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Gómez González C, Del Campo Cano I, Isabel Fernández-Avila A, Paz Suárez-Mier M, José Sagastizábal M, Álvarez García-Rovés R, Méndez Fernández I, Vilches S, Centeno Jiménez M, Siles Sánchez-Manjavacas A, Usano Carrasco A, Gonzalez-Vioque E, Pablo Ochoa J, Medrano C, González López E, García-Pavía P, Bermejo J, Angeles Espinosa Castro M. Sudden cardiac death triggered by minimal alcohol consumption in the context of novel PPA2 mutations in 2 unrelated families. Gene 2024; 916:148437. [PMID: 38582264 DOI: 10.1016/j.gene.2024.148437] [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] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/08/2024]
Abstract
Biallelic variants in PPA2 gene cause a rare but lethal mitochondrial disorder. We describe the first four cases reported in Spain of PPA2 disease in two unrelated families. We have conducted a revision of the clinical history, necropsies, and postmortem genetic testing from probands, and clinical evaluation, genetic testing and blood transcript analysis in family members. All the cases harbored biallelic PPA2 variants in compound heterozygous status. Two brothers from family 1 suffered sudden death after a small first intake of alcohol in 2013 and 2022. The sister remains alive but affected with cardiomyopathy, extensive scar on cardiac imaging, and high sensitivity to alcohol intake. The three siblings carried PPA2 c.290A > G (p.Glu97Gly) novel missense variant and PPA2 c.513C > T (p.Cys171 = ) altering splicing site variant, both probably leading to mRNA degradation based on in-silico and transcript analyses. A teenager from family 2 suffered sudden death after a small intake of alcohol in 2018 and carried PPA2 c.683C > T (p.Pro228Leu) missense and PPA2 c.980_983del (p.Gln327fs) novel frameshift variant, both probably leading to abnormal protein structure. All cases were asymptomatic until adolescence. Furthermore, the sister in family 1 has survived as an asymptomatic adult. PPA2 disease can manifest as cardiac arrest in the young, especially after alcohol exposure. Our results show that PPA2 deficiency can be related to different pathogenicity mechanisms such as abnormal protein structure but also mRNA decay caused by synonymous or missense variants. Strict avoidance of alcohol consumption and early defibrillator implantation might prevent lethal arrhythmias in patients at risk.
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Affiliation(s)
- Cristina Gómez González
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBERCV, Spain
| | - Iván Del Campo Cano
- Department of Pediatrics, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; IDIPHISA, Madrid, Spain
| | - Ana Isabel Fernández-Avila
- Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBERCV, Spain.
| | - Maria Paz Suárez-Mier
- Servicio de Histopatología. Instituto Nacional de Toxicología y Ciencias Forenses. Madrid. Spain
| | | | - Reyes Álvarez García-Rovés
- Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Pediatric Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Irene Méndez Fernández
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBERCV, Spain
| | - Silvia Vilches
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBERCV, Spain
| | - Miriam Centeno Jiménez
- Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Pediatric Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Siles Sánchez-Manjavacas
- Department of Pediatrics, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; IDIPHISA, Madrid, Spain
| | - Ana Usano Carrasco
- Department of Pediatrics, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; IDIPHISA, Madrid, Spain
| | | | - Juan Pablo Ochoa
- Health in Code. A Coruña. Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Constancio Medrano
- Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Pediatric Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Esther González López
- CIBERCV, Spain; IDIPHISA, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Pablo García-Pavía
- CIBERCV, Spain; IDIPHISA, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Cardiology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Javier Bermejo
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBERCV, Spain
| | - María Angeles Espinosa Castro
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBERCV, Spain
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Centeno M, Álvarez García-Rovés R, Pérez-Caballero R, Arenal Á, Atienza F, González-Torrecilla E, Carta A, Ríos-Muñoz GR, Medrano C, Gil-Jaurena JM, Fernández-Avilés F, Ávila P. Complications and inappropriate shocks in pediatric patients receiving a subcutaneous implantable cardioverter defibrilator. Rev Esp Cardiol (Engl Ed) 2024; 77:362-369. [PMID: 38000625 DOI: 10.1016/j.rec.2023.08.014] [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] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/08/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION AND OBJECTIVES There is limited evidence regarding the use of subcutaneous implantable cardioverter-defibrillators (S-ICD) in pediatric patients. The aim of this study was to determine the incidence of complications in these patients at our center, according to the type of ICD and patient size. METHODS We included all patients aged<18 years who received an S-ICD since 2016 at our center. As a control group, we also included contemporary patients (since 2014) who received a transvenous ICD (TV-ICD). The primary endpoint was a composite of complications and inappropriate shocks. RESULTS A total of 26 patients received an S-ICD (median age, 14 [5-17] years; body mass index [BMI], 20.2 kg/m2). Implantation was intermuscular in 23 patients (88%) and subserratus in the remainder. Two incisions were used in 24 patients (92%). In all patients, 2 zones were programmed: a conditional zone set at 230 (220-230) bpm, and a shock zone set at 250 bpm. Nineteen patients received a TV-ICD (median age, 11 [range, 5-16] years; BMI, 19.2 kg/m2, 79% single-chamber). Survival free from the primary endpoint at 5 years was 80% in the S-ICD group and 63% in the TV-ICD group (P=.54). Survival free from inappropriate shocks was similar (85% vs 89%, P=.86), while survival free from complications was higher in the S-ICD group (96% vs 57%, cloglog P=.016). There were no therapy failures in the S-ICD group, and no increased complication rates were observed in patients with BMI ≤20 kg/m2. CONCLUSIONS With contemporary implantation techniques and programming, S-ICD is a safe and effective therapy in pediatric patients. The number of inappropriate shocks is similar to TV-ICD, with fewer short- and mid-term complications.
