain; Centro de investigación biomédica en red - Enfermedades cardiovasculares (CIBERCV, Instituto de Salud Carlos III, Madrid), Spain
| | - Francisco Fernández-Avilés
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Spain; Universidad Complutense de Madrid, Spain; Centro de investigación biomédica en red - Enfermedades cardiovasculares (CIBERCV, Instituto de Salud Carlos III, Madrid), Spain
| | - Enrique Gutiérrez
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Spain; Universidad Complutense de Madrid, Spain; Centro de investigación biomédica en red - Enfermedades cardiovasculares (CIBERCV, Instituto de Salud Carlos III, Madrid), Spain.
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Gutiérrez-Chico JL, Cortés C, Ayoub M, Lauer B, Otto S, Reisbeck B, Reisbeck M, Schulze C, Mashayekhi K. Subintimal shift as mechanism for side-branch occlusion in percutaneous treatment of chronic total occlusions with bifurcation lesions. Cardiol J 2023; 30:24-35. [PMID: 34231874 PMCID: PMC9987534 DOI: 10.5603/cj.a2021.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/04/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of this study was to describe the mechanism of subintimal shift (SIS), standardise diagnostic criteria and sensitise the interventional community to this phenomenon. The treatment of chronic total occlusions (CTO) by means of percutaneous coronary intervention (PCI) is complicated by bifurcation lesions involved in the CTO segment or adjacent to it. Extraplaque expansion of intracoronary devices during CTO PCI may extend the dissection plane over the bifurcation with the consequential side or main branch compression by an intimo-medial flap. This phenomenon is hereby described for the first time and named subintimal shift. METHODS Experienced CTO operators from 3 international high volume centers for CTO PCI retrospectively searched their personal records for paradigmatic cases of SIS, summarising key features and proposing diagnostic criteria. RESULTS The series comprised 7 demonstrative cases, illustrating SIS by intravascular imaging (2 cases) or indirect angiographic signs during CTO PCI (5 cases). Five cases were triggered by stent expansion, 1 by balloon inflation and 1 case was aborted after angiographic warning signs. In 4 cases, SIS resulted in total occlusion of a branch, refractory to ballooning whenever attempted. Four cases required bailout intervention and in 2 cases the branch was left occluded, resulting in a rise of cardiac markers. CONCLUSIONS Subintimal shift is a noteworthy complication in CTO bifurcations, potentially resulting in occlusion of the relevant side or even the main branch. Intracoronary imaging prior to stenting is recommended to understand the tissue planes. Some counterintuitive peculiarities of this phenomenon, like its refractoriness to ballooning, must be known by CTO operators for its efficient resolution.
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Affiliation(s)
- Juan Luis Gutiérrez-Chico
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,CardioCare Heart Center, Marbella, Spain.
| | - Carlos Cortés
- Miguel Servet University Hospital, Zaragoza, Spain.,Hospital Clínico Universitario de Valladolid, Spain
| | - Mohamed Ayoub
- Division of Cardiology and Angiology II, University Heartcenter Freiburg - Bad Krozingen, Jena University Hospital, Jena, Germany
| | | | | | | | | | | | - Kambis Mashayekhi
- Division of Cardiology and Angiology II, University Heartcenter Freiburg - Bad Krozingen, Jena University Hospital, Jena, Germany
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8
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Gutiérrez-Chico JL, Cortés C, Holm NR, Christiansen EH, Lesiak M, Lauer B, Otto S, Lavarra F, Sasi V, Chatzizisis YS, Rathore S, Mashayekhi K. Anatomical classification of chronic total occlusions in coronary bifurcations. Cardiol J 2023; 30:6-11. [PMID: 36510793 PMCID: PMC9987547 DOI: 10.5603/cj.a2022.0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 10/04/2022] [Accepted: 10/19/2022] [Indexed: 12/15/2022] Open
Abstract
Percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) in coronary bifurcation lesions (CBL) is undergoing substantial technical progress and standardization, paralleling the evolution of dedicated devices, tools, and techniques. A standard consensus to classify CTO-CBL might be instrumental to homogenize data collection and description of procedures for scientific and educational purposes. The Medina-CTO classification replicates the classical three digits in Medina classification for bifurcations, representing the proximal main vessel, distal main vessel, and side branch, respectively. Each digit can take a value of 1 if it concerns atherosclerosis and is anatomically stenosed, or 0 if it is not. In addition, the occluded segment(s) of the bifurcation are noted by a subscript, which describes key interventional features of the cap: t (tapered), b (blunt), or a (ambiguous). This approach results in 56 basic categories that can be grouped by means of different elements, depending on the specific needs of each study. Medina-CTO classification, consisting of adding a subscript describing the basic cap characteristics to the totally occluded segment(s) of the standard Medina triplet, might be a useful methodological tool to standardize percutaneous intervention of bifurcational CTO lesions, with interesting scientific and educational applications.
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Affiliation(s)
| | | | | | | | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Bernward Lauer
- Klinik für Innere Medizin I, Universitätsklinikum Jena, Germany
| | - Sylvia Otto
- Klinik für Innere Medizin I, Universitätsklinikum Jena, Germany
| | | | - Viktor Sasi
- Department of Internal Medicine, University of Szeged, Hungary
| | | | - Sudhir Rathore
- Frimley Health NHS Foundation Trust, Camberley, Surrey, United Kingdom
| | - Kambis Mashayekhi
- Division of Cardiology and Angiology II, University Heart Center Freiburg - Bad Krozingen, Germany.,MedClin Heart Center Lahr, Department for Internal Medicine and Cardiology, Lahr, Germany
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9
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Peiro B, Cerdán L, Diarte JA, Ortas MR, Cortés C. Severe hypocalcemia mimicking acute ST-segment elevation myocardial infarction: Paradigmatic case and review of literature. Cardiol J 2022; 29:710-713. [PMID: 35621088 PMCID: PMC9273247 DOI: 10.5603/cj.a2022.0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Belén Peiro
- Miguel Servet University Hospital, Zaragoza, Spain
| | - Luis Cerdán
- Miguel Servet University Hospital, Zaragoza, Spain
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10
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Cortés C, Liu L, Berdin SL, Fernández-Corredoira PM, Zhang R, Schäfer U, López M, Diarte JA, Tu S, Gutiérrez-Chico JL. Agreement between Murray law-based quantitative flow ratio (uQFR) and three-dimensional quantitative flow ratio (3D-QFR) in non-selected angiographic stenosis: A multicenter study. Cardiol J 2022; 29:388-395. [PMID: 35578755 PMCID: PMC9170317 DOI: 10.5603/cj.a2022.0030] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background The agreement between single-projection Murray-based quantitative flow ratio (μQFR) and conventional three-dimensional quantitative flow ratio (3D-QFR) has not been reported hitherto. Methods Patients from a multinational database were randomly selected for the study of agreement, according to sample size calculation. Both conventional 3D-QFR and μQFR were analyzed for all available arteries at a central corelab by independent analysts, blinded to each other’s results. Results Ninety-eight coronary arteries from 35 patients were finally analyzed. Median 3D-QFR was 0.82 (interquartile range 0.78–0.87). The intraclass correlation coefficient for the absolute agreement between 3D-QFR and μQFR was 0.996 (95% confidence interval [CI]: 0.993–0.997); Lin’s coefficient 0.996 (95% CI: 0.993–0.997), without constant or proportional bias (intercept = 0 and slope = 1 in orthogonal regression). As dichotomous variable, there was absolute agreement between μQFR and 3D-QFR, resulting in no single false positive or negative. Kappa index was 1 and the diagnostic accuracy 100%. Conclusions μQFR using a single angiographic projection showed almost perfect agreement with standard 3D-QFR. These results encourage the interchangeable use of μQFR and 3D-QFR, which can be interesting to improve QFR feasibility in retrospective studies, wherein appropriate double angiographic projections might be challenging to obtain.
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Affiliation(s)
| | - Lili Liu
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Scarlet Luisa Berdin
- Bundeswehrkrankenhaus (Federal Army Military Hospital), Hamburg, Germany.,Asklepios Klinik St. Georg (Asklepios St. Georg Clinic), Hamburg, Germany
| | | | - Ruiyan Zhang
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ulrich Schäfer
- Bundeswehrzentralkrankenhaus (Federal Army Central Military Hospital), Koblenz, Germany
| | - María López
- Nursing High School, University of Valladolid, Valladolid, Spain
| | | | - Shengxian Tu
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Juan Luis Gutiérrez-Chico
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Bundeswehrzentralkrankenhaus (Federal Army Central Military Hospital), Koblenz, Germany.
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11
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García-Guimarães M, Fuertes-Ferre G, Jiménez-Valero S, Lozano Í, Cruz-González I, Cortés C, Portero-Portaz JJ, Valero E, Bastante T, Alfonso F. Characteristics, Acute Results, and Prognostic Impact of Percutaneous Coronary Interventions in Spontaneous Coronary Artery Dissection (from the Prospective Spanish Registry on SCAD [SR-SCAD]). Am J Cardiol 2022; 171:177-178. [PMID: 35321804 DOI: 10.1016/j.amjcard.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/13/2022] [Accepted: 02/16/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Marcos García-Guimarães
- Department of Cardiology, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | | | | | - Íñigo Lozano
- Department of Cardiology, Hospital Universitario de Cabueñes, Gijon, Spain
| | - Ignacio Cruz-González
- Department of Cardiology, Hospital Clínico Universitario de Salamanca, Instituto de Investigación Biosanitaria de Salamanca (IBSAL), CIBERCV, Salamanca, Spain
| | - Carlos Cortés
- Department of Cardiology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Ernesto Valero
- Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Teresa Bastante
- Department of Cardiology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), CIBER-CV, Madrid, Spain
| | - Fernando Alfonso
- Department of Cardiology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), CIBER-CV, Madrid, Spain
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12
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Chu M, Cortés C, Liu L, Martínez-Hervás-Alonso MÁ, Reisbeck B, Zhang R, Tu S, Gutiérrez-Chico JL. Comprehensive appraisal of cardiac motion artefact in optical coherence tomography. Cardiol J 2021; 30:543-555. [PMID: 34708865 PMCID: PMC10508074 DOI: 10.5603/cj.a2021.0137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/11/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The relation between cardiac motion artefact (CMA) in optical coherence tomography (OCT) and the phases of cardiac cycle is unclear. METHODS Optical coherence tomography pullbacks containing metallic stents were co-registered with angiography and retrospectively analyzed. The beginning of three phases, namely ejection, rapid-inflow and diastasis, was identified in angiography. Rotation, shortening, elongation and repetition were qualitatively labelled as CMA artefacts. Platforms with coaxial longitudinal connectors (ML8 and Magmaris) entered a quantitative sub-study, consisting of measuring the length of their connector at the beginning of each phase. RESULTS A total of 261 stents (127 patients) were analyzed, including 105 stents for quantitative sub-study. CMA was detected in 61 (23.4%) stents: rotation in 6 (2.3%), shortening in 50 (19.2%), elongation in 51 (19.5%) and repetition in 12 (4.6%). Shortening was always observed during ejection phase, while elongation and repetition were always observed during rapid-inflow. Rotation occurred in both ejection and rapid-inflow phases, while no artefact was reported during diastasis. Longitudinal connectors measured in early ejection phase and in early rapid-inflow phase were shorter and longer, respectively, than those measured in diastasis, irrespective of the presence of CMA in the qualitative assessment. CONCLUSIONS Cardiac motion artefact is prevalent in OCT studies, but shortening and elongation of vascular structures occur during early ejection and during early rapid-inflow, respectively, to a greater or lesser extent in all cases. Diastasis is free of CMA and hence the period in which longitudinal measurements can be more accurately quantified.
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Affiliation(s)
- Miao Chu
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- Cardiology Department, Campo de Gibraltar Health Trust, Algeciras (Cádiz), Spain
| | - Carlos Cortés
- Klinikum Frankfurt (Oder), Frankfurt (Oder), Germany
- Miguel Servet University Hospital, Zaragoza, Spain
| | - Lili Liu
- Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | | | - Bernd Reisbeck
- CardioCare Heart Center, Marbella, Spain
- Cardiology Department, Campo de Gibraltar Health Trust, Algeciras (Cádiz), Spain
| | - Ruiyan Zhang
- Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengxian Tu
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Juan Luis Gutiérrez-Chico
- Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Cardiology Department, Campo de Gibraltar Health Trust, Algeciras (Cádiz), Spain.
- Klinikum Frankfurt (Oder), Frankfurt (Oder), Germany.
- DRK Klinikum Westend, Berlin, Germany.
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13
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Díez-Villanueva P, García-Guimaraes M, Sanz-Ruiz R, Roura G, Macaya F, Barahona Alvarado JC, Tizón-Marcos H, Flores-Ríos X, Masotti M, Lezcano-Pertejo C, Cortés C, Fuertes-Ferre G, Becerra-Muñoz VM, Lozano Ruiz-Poveda F, Valero E, Portero-Portaz JJ, Vera A, Salamanca J, Alfonso F. Spontaneous coronary artery dissection in old patients: clinical features, angiographic findings, management and outcome. Eur Heart J Acute Cardiovasc Care 2021; 10:926-932. [PMID: 33620451 DOI: 10.1093/ehjacc/zuaa029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/20/2020] [Accepted: 10/29/2020] [Indexed: 06/12/2023]
Abstract
AIMS Spontaneous coronary artery dissection (SCAD) is a relatively rare but well-known cause of acute coronary syndrome. Clinical features, angiographic findings, management and outcomes of SCAD in old patients (>65 years of age) remain unknown. METHODS AND RESULTS The Spanish multicentre prospective SCAD registry (NCT03607981), included 318 consecutive patients with SCAD. Data were collected between June 2015 and April 2019. All angiograms were analysed in a centralized corelab. For the purposes of this study, patients were classified according to age in two groups <65 and ≥65 years old and in-hospital outcomes were analysed. Fifty-five patients (17%) were ≥65 years old (95% women). Older patients had more often hypertension (76% vs. 29%, P < 0.01) and dyslipidaemia (56% vs. 30%, P < 0.01), and less previous (4% vs. 18%, P < 0.001) or current smoking habit (4% vs. 33%, P < 0.001). An identifiable trigger was less often present in old patients (27% vs. 43%, P = 0.028). They also had more often severe coronary tortuosity (36% vs. 11%, P = 0.036) and showed more frequently coronary ectasia (24% vs. 9%, P < 0.01). Older patients were more often managed conservatively (89% vs. 75%, P = 0.025), with no significant differences in major adverse cardiac events during index admission (7% vs. 8%, P = 0.858). There were no differences between groups in terms of in-hospital stay, new acute myocardial infarction, unplanned coronary angiography or heart failure. CONCLUSION Older patients with SCAD show different clinical and angiographic characteristics compared with younger patients. Initial treatment strategy was different between groups, though in-hospital outcomes do not significantly differ (NCT03607981).
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Affiliation(s)
| | - Marcos García-Guimaraes
- Servicio de Cardiología, Hospital del Mar - Parc de Salut Mar, Barcelona, Grupo de Investigación Biomédica en Enfermedades del Corazón, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Ricardo Sanz-Ruiz
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Madrid, Spain
| | - Gerard Roura
- Servicio de Cardiología, Hospital Universitari de Bellvitge, ĹHospitalet de Llobregat, Barcelona, Spain
| | - Fernando Macaya
- Servicio de Cardiología, Hospital Clínico San Carlos, IdISSC and Universidad Complutense de Madrid, Madrid, Spain
| | | | - Helena Tizón-Marcos
- Servicio de Cardiología, Hospital del Mar - Parc de Salut Mar, Barcelona, Grupo de Investigación Biomédica en Enfermedades del Corazón, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Xacobe Flores-Ríos
- Servicio de Cardiología, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Mónica Masotti
- Servicio de Cardiología, Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - Carlos Cortés
- Servicio de Cardiología, Hospital San Pedro de Logroño, Logroño, Spain
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Víctor Manuel Becerra-Muñoz
- Unidad de Gestión Clínica Área del Corazón, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Málaga, Spain
| | | | - Ernesto Valero
- Servicio de Cardiología, Hospital Clínico de Valencia, Valencia, Spain
| | | | - Alberto Vera
- Servicio de Cardiología, Hospital Universitario La Princesa, Madrid, Spain
| | - Jorge Salamanca
- Servicio de Cardiología, Hospital Universitario La Princesa, Madrid, Spain
| | - Fernando Alfonso
- Servicio de Cardiología, Hospital Universitario La Princesa, Madrid, Spain
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14
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Cortés C. Steady Advance Toward Fully Percutaneous Treatment for Multivalvular Heart Disease. JACC Cardiovasc Interv 2021; 13:2792-2794. [PMID: 33303118 DOI: 10.1016/j.jcin.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 08/04/2020] [Indexed: 10/22/2022]
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15
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Cortés C, Rivero F, Gutiérrez-Ibañes E, Aparisi Á, San Román JA, Amat-Santos IJ. Validación prospectiva y comparación de los nuevos índices de evaluación de las estenosis coronarias: resting full-cycle y quantitative flow ratio. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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16
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Jesús S, Periñán MT, Cortés C, Buiza-Rueda D, Macías-García D, Adarmes A, Muñoz-Delgado L, Labrador-Espinosa MÁ, Tejera-Parrado C, Gómez-Garre MP, Mir P. Integrating genetic and clinical data to predict impulse control disorders in Parkinson's disease. Eur J Neurol 2020; 28:459-468. [PMID: 33051953 DOI: 10.1111/ene.14590] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/01/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Impulse control disorders (ICDs) are frequent in Parkinson's disease (PD), with associated clinical and genetic risk factors. This study was aimed at analyzing the clinical features and the genetic background that underlie ICDs in PD. METHODS We included 353 patients with PD in this study (58.9% men, mean age 62.4 ± 10.58 years, mean age at disease onset 52.71 ± 11.94 years). We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease for ICDs screening. Motor, nonmotor, and treatment-related features were evaluated according to the presence of ICDs. Twenty-one variants related to dopaminergic, serotonergic, glutamatergic, and opioid neurotransmitter systems were assessed. Association studies between polymorphisms and ICDs were performed. The combination of clinical and genetic variables was analyzed with receiver operating characteristic curves to assess the predictability of experiencing ICDs. RESULTS Impulse control disorders appeared in 25.1% of the cases. Patients with ICDs were younger and presented a higher rate of anxiety. Treatment with dopamine agonists increased the risk of ICDs and it was dose dependent (P < 0.05). Genetic association studies showed that the DOPA decarboxylase gene (DDC), rs1451375, might modulate the risk of ICDs. Plotting the clinical-genetic model, the predictability of ICDs increased 11% (area under curve = 0.80; z = 3.22, P = 0.001) when adding the genotype data for single nucleotide polymorphisms. CONCLUSIONS Polymorphisms in DDC might act as risk markers for ICDs in PD. The predictability of experiencing ICDs increased by adding genetic factors to clinical features. It is therefore important to assess the patient's genetic background to identify individuals at risk for ICDs.
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Affiliation(s)
- S Jesús
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - M T Periñán
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - C Cortés
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain
| | - D Buiza-Rueda
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - D Macías-García
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - A Adarmes
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - L Muñoz-Delgado
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain
| | - M Á Labrador-Espinosa
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - C Tejera-Parrado
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain
| | - M P Gómez-Garre
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - P Mir
- Movement Disorders Unit, Department of Neurology and Clinical Neurophysiology/Institute of Biomedicine of Seville, University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
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17
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Cortés C, Johnson TW, Silber S, Buszman PP, Poerner TC, Lavarra F, Ibáñez B, Kim Y, Mischke K, Jaguszewski M, Gutiérrez-Chico JL. ISCHEMIA trial: The long-awaited evidence to confirm our prejudices. Cardiol J 2020; 27:336-341. [DOI: 10.5603/cj.2020.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 11/25/2022] Open
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18
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Jurado-Román A, Rodríguez O, Amat I, Romani SA, García-Touchard A, Cruz-González I, Benito-González T, Fernández-Cisnal A, Córdoba-Soriano JG, Subinas A, Hernández-Antolín R, Bayón J, García-Tejada J, Salinas P, Cortés C, Lozano F, Bastante T, Núñez-Gil IJ, Moreno R, López-Sendón JL. Clinical Outcomes After Implantation of Polyurethane-Covered Cobalt-Chromium Stents: Insights from the Papyrus-Spain Registry. Cardiovasc Revasc Med 2020; 29:22-28. [PMID: 32859538 DOI: 10.1016/j.carrev.2020.08.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/17/2020] [Accepted: 08/10/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND/PURPOSE The main indication of covered stents (CS) is coronary artery perforation (CAP), but, they have been increasingly used in other scenarios. Data on the long-term follow-up of CS is limited, and no studies have been conducted specifically using new-generation polyurethane-covered cobalt-chromium Papyrus CS. PURPOSE to evaluate the clinical outcomes after hospital discharge of Papyrus CS and to compare their outcome after implantation in CAP or coronary artery aneurysms (CAA). METHODS/MATERIALS We evaluated the baseline clinical characteristics, lesion subsets, procedural features and the outcomes after initial discharge of Papyrus CS implanted in 17 high-PCI-volume centers. RESULTS 127 Papyrus CS were implanted in 108 patients (68 ± 1 years; 82.8% male) admitted for stable coronary disease (32.3%), NSTEMI (42.4%) or STEMI (25.3%). The number of CS per patient was 1.2 ± 0.6 (diameter: 3.5 ± 1.7 mm; length: 18.5 ± 3.7 mm). Angiographic success rate was 96%. CS diameter was larger in CAA (CAP:3.04 ± 0.5 mm vs CAA:4.1 ± 2.7 mm; p = .022). Intracoronary imaging techniques were used more frequently in CAA (p < .0001). After a mean follow-up of 22 ± 16 months, the major cardiovascular adverse events (MACE) rate was 7.1% [cardiac death: 2%, Myocardial infarction: 5%, Target Lesion Revascularization: 5% and Stent Thrombosis (ST): 3%]. MACE rate was similar in CAP (7.7%) and CAA (7.1%) (p = .9). However, CAA showed a higher ST rate (CAP: 0% vs CA: 7.1%; p = .04). CONCLUSION After hospital discharge, clinical outcomes after Papyrus CS implantation are acceptable (considering the clinical scenario and compared with other treatment alternatives) with no significant differences in the MACE rate between those implanted in CAA or in CAP. However, CAA group showed a higher ST rate.
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Affiliation(s)
| | - Oriol Rodríguez
- Cardiology Department, Germans Trias I Pujol Hospital, Badalona, Spain
| | - Ignacio Amat
- Cardiology Department, Hospital Clínico de Valladolid, Spain
| | | | | | | | | | | | | | - Asier Subinas
- Cardiology Department, University Hospital Galdakao, Spain
| | | | - Jeremías Bayón
- Cardiology Department, University Hospital Lucus Augusti, Lugo, Spain
| | | | - Pablo Salinas
- Cardiology Department, University Hospital Clínico San Carlos, Madrid, Spain
| | - Carlos Cortés
- Cardiology Department, Hospital San Pedro de Logroño, Logroño, Spain
| | - Fernando Lozano
- Cardiology Department, University Hospital of Ciudad Real, Ciudad Real, Spain
| | - Teresa Bastante
- Cardiology Department, University Hospital La Princesa, Madrid, Spain
| | - Iván J Núñez-Gil
- Cardiology Department, University Hospital Clínico San Carlos, Madrid, Spain
| | - Raúl Moreno
- Cardiology Department, La Paz University Hospital, Madrid, Spain
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19
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Cortés C, Rivero F, Gutiérrez-Ibañes E, Aparisi Á, San Román JA, Amat-Santos IJ. Prospective validation and comparison of new indexes for the assessment of coronary stenosis: resting full-cycle and quantitative flow ratio. ACTA ACUST UNITED AC 2020; 74:94-97. [PMID: 32792309 DOI: 10.1016/j.rec.2020.05.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/12/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Carlos Cortés
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Instituto de Ciencias del Corazón (ICICOR), Valladolid, Spain; Servicio de Cardiología, Hospital de San Pedro, Logroño, Spain.
| | - Fernando Rivero
- Servicio de Cardiología, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Enrique Gutiérrez-Ibañes
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III, Madrid, Spain
| | - Álvaro Aparisi
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Instituto de Ciencias del Corazón (ICICOR), Valladolid, Spain
| | - José A San Román
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Instituto de Ciencias del Corazón (ICICOR), Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Ignacio J Amat-Santos
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Instituto de Ciencias del Corazón (ICICOR), Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
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20
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Fierro A, Cortés C, Eguibar J. 0249 Effects of Alcohol Consumption on Sleep-Wake Pattern of a Rat Model of Anxiety. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Anxiety is an important factor for self-administered alcohol as a tool to reduce its symptoms. However, alcohol is capable to disrupt sleep-wake patterns in subjects with medium- to high-alcohol consumption. We have selectively bred two sublines from Sprague-Dawley rats that differ on its yawning frequency. High-yawning (HY) rats have a mean of 20 yawns/h, whereas the Low-yawning (LY) rats have only 2 yawns/hour. LY rats also showed anxious responses when evaluated on standardized tests. The aim of this study was to assess the changes on sleep-wake patterns after chronic alcohol consumption.
Methods
We used 8 males from HY and LY sublines at 3 months of age, they lived in acrylic cages with water and food pellets available ad libitum under a 12:12 light-dark cycle (lights on at 0700) and temperature of 21±1 °C. All subjects were implanted to record EEG, EMG and EOG to characterize sleep-wake phases. A baseline sleep-wake recording was obtained for 24 h. A solution of 9.6% alcohol was administered as a single source of hydration for seven days and then a second sleep-wake recording was obtained. After that period, an additional bottle containing purified water was available. Position of the bottles was randomly changed daily. Water and alcohol consumption were measured daily for a period of 3 weeks and then a third sleep-wake recording was obtained.
Results
LY rats consumed more alcohol than HY rats (P<0.05), and they had an increase of bouts and duration of slow wave sleep and REM sleep on their active phase after alcohol administration (P<0.05).
Conclusion
LY rats display an anxious behavior and therefore consumed more alcohol compared to HY rats, and only LY rats were susceptible to alcohol effects on sleep on their active phase.
Support
Partially supported by CONACYT grants 243333 and 243247 to CC and JRE, respectively. Grants from VIEP-BUAP 2018 and CA in Neuroendocrinología BUAP-CA-288.
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Affiliation(s)
- A Fierro
- Institute of Physiology, Puebla, MEXICO
| | - C Cortés
- Institute of Physiology, Puebla, MEXICO
| | - J Eguibar
- Research Office, VIEP, Puebla, MEXICO
- Institute of Physiology, Puebla, MEXICO
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21
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Cortés C, Carrasco‐Moraleja M, Aparisi A, Rodriguez‐Gabella T, Campo A, Gutiérrez H, Julca F, Gómez I, San Román JA, Amat‐Santos IJ. Quantitative flow ratio—Meta‐analysis and systematic review. Catheter Cardiovasc Interv 2020; 97:807-814. [DOI: 10.1002/ccd.28857] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 02/19/2020] [Accepted: 03/07/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Carlos Cortés
- Department of Cardiology Hospital Clínico Universitario de Valladolid Valladolid Spain
- Department of Cardiology Hospital San Pedro de Logroño Logroño Spain
| | | | - Alvaro Aparisi
- Department of Cardiology Hospital Clínico Universitario de Valladolid Valladolid Spain
| | | | - Alberto Campo
- Department of Cardiology Hospital Clínico Universitario de Valladolid Valladolid Spain
| | - Hipolito Gutiérrez
- Department of Cardiology Hospital Clínico Universitario de Valladolid Valladolid Spain
| | - Fabián Julca
- Department of Cardiology Hospital Clínico Universitario de Valladolid Valladolid Spain
| | - Itziar Gómez
- CIRBERCV Hospital Clínico Universitario de Valladolid Valladolid Spain
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22
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Catalá P, Amat-Santos IJ, Carrasco-Moraleja M, Aparisi Á, Cortés C, San Román JA. El Multivalvular Score para predecir la evolución de la insuficiencia mitral en pacientes con estenosis aórtica tratados con TAVI: validación prospectiva. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2018.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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23
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Gutiérrez-Chico JL, Cortés C, Jaguszewski M, Schincariol M, Amat-Santos IJ, Franco-Peláez JA, Żuk G, Ciećwierz D, Wojakowski W, Navarro F, Tu S, Ibáñez B. A simplified formula to calculate fractional flow reserve in sequential lesions circumventing the measurement of coronary wedge pressure: The APIS-S pilot study. Cardiol J 2019; 26:310-321. [PMID: 31257567 DOI: 10.5603/cj.a2019.0067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 05/04/2019] [Accepted: 06/24/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND A simplified formula to calculate the predicted fractional flow reserve (FFR) in sequen-tial coronary stenosis without balloon inflation is hereby proposed. METHODS In patients with an indication for FFR and sequential coronary stenosis, FFR was recorded distally and between the lesions. The predicted FFR for each stenosis was calculated with a novel formu-la. While treating one of the lesions, wedge pressure was measured during balloon inflation to calculate Pijls' formula. FFR of the remaining lesion was finally recorded (measured FFR). RESULTS Forty patients were enrolled in the study, 4 (10.0%) had a distal FFR > 0.80 and were excluded from the main analysis. In the remaining 36 patients, the novel formula and Pijls' formula showed virtually absolute agreement (ICCa 0.999, R2 = 0.997 for the proximal lesion, R2 = 0.999 for the distal lesion, kappa 1.000, Se 100%, Sp 100%). The agreement between predicted and measured FFR was good (ICCa 0.820; 0.640-0.909, R2 = 0.717, intercept = 0.05, slope = 0.92, kappa 0.748, Se 75%, Sp 96%). In 19 (47.5%) cases the use of the formula enabled the operator to freely decide which lesion should be treated first, an option not available if the percutaneous coronary intervention (PCI) were guided by the largest pressure drop across each lesion. CONCLUSIONS The predicted FFR for each lesion in sequential coronary stenosis can be accurately calculated by a simplified formula circumventing the need for balloon inflation. This approach provides the operator upfront, with detailed information on physiology, thus having a potentially high impact on the corresponding PCI strategy.
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Affiliation(s)
- Juan Luis Gutiérrez-Chico
- Klinikum Frankfurt (Oder), Interventional Cardiology, Germany. .,Institute of Cardiovascular Translational Research of Atlantic (ICTRA), Berlin, Germany. .,DRK-Klinikum Westend, Berlin, Germany.
| | - Carlos Cortés
- Klinikum Frankfurt (Oder), Interventional Cardiology, Germany.,CIBERCV Hospital Clínico Universitario de Valladolid, ICICOR, Spain
| | - Miłosz Jaguszewski
- Klinikum Frankfurt (Oder), Interventional Cardiology, Germany.,Institute of Cardiovascular Translational Research of Atlantic (ICTRA), Berlin, Germany.,First Department of Cardiology, Medical University of Gdansk, Poland
| | - Michele Schincariol
- Institute of Cardiovascular Translational Research of Atlantic (ICTRA), Berlin, Germany
| | | | | | - Grzegorz Żuk
- First Department of Cardiology, Medical University of Gdansk, Poland
| | - Dariusz Ciećwierz
- First Department of Cardiology, Medical University of Gdansk, Poland
| | | | - Felipe Navarro
- IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - Shengxian Tu
- Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Borja Ibáñez
- IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain.,CIBERCV, Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
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24
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Cortés C, Rodríguez-Gabella T, Gutiérrez H, Arnold R, María Serrador A, Ramos B, Catalá P, Aparisi Á, Hinojosa W, Gómez I, Carrasco Moraleja M, Gutiérrez-Chico JL, San Román JA, Amat-Santos IJ. <i>Quantitative flow ratio</i> en infarto de miocardio para la evaluaci�n de lesiones en arterias no culpables. Estudio piloto QIMERA. RECIC 2019. [DOI: 10.24875/recic.m19000017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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25
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Cortés C, Jaguszewski M, Gutiérrez-Chico JL. [Inferior ST elevation: beyond myocardial infarction]. Emergencias 2019; 29:435. [PMID: 29227057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Carlos Cortés
- Klinikum Frankfurt (Oder), Interventional Cardiology, Alemania. Hospital Clínico Universitario de Valladolid, ICICOR, España
| | - Milosz Jaguszewski
- Klinikum Frankfurt (Oder), Interventional Cardiology, Alemania. Institute of Cardiovascular Translational Research of Atlantic (ICTRA), Berlin, Alemania
| | - Juan Luis Gutiérrez-Chico
- Klinikum Frankfurt (Oder), Interventional Cardiology, Alemania. Institute of Cardiovascular Translational Research of Atlantic (ICTRA), Berlin, Alemania
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26
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Catalá P, Amat-Santos IJ, Carrasco-Moraleja M, Aparisi Á, Cortés C, San Román JA. The Multivalvular Score for Predicting the Outcome of Mitral Regurgitation in Aortic Stenosis Patients Treated With TAVI: Prospective Validation. ACTA ACUST UNITED AC 2018; 72:781-783. [PMID: 30514658 DOI: 10.1016/j.rec.2018.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/05/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Pablo Catalá
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Ignacio J Amat-Santos
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
| | - Manuel Carrasco-Moraleja
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Álvaro Aparisi
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Carlos Cortés
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - José A San Román
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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27
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Gutiérrez-Chico JL, Cortés C, Schincariol M, Jaguszewski M. A formula to calculate the contrast volume required for optimal imaging quality in optical coherence tomography with non-occlusive technique. Cardiol J 2018; 25:574-581. [PMID: 30246237 DOI: 10.5603/cj.a2018.0112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 08/13/2018] [Accepted: 09/11/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Non-occlusive technique is universally accepted for acquisition of coronary optical coherence tomography (OCT), but the amount of contrast infused is still inconsistently calculated. Proposed herein, is an empirical formula for accurate contrast volume calculation. METHODS In an observational prospective study, contrast volume of consecutive patients undergoing OCT was either calculated with formula, or eyeballed based on manufacturer recommendations. The quality of pullback, defined as % of high quality cross-sections (CS) in the segment of interest (SOI), was analyzed by two independent operators and compared between groups, together with the amount of contrast per pullback. RESULTS Sixty patients (115 pullbacks, 4252 CS) were imaged using the formula, vs. 18 patients (22 pullbacks, 777 CS) eyeballing the contrast volume. The formula group used 18 mm/s as pullback speed more often (82.6% vs. 40.9%, p = 0.0001), but there were no significant differences between groups in SOI length or vessel imaged. The formula resulted in higher pullback quality than eyeballing (96.55% vs. 63.55%, p < 0.0001), interobserver agreement Kappa 0.903 (p < 0.0001), and tended to use less contrast per pullback than the eyeball group (13.03 mL vs. 14.55 mL, p = 0.057). After adjusting for pullback speed, SOI length and vessel in multivariate linear regression, the use of the formula significantly reduced the amount of contrast in 4.50 mL on average. CONCLUSIONS Optical coherence tomography acquisition with the non-occlusive technique can be substantially eased with the use of a novel formula to calculate the contrast volume required. This method optimises the quality of the images whilst reducing the amount of contrast per pullback.
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Affiliation(s)
- Juan Luis Gutiérrez-Chico
- Klinikum Frankfurt (Oder), Interventional Cardiology, Germany, Frankfurt/O, Germany; Institute for Cardiovascular Translational Research of the Atlantic, ICTRA, Berlin, Germany.
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28
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Goncalves-Ramírez LR, Gutiérrez H, Cortés C, Gómez I, San Román JA, Amat-Santos IJ. Functional and Structural Coronary Recovery at the 5-year Follow-up After Bioresorbable Vascular Scaffold Implantation. An Optical Coherence Tomography Analysis. ACTA ACUST UNITED AC 2018; 72:357-359. [PMID: 30905344 DOI: 10.1016/j.rec.2018.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 04/02/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Luis R Goncalves-Ramírez
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario, Valladolid, Spain.
| | - Hipólito Gutiérrez
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario, Valladolid, Spain; Hemodinámica y Cardiología Intervencionista, Instituto de Ciencias del Corazón, Hospital Clínico Universitario, Valladolid, Spain
| | - Carlos Cortés
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario, Valladolid, Spain
| | - Itziar Gómez
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario, Valladolid, Spain
| | - José A San Román
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario, Valladolid, Spain; Hemodinámica y Cardiología Intervencionista, Instituto de Ciencias del Corazón, Hospital Clínico Universitario, Valladolid, Spain
| | - Ignacio J Amat-Santos
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario, Valladolid, Spain; Hemodinámica y Cardiología Intervencionista, Instituto de Ciencias del Corazón, Hospital Clínico Universitario, Valladolid, Spain
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29
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Amat-Santos IJ, Cortés C, Nombela Franco L, Muñoz-García AJ, Suárez De Lezo J, Gutiérrez-Ibañes E, Serra V, Larman M, Moreno R, De La Torre Hernandez JM, Puri R, Jimenez-Quevedo P, Hernández García JM, Alonso-Briales JH, García B, Lee DH, Rojas P, Sevilla T, Goncalves R, Vera S, Gómez I, Rodés-Cabau J, San Román JA. Prosthetic Mitral Surgical Valve in Transcatheter Aortic Valve Replacement Recipients: A Multicenter Analysis. JACC Cardiovasc Interv 2018; 10:1973-1981. [PMID: 28982562 DOI: 10.1016/j.jcin.2017.07.045] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The aim of this study was to determine the prognosis and specific complications of patients with prosthetic mitral valves (PMVs) undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND TAVR is performed relatively often in patients with PMVs, but specific risks are not well described. METHODS A multicenter analysis was conducted, including patients with severe symptomatic aortic stenosis who underwent TAVR at 10 centers. Patients' clinical characteristics and outcomes were evaluated according to the presence of a PMV. RESULTS The mean age of the study population (n = 2,414) was 81 ± 8 years, and 48.8% were men. A total of 91 patients (3.77%) had PMVs. They were more commonly women, younger, and had higher surgical risk. PMVs were implanted a median of 14 years before TAVR, and most patients had mechanical prostheses (73.6%). Eighty-six patients (94.5%) were on long-term vitamin K inhibitor therapy, and bridging antithrombotic therapy was administered in 59 (64.8%). TAVR device embolization occurred in 6.7% (vs. 3.3% in the non-PMV group; p = 0.127), in all instances when distance between the PMV and the aortic annulus was <7 mm. Mortality rates did not show a difference, but the rate of bleeding was higher in patients with PMV (24.2% vs. 16.1%; p = 0.041), even in those treated via the transfemoral approach (22.2% vs. 13.9%; p = 0.048). Indeed, bleeding complications, prior atrial fibrillation, chronic obstructive pulmonary disease, surgical risk, and New York Heart Association functional class were independent predictors of mortality. CONCLUSIONS TAVR presents similar mortality irrespective of the presence of a PMV. However, patients with PMVs had higher bleeding risk that was independently associated with higher mortality. Risk for valve embolization was relatively high, but it occurred only in patients with PMV-to-aortic annulus distances <7 mm.
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Affiliation(s)
| | - Carlos Cortés
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | | | | | | | | | - Vicenç Serra
- Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | | | - Raúl Moreno
- Hospital Universitario La Paz, Madrid, Spain
| | | | - Rishi Puri
- Institute Universitaire de Cardiologie et Pneumologie de Quebec, Ville de Québec, Québec, Canada; Department of Medicine, University of Adelaide, Australia; Cleveland Clinic Coordinating Center for Clinical Research, Cleveland, Ohio
| | | | | | | | - Bruno García
- Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Dae-Hyun Lee
- Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - Paol Rojas
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | - Teresa Sevilla
- CIBERCV, Hospital Clínico Universitario, Valladolid, Spain
| | | | - Silvio Vera
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | - Itziar Gómez
- CIBERCV, Hospital Clínico Universitario, Valladolid, Spain
| | - Josep Rodés-Cabau
- Institute Universitaire de Cardiologie et Pneumologie de Quebec, Ville de Québec, Québec, Canada
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Gutiérrez-Chico JL, Cortés C, Schincariol M, Limon U, Yalcinli M, Durán-Cortés MA, Jaguszewski M. Implantation of bioresorbable scaffolds under guidance of optical coherence tomography: Feasibility and pilot clinical results of a systematic protocol. Cardiol J 2018; 25:443-458. [PMID: 29774520 DOI: 10.5603/cj.a2018.0055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 05/10/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Herein is hypothesised that a comprehensive optical coherence tomography (OCT)-guided implantation protocol for bioresorbable scaffolds (BRS) can improve expansion and apposition, thus resulting in better clinical outcomes, particularly in reducing thrombotic events. METHODS Patients considered suitable for BRS therapy in de novo coronary lesions underwent OCT. The predominant type of plaque was classified as lipidic, fibrous or calcific. Accordingly they underwent tailored plaque preparation. After proper sizing, BRS was deployed and final OCT was acquired. Post-dilation was performed only in cases of suboptimal deployment. Procedural and 12 month clinical follow-up is reported. RESULTS Twenty nine patients (41 lesions) who were considered clinically and angiographically suitable for BRS were enrolled, including challenging clinical scenarios such as ST-segment elevation myocardial infarction or CTOs. The OCT-guided protocol was feasible in 90.2% of the lesions: 14 (37.8%) lipidic, 11 (29.7%) fibrous, and 12 (32.4%) calcific. Three (8%) lesions classified as calcific were changed to treatment with metallic stent. BRS were implanted in 34 (91.9%) lesions, thereof 30 (88.2%) with optimal deployment in OCT. One (3.6%) periprocedural MI occurred, resulting in 3.6% target vessel failure and 0% scaffold thrombosis of any kind after a 12 month follow-up. CONCLUSIONS OCT-guided BRS implantation is feasible in 90.2% of de novo lesions and results in optimal expansion and apposition, correlating with 3.6% incidence of target vessel failure and 0% scaffold thrombosis at 12 m follow-up, probably due to better selection of lesions amenable for BRS treatment and to a possibility of tailoring intervention to the type of plaque. These encouraging pilot results require confirmation in larger clinical studies.
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Affiliation(s)
- Juan Luis Gutiérrez-Chico
- Klinikum Frankfurt (Oder), Interventional Cardiology, Germany, Frankfurt/O, Germany; Institute of Cardiovascular Translation Research of the Atlantic (ICTRA), Berlin, Germany.
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Cortés C, Jaguszewski M, Schincariol M, Durán-Cortés MA, Limon U, Gutiérrez-Chico JL. Dislodgement of a magnesium bioresorbable scaffold from the delivery system in the left main: A true "nightmaris". Cardiol J 2018; 24:700-701. [PMID: 29297580 DOI: 10.5603/cj.2017.0144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 05/28/2017] [Accepted: 07/13/2017] [Indexed: 11/25/2022] Open
Affiliation(s)
| | | | | | | | | | - Juan Luis Gutiérrez-Chico
- Institute of Cardiovascular Translational Research of Atlantic (ICTRA), Berlin, Germany; Klinikum Frankfurt (Oder), Interventional Cardiology, Germany, Frankfurt/O, Germany.
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Muñoz-de-la-Torre LP, Eguibar JR, Cortés C, Ugarte A, Trujillo A. Follicular Development and Secretion of Ovarian Hormones during the Juvenile and Adult Reproductive Lives of the Myelin Mutant taiep Rat: An Animal Model of Demyelinating Diseases. Int J Endocrinol 2018; 2018:5718782. [PMID: 30363667 PMCID: PMC6180977 DOI: 10.1155/2018/5718782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/26/2018] [Accepted: 08/05/2018] [Indexed: 11/18/2022] Open
Abstract
Infertility and reproductive problems have been reported in women with several neurological disorders, for example, demyelination. However, the physiology of such problems has remained unknown so far. The taiep rats are an animal neurological model that initially shows a hypomyelination followed by a progressive demyelination of the central nervous system. This animal has reproductive problems, and the aim of this work is to characterize the follicular development, secretion of ovarian hormones, and presence of noradrenaline in the ovaries of the female taiep rats in the juvenile and adult stages. The taiep rats have low body weight (approximately 19% less than that of SD rats), a delay of 4 days in the age of vaginal opening, and an irregularity in the estrous cycle by the absence or prolongation of some estral cycle stage. In the juvenile stage, we observed a decrease of approximately 44% in the total number of follicles with a 15% increase of atresia and an 80% decrease in the fluorescence intensity of catecholamines in the ovaries, with a 21% increment in plasma concentrations of testosterone. In the adult stage, we observed follicular cysts and a 50% decrease in fluorescence intensity of catecholamines in the ovaries, with changes in the secretion of ovarian hormones, an increase of 20 times in progesterone, and a decrement of a half in estradiol. The demyelination in taiep rats affects follicular development and steroidogenesis in the early stages of the animal's life, and this is maintained until adulthood.
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Affiliation(s)
| | - J. R. Eguibar
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 72570 Puebla, Mexico
- Vicerrectoría de Investigación y Estudios de Posgrado, Benemérita Universidad Autónoma de Puebla, 72000 Puebla, Mexico
| | - C. Cortés
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 72570 Puebla, Mexico
| | - A. Ugarte
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 72570 Puebla, Mexico
| | - A. Trujillo
- Facultad de Ciencias Biológicas, Benemérita Universidad Autónoma de Puebla, 72570 Puebla, Mexico
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Cortés C, Amat-Santos IJ, Nombela-Franco L, Muñoz-Garcia AJ, Gutiérrez-Ibanes E, De La Torre Hernandez JM, Córdoba-Soriano JG, Jimenez-Quevedo P, Hernández-García JM, Gonzalez-Mansilla A, Ruano J, Jimenez-Mazuecos J, Castrodeza J, Tobar J, Islas F, Revilla A, Puri R, Puerto A, Gómez I, Rodés-Cabau J, San Román JA. Mitral Regurgitation After Transcatheter Aortic Valve Replacement: Prognosis, Imaging Predictors, and Potential Management. JACC Cardiovasc Interv 2017; 9:1603-14. [PMID: 27491611 DOI: 10.1016/j.jcin.2016.05.025] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/09/2016] [Accepted: 05/15/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This study sought to analyze the clinical impact of the degree and improvement of mitral regurgitation in TAVR recipients, validate the main imaging determinants of this improvement, and assess the potential candidates for double valve repair with percutaneous techniques. BACKGROUND Many patients with severe aortic stenosis present with concomitant mitral regurgitation (MR). Cardiac imaging plays a key role in identifying prognostic factors of MR persistence after transcatheter aortic valve replacement (TAVR) and for planning its treatment. METHODS A total of 1,110 patients with severe aortic stenosis from 6 centers who underwent TAVR were included. In-hospital to 6-month follow-up clinical outcomes according to the degree of baseline MR were evaluated. Off-line analysis of echocardiographic and multidetector computed tomography images was performed to determine predictors of improvement, clinical outcomes, and potential percutaneous alternatives to treat persistent MR. RESULTS Compared with patients without significant pre-TAVR MR, 177 patients (16%) presented with significant pre-TAVR MR, experiencing a 3-fold increase in 6-month mortality (35.0% vs. 10.2%; p < 0.001). After TAVR, the degree of MR improved in 60% of them. A mitral annular diameter of >35.5 mm (odds ratio: 9.0; 95% confidence interval: 3.2 to 25.3; p < 0.001) and calcification of the mitral apparatus by multidetector computed tomography (odds ratio: 11.2; 95% confidence interval: 4.03 to 31.3; p < 0.001) were independent predictors of persistent MR. At least 14 patients (1.3% of the entire cohort, 13.1% of patients with persistent MR) met criteria for percutaneous mitral repair with either MitraClip (9.3%) or a balloon-expandable valve (3.8%). CONCLUSIONS Significant MR is not uncommon in TAVR recipients and associates with greater mortality. In more than one-half of patients, the degree of MR improves after TAVR, which can be predicted by characterizing the mitral apparatus with multidetector computed tomography. According to standardized imaging criteria, at least 1 in 10 patients whose MR persists after TAVR could benefit from percutaneous mitral procedures, and even more could be treated with MitraClip after dedicated pre-imaging evaluation.
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Affiliation(s)
- Carlos Cortés
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | | | | | | | | | | | | | | | | | | | - Javier Ruano
- Hospital Universitario Marques de Valdecilla, Santander, Spain
| | | | - Javier Castrodeza
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | - Javier Tobar
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | - Fabian Islas
- Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Ana Revilla
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | - Rishi Puri
- Quebec Heart and Lung Institute, Quebec, Canada
| | - Ana Puerto
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | - Itziar Gómez
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | | | - José A San Román
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
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Cortés C, Jaguszewski M, Amat-Santos IJ, Gutiérrez-Chico JL. Bas-relief in three dimensional optical coherence tomography: a novel sign after subintimal scaffolding in a chronic total occlusion. Eur Heart J 2017; 38:2445. [PMID: 28329344 DOI: 10.1093/eurheartj/ehx126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Carlos Cortés
- Klinikum Frankfurt (Oder), Interventional Cardiology, Müllroser Chaussee 7, 15236 - Frankfurt (Oder), Germany.,Hospital Clínico Universitario de Valladolid, ICICOR, Avda. Ramón y Cajal 3, 47003 Valladolid, Spain
| | - Milosz Jaguszewski
- Klinikum Frankfurt (Oder), Interventional Cardiology, Müllroser Chaussee 7, 15236 - Frankfurt (Oder), Germany.,Institute of Cardiovascular Translational Research of Atlantic (ICTRA), Reinhardtraße 48, 10117 Berlin, Germany
| | - Ignacio J Amat-Santos
- Hospital Clínico Universitario de Valladolid, ICICOR, Avda. Ramón y Cajal 3, 47003 Valladolid, Spain
| | - Juan Luis Gutiérrez-Chico
- Klinikum Frankfurt (Oder), Interventional Cardiology, Müllroser Chaussee 7, 15236 - Frankfurt (Oder), Germany.,Institute of Cardiovascular Translational Research of Atlantic (ICTRA), Reinhardtraße 48, 10117 Berlin, Germany
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Jaguszewski MJ, Cortés C, Gutiérrez-Chico JL. Implantation of magnesium-bioresorbable scaffolds in a bifurcation under optical coherence tomography guidance. Eur Heart J 2017; 38:2017-2018. [PMID: 27941012 DOI: 10.1093/eurheartj/ehw539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Milosz Jaroslaw Jaguszewski
- Department of Interventional Cardiology, Klinikum Frankfurt (Oder), Müllroser Chaussee 7, 15236 Frankfurt (Oder), Germany.,Institute of Cardiovascular Translational Research of the Atlantic (ICTRA), Reinhardtraße 48, 10117-Berlin, Germany.,First Department of Cardiology, Medical University of Gdansk, M. Slodowskiej-Curie Str 3a, 80-120, Gdansk, Poland
| | - Carlos Cortés
- Department of Interventional Cardiology, Klinikum Frankfurt (Oder), Müllroser Chaussee 7, 15236 Frankfurt (Oder), Germany.,Hospital Clínico Universitario de Valladolid, ICICOR, Avda. Ramón y Cajal 3, 47003 - Valladolid, Spain
| | - Juan Luis Gutiérrez-Chico
- Department of Interventional Cardiology, Klinikum Frankfurt (Oder), Müllroser Chaussee 7, 15236 Frankfurt (Oder), Germany.,Institute of Cardiovascular Translational Research of the Atlantic (ICTRA), Reinhardtraße 48, 10117-Berlin, Germany
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Rojas P, Amat-Santos IJ, Cortés C, Castrodeza J, Tobar J, Puri R, Sevilla T, Vera S, Varela-Falcón LH, Zunzunegui JL, Gómez I, Rodés-Cabau J, San Román JA. Acquired Aseptic Intracardiac Shunts Following Transcatheter Aortic Valve Replacement: A Systematic Review. JACC Cardiovasc Interv 2016; 9:2527-2538. [PMID: 27889349 DOI: 10.1016/j.jcin.2016.09.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/07/2016] [Accepted: 09/22/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aim of this study was to describe the incidence, mechanisms, features, and management of aseptic intracardiac shunts (AICS). BACKGROUND AICS following transcatheter aortic valve replacement (TAVR) are an uncommon and barely described complication. METHODS A systematic review was performed of all published cases of AICS following TAVR, and the incidence, predictors, main features, management, and related outcomes were analyzed. RESULTS A total of 31 post-TAVR AICS were gathered. After excluding transapical fistulas, the 28 remaining cases corresponded with an incidence of about 0.5%. Mean age and mean logistic European System for Cardiac Operative Risk Evaluation score were 80 ± 11 years and 19.2 ± 8.3%, respectively. Prior radiation therapy for cancer was present in 14.3%, and 42.8% had severe calcification of the aortic valve. TAVR was undertaken using balloon-expandable prostheses in the majority of cases (85.7%), via the transapical approach in one-third. Median time from TAVR to diagnosis was 21 days (interquartile range: 7 to 30 days), with intraprocedural suspicion in 12 cases (42.9%) and a mean Qp/Qs ratio of 1.8 ± 0.6. The most common location for AICS was the interventricular septum (60.7%). Heart failure was frequent (46.4%), but 14 patients (50%) remained asymptomatic. Medical treatment (71.4%) was associated with poor outcomes (30-day mortality rate 25%), especially in symptomatic patients (35% vs. 0%; p = 0.020) and in those with higher Qp/Qs ratios (1.9 ± 0.6 vs. 1.4 ± 0.1), while cardiac surgery (3.6%), and percutaneous closure (25%) led to good outcomes after a median follow-up period of 3 months (interquartile range: 1 to 9 months). CONCLUSIONS Post-TAVR AICS are uncommon but have high 30-day mortality if left untreated, especially in symptomatic patients. Percutaneous closure was feasible and safe in symptomatic patients but remains controversial in asymptomatic subjects.
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Affiliation(s)
- Paol Rojas
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | | | - Carlos Cortés
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | - Javier Castrodeza
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | - Javier Tobar
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | - Rishi Puri
- Quebec Heart & Lung Institute, Quebec, Quebec, Canada
| | - Teresa Sevilla
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | - Silvio Vera
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | | | | | - Itziar Gómez
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
| | | | - José A San Román
- Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain
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Cortés C, Amat-Santos IJ, Jaguszewski M, Rojas P, Gonçalves LR, Gutiérrez-Chico JL, San Román JA. Optical coherence tomography imaging after successful percutaneous coronary intervention treatment of coronary perforation following bioabsorbable vascular scaffold implantation: Consecutive ping-pong and child-in-mother techniques. Cardiol J 2016; 23:413-5. [DOI: 10.5603/cj.2016.0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 07/20/2016] [Accepted: 07/25/2016] [Indexed: 11/25/2022] Open
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Amat-Santos IJ, Cortés C, Varela-Falcón LH. Delayed left anterior mitral leaflet perforation and infective endocarditis after transapical aortic valve implantation-Case report and systematic review. Catheter Cardiovasc Interv 2016; 89:951-954. [PMID: 26775197 DOI: 10.1002/ccd.26410] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 12/26/2015] [Indexed: 11/10/2022]
Abstract
AIM We aimed to illustrate the physiopathology of anterior mitral leaflet perforation after TAVI in patients suffering from infective endocarditis (IE). METHODS AND RESULTS The first known case of balloon-expandable transapical case from our series suffering from this complication was reported. In addition, a systematic electronic search of all published cases reporting both entities was performed. Five transfemoral cases have been published to the date, all males with mean age of 79.2 year (range: 66-88). Four were treated with self-expandable prostheses (deeply implanted in the outflow tract). There was moderate residual aortic regurgitation in four. Fever and positive blood cultures for typical micoorganisms were present at certain time point in all cases between the first week and up to 11 months (early IE). Three cases underwent cardiac surgery with adequate outcomes and two others died during hospitalization. Medical management in the case from our series allowed patient's survival at 1-year follow up. CONCLUSIONS Early suspicion of IE whenever anterior mitral perforation is found after TAVI can be life-saving. The hypothetical higher risk of this complication due to higher rate of aortic regurgitation has to be prevented through adequate prosthesis depth and careful sterile surgical technique. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Carlos Cortés
- Cardiology Department, Hospital Clínico Universitario De Valladolid, Spain
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Amat-Santos IJ, Cortés C, Revilla A, San Román JA. Infective Endocarditis: Cause or Consequence of Delayed Anterior Mitral Leaflet Perforation After Transcatheter Aortic Valve Implantation? ACTA ACUST UNITED AC 2015; 69:87. [PMID: 26643770 DOI: 10.1016/j.rec.2015.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 09/08/2015] [Indexed: 11/18/2022]
Affiliation(s)
| | - Carlos Cortés
- Servicio de Cardiología, Hospital Clínico Universitario, Valladolid, Spain
| | - Ana Revilla
- Servicio de Cardiología, Hospital Clínico Universitario, Valladolid, Spain
| | - José A San Román
- Servicio de Cardiología, Hospital Clínico Universitario, Valladolid, Spain
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Cavaco P, Santos AS, Cortés C, Lopes C, Madureira B, Viegas E, Falcão F. PS-099 Drug-drug interactions in fluoropyrimidines-based regimens used in colorectal cancer treatment. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Castaño R, Torres V, Garcia C, Cortés C, Chavernas S, Amar D, Torres E. CP-054 Off-label use of Emtricitabine/Rilpivirine/Tenofovir. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Cavaco P, Santos AS, Cortés C, Lopes C, Madureira B, Viegas E, Falcão F. PS-099 Drug-drug interactions in fluoropyrimidines-based regimens used in colorectal cancer treatment. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Castaño R, Torres V, Garcia C, Cortés C, Chavernas S, Amar D, Torres E. CP-054 Off-label use of Emtricitabine/Rilpivirine/Tenofovir. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Urena M, Hayek S, Cheema AN, Serra V, Amat-Santos IJ, Nombela-Franco L, Ribeiro HB, Allende R, Paradis JM, Dumont E, Thourani VH, Babaliaros V, Francisco Pascual J, Cortés C, del Blanco BG, Philippon F, Lerakis S, Rodés-Cabau J. Arrhythmia Burden in Elderly Patients With Severe Aortic Stenosis as Determined by Continuous Electrocardiographic Recording. Circulation 2015; 131:469-77. [PMID: 25466975 DOI: 10.1161/circulationaha.114.011929] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
This study sought to evaluate the prevalence of previously undiagnosed arrhythmias in candidates for transcatheter aortic valve replacement (TAVR) and to determine the impact on therapy changes and arrhythmic events after the procedure.
Methods and Results—
A total of 435 candidates for TAVR underwent 24-hour continuous ECG monitoring the day before the procedure. Newly diagnosed arrhythmias were observed in 70 patients (16.1%) before TAVR: paroxysmal atrial fibrillation (AF)/atrial tachycardia (AT) in 28, advanced atrioventricular block or severe bradycardia in 24, nonsustained ventricular tachycardia in 26, and intermittent left bundle-branch block in 3 patients. All arrhythmic events but one were asymptomatic and led to a therapy change in 43% of patients. In patients without known AF/AT, the occurrence of AF/AT during 24-hour ECG recording was associated with a higher rate of 30-day cerebrovascular events (7.1% versus 0.4%;
P
=0.030). Among the 53 patients with new-onset AF/AT after TAVR, 30.2% had newly diagnosed paroxysmal AF/AT before the procedure. In patients who needed permanent pacemaker implantation after the procedure (n=35), 31.4% had newly diagnosed advanced atrioventricular block or severe bradycardia before TAVR. New-onset persistent left bundle-branch block after TAVR occurred in 37 patients, 8.1% of whom had intermittent left bundle-branch block before the procedure.
Conclusions—
Newly diagnosed arrhythmias were observed in approximately a fifth of TAVR candidates, led to a higher rate of cerebrovascular events, and accounted for a third of arrhythmic events after the procedure. This high arrhythmia burden highlights the importance of an early diagnosis of arrhythmic events in such patients to implement the appropriate therapeutic measures earlier.
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Affiliation(s)
- Marina Urena
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Salim Hayek
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Asim N. Cheema
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Vicenç Serra
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Ignacio J. Amat-Santos
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Luis Nombela-Franco
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Henrique B. Ribeiro
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Ricardo Allende
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Jean-Michel Paradis
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Eric Dumont
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Vinod H. Thourani
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Vasilis Babaliaros
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Jaume Francisco Pascual
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Carlos Cortés
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Bruno García del Blanco
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - François Philippon
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Stamatios Lerakis
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
| | - Josep Rodés-Cabau
- From the Quebec Heart and Lung Institute, Laval University, Quebec, Quebec, Canada (M.U., I.J.A.-S., H.B.R., R.A., J.P., E.D., F.P., J.R.-C.); Emory University School of Medicine, Atlanta, GA (S.H., V.H.T., V.B., S.L.); St Michael’s Hospital, Toronto University, Toronto, Ontario, Canada (A.N.C.); Hospital Universitari Vall d’Hebron, Barcelona, Spain (V.S., J.F.P., B.G.d.B.); Hospital Clínico Universitario de Valladolid, Valladolid, Spain (I.J.A.-S., C.C.); and Hospital Clínico San Carlos de Madrid,
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González-Osnaya L, Cortés C, Soriano J, Moltó J, Mañes J. Occurrence of deoxynivalenol and T-2 toxin in bread and pasta commercialised in Spain. Food Chem 2011. [DOI: 10.1016/j.foodchem.2010.06.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Orden JA, Cortés C, Horcajo P, De la Fuente R, Blanco JE, Mora A, López C, Blanco J, Contreras A, Sánchez A, Corrales JC, Domínguez-Bernal G. A longitudinal study of verotoxin-producing Escherichia coli in two dairy goat herds. Vet Microbiol 2008; 132:428-34. [PMID: 18603384 DOI: 10.1016/j.vetmic.2008.05.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 05/20/2008] [Accepted: 05/26/2008] [Indexed: 11/18/2022]
Abstract
A longitudinal study was conducted on two dairy farms to investigate the pattern of shedding of verotoxin-producing Escherichia coli (VTEC) in goats. Faecal samples were taken from 20 goat kids once weekly during the first 4 weeks of life and then once every month for the next 5 months of life, and from 18 replacement animals and 15 adults once every month for 12 months. The proportion of samples containing VTEC was higher for replacement animals and adults (85.7% and 78.7%, respectively) than for goat kids (25.4%). About 90% of the VTEC colonies isolated from healthy goats belonged to five serogroups (O33, O76, O126, O146 and O166) but the most frequent serogroups of these isolates, except one, were different in the two herds studied. E. coli O157:H7 was found in three goat kids on only one occasion. None of the VTEC isolates, except the three E. coli O157:H7 isolates, was eae-positive. The patterns of shedding of VTEC in goat kids were variable, but, in contrast, most of the replacement animals and adults were persistent VTEC shedders. Our results show that isolates of VTEC O33, O76, O126, O146 and O166 are adapted for colonising the intestine of goats but that, in contrast, infection with VTEC O157:H7 in goats seems to be transient.
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Affiliation(s)
- J A Orden
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, 28040 Madrid, Spain.
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Abstract
PURPOSE To study the prevalence, characteristics, indications for and results of strabismus treatment secondary to congenital cataracts. MATERIALS AND METHODS This was a retrospective study of 21 cases from 29 with congenital cataracts with strabismus (unilateral in 11 and bilateral in 10 cases). In 20 patients surgery on the cataracts was performed, with an intraocular lens inserted in 15 patients. Botulinum toxin and/or strabismus surgery were deemed to be indicated when the deviation was stable after rehabilitation therapy. A good motor end result was considered when the final deviation was < or =5 degrees, and a good sensorial result was when there was no suppression in the Worth test even without stereopsis in the TNO test. RESULTS The strabismus prevalence was 72.4%. Strabismus was present before cataract surgery was performed in 12 cases, 8 with esotropia (ET) and 4 with exotropia (XT). Strabismus which appeared after cataract surgery was classified as 13 ET, 5 XT, 1 ET with vertical anisotropia in <<V>>, and 2 XT with dissociated vertical deviation (DVD). The strabismus angle was variable in 6 patients and was not treated. The other 6 cases required strabismus treatment. Botulinum toxin was injected as the only treatment in 1 patient, strabismus surgery was performed in 4, and strabismus surgery and botulinum toxin were used in another case. The average age at the time of treatment was 5.2 years. The motor result was good in 5 cases (83.3%) and the sensorial result good in two (33.3%). CONCLUSIONS Strabismus secondary to congenital cataracts occurred in a significant number of patients and increased after cataract extraction. Esotropia occurred twice as often as exotropia. Strabismus surgery was not required in most of the cases. The motor results were better than sensorial results.
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Affiliation(s)
- P Merino
- Sección de Motilidad Ocular, Departamento de Oftalmología, HGU Gregorio Marañón, Madrid, España.
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Ferrer E, Minguez C, Mariño A, Geijo P, Brun F, Sanz J, Velasco M, Cortés C, Castro A, Ortí A, Force L, Barrufet P, Villalonga C, Podzamczer D. Cardiovascular risk estimation in Spanish HIV-infected patients: a multicenter cohort study. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Meléndez-Ackerman EJ, Cortés C, Sustache J, Aragón S, Morales-Vargas M, García-Bermúdez M, Fernández DS. Diet of Feral Goats in Mona Island Reserve, Puerto Rico. CARIBB J SCI 2008. [DOI: 10.18475/cjos.v44i2.a7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Mendoza-Mendoza A, Rosales-Saavedra T, Cortés C, Castellanos-Juárez V, Martínez P, Herrera-Estrella A. The MAP kinase TVK1 regulates conidiation, hydrophobicity and the expression of genes encoding cell wall proteins in the fungus Trichoderma virens. Microbiology (Reading) 2007; 153:2137-2147. [PMID: 17600058 DOI: 10.1099/mic.0.2006/005462-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Mitogen-activated protein (MAP) kinases modulate morphological and genetic processes, which determine cell fate. The tvk1 gene encodes a MAP kinase of Trichoderma virens and its deletion promotes an unusual conidiation phenotype in submerged culture. Here, it is reported that the morphology, physiology and expression of genes encoding cell wall proteins from Trichoderma are significantly affected by Tvk1. Morphological changes were evident in the cell walls of aerial conidia produced by a MAPK null mutant when compared to those produced by the wild-type. Unexpectedly, conidia produced in submerged culture by the Deltatvk1 strain were highly hydrophobic, whereas in aerial conidia hydrophobicity was severely reduced. In addition, the Deltatvk1 strain was unable to break the liquid-air interface when the fungus grew in rich medium; however, when it grew in minimal medium the fungus produced large filaments which were much more efficient at breaking the interface than the wild-type. Through cDNA subtractive hybridization between the wild-type and Deltatvk1 grown in submerged culture, five genes encoding hydrophobin-like proteins and two additional genes encoding cell wall proteins were identified. Four hydrophobin-encoding genes (Tv-hfb1, Tv-srh1, tv-cfth1 and Tv-qid3) and a gene encoding a clock-controlled-like protein (Tv-ccg14/TvSm1) were upregulated in Deltatvk1, whereas genes encoding a cell wall protein (tv-qid74) and an additional hydrophobin (tv-hfb3) were absent in the mutant strain. Clear differences in gene expression were shown during conidiation and emergence from the liquid-air interface, suggesting different functions of the corresponding proteins in these two phenomena. The results support a model in which Tvk1 regulates morphology and genes encoding cell wall proteins during development of Trichoderma.
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Affiliation(s)
- Artemio Mendoza-Mendoza
- Laboratorio Nacional de Genómica para la Biodiversidad, Centro de Investigación y de Estudios Avanzados, Campus Guanajuato, Apartado Postal 629, 36500, Irapuato, Guanajuato, Mexico
| | - Teresa Rosales-Saavedra
- Laboratorio Nacional de Genómica para la Biodiversidad, Centro de Investigación y de Estudios Avanzados, Campus Guanajuato, Apartado Postal 629, 36500, Irapuato, Guanajuato, Mexico
| | - Carlos Cortés
- Laboratorio Nacional de Genómica para la Biodiversidad, Centro de Investigación y de Estudios Avanzados, Campus Guanajuato, Apartado Postal 629, 36500, Irapuato, Guanajuato, Mexico
| | - Verónica Castellanos-Juárez
- Laboratorio Nacional de Genómica para la Biodiversidad, Centro de Investigación y de Estudios Avanzados, Campus Guanajuato, Apartado Postal 629, 36500, Irapuato, Guanajuato, Mexico
| | - Pedro Martínez
- Laboratorio Nacional de Genómica para la Biodiversidad, Centro de Investigación y de Estudios Avanzados, Campus Guanajuato, Apartado Postal 629, 36500, Irapuato, Guanajuato, Mexico
| | - Alfredo Herrera-Estrella
- Laboratorio Nacional de Genómica para la Biodiversidad, Centro de Investigación y de Estudios Avanzados, Campus Guanajuato, Apartado Postal 629, 36500, Irapuato, Guanajuato, Mexico
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