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Affiliation(s)
- Miriam Centeno
- Servicio de Cardiología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Reyes Álvarez García-Rovés
- Servicio de Cardiología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Ramón Pérez-Caballero
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Unidad de Cirugía Cardiaca Infantil, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ángel Arenal
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Felipe Atienza
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Esteban González-Torrecilla
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Alejandro Carta
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Gonzalo R Ríos-Muñoz
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Bioingeniería, Universidad Carlos III, Madrid, Spain
| | - Constancio Medrano
- Servicio de Cardiología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Juan M Gil-Jaurena
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Unidad de Cirugía Cardiaca Infantil, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Francisco Fernández-Avilés
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Pablo Ávila
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
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3
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Carcavilla A, Cambra A, Santomé JL, Seidel V, Cruz J, Alonso M, Pozo J, Valenzuela I, Guillén-Navarro E, Santos-Simarro F, González-Casado I, Rodríguez A, Medrano C, López-Siguero JP, Ezquieta B. Genotypic Findings in Noonan and Non-Noonan RASopathies and Patient Eligibility for Growth Hormone Treatment. J Clin Med 2023; 12:5003. [PMID: 37568403 PMCID: PMC10420167 DOI: 10.3390/jcm12155003] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Molecular study has become an invaluable tool in the field of RASopathies. Treatment with recombinant human growth hormone is approved in Noonan syndrome but not in the other RASopathies. The aim of this study was to learn about the molecular base of a large cohort of patients with RASopathies, with particular emphasis on patients with pathogenic variants in genes other than PTPN11, and its potential impact on rGH treatment indication. We reviewed the clinical diagnosis and molecular findings in 451 patients with a genetically confirmed RASopathy. HRAS alterations were detected in only 2 out of 19 patients referred with a Costello syndrome suspicion, whereas pathogenic variants in RAF1 and SHOC2 were detected in 3 and 2, respectively. In 22 patients referred with a generic suspicion of RASopathy, including cardiofaciocutaneous syndrome, pathogenic alterations in classic Noonan syndrome genes (PTPN11, SOS1, RAF1, LZTR1, and RIT1) were found in 7 patients and pathogenic variants in genes associated with other RASopathies (HRAS, SHOC2, and PPPCB1) in 4. The correct nosological classification of patients with RASopathies is critical to decide whether they are candidates for treatment with rhGH. Our data illustrate the complexity of differential diagnosis in RASopathies, as well as the importance of genetic testing to guide the diagnostic orientation in these patients.
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Affiliation(s)
- Atilano Carcavilla
- Pediatric Endocrinology Department, Hospital Universitario La Paz, 28046 Madrid, Spain
- Multidisciplinary Unit for RASopathies, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Ana Cambra
- Molecular Diagnostics Laboratory, Department of Laboratory Medicine, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Gregorio Marañon Health Research Institute (IiSGM), 28009 Madrid, Spain
| | - José L. Santomé
- Molecular Diagnostics Laboratory, Department of Laboratory Medicine, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Gregorio Marañon Health Research Institute (IiSGM), 28009 Madrid, Spain
| | - Verónica Seidel
- Clinical Genetics Unit, Pediatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Jaime Cruz
- Pediatrics Department, Hospital Universitario Doce de Octubre, 28041 Madrid, Spain
| | - Milagros Alonso
- Pediatrics Department, Hospital Ramón y Cajal, 28034 Madrid, Spain
| | - Jesús Pozo
- Pediatric Endocrinology Department, Hospital Universitario Niño Jesús, 28009 Madrid, Spain
| | - Irene Valenzuela
- Genetics Department, Hospital Universitario Vall D’Hebrón, 08035 Barcelona, Spain
| | | | - Fernando Santos-Simarro
- Multidisciplinary Unit for RASopathies, Hospital Universitario La Paz, 28046 Madrid, Spain
- Institute of Medical & Molecular Genetics, Hospital Universitario la Paz, 28046 Madrid, Spain
| | - Isabel González-Casado
- Pediatric Endocrinology Department, Hospital Universitario La Paz, 28046 Madrid, Spain
- Multidisciplinary Unit for RASopathies, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Amparo Rodríguez
- Gregorio Marañon Health Research Institute (IiSGM), 28009 Madrid, Spain
- Pediatric Endocrinology, Pediatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Constancio Medrano
- Gregorio Marañon Health Research Institute (IiSGM), 28009 Madrid, Spain
- Pediatric Cardiology Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Juan Pedro López-Siguero
- Pediatric Endocrinology Department, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Begoña Ezquieta
- Molecular Diagnostics Laboratory, Department of Laboratory Medicine, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Gregorio Marañon Health Research Institute (IiSGM), 28009 Madrid, Spain
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4
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Gil-Jaurena JM, Pérez-Caballero R, Murgoitio U, Pardo C, Pita A, Calle C, Camino M, Medrano C. A Neonatal ABO non-compatible heart transplant from a circulatory-determined death donor using NRP/Cold storage. Pediatr Transplant 2022; 26:e14169. [PMID: 34661339 DOI: 10.1111/petr.14169] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/16/2021] [Accepted: 10/05/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Donation after Circulatory death is gaining worldwide acceptance. Most protocols regard their first cases to be performed with donor and recipient in the same institution. Few records of children or distant procurement have been published. METHODS Our institution was offered a heart from a 3-day-old, 3.4-kg child, blood group A, suffering irreversible encephalopathy. Parents accepted withdrawal of life-sustaining therapy and agreed to donation. The donor hospital was located 340 km away. Concomitantly, a 2-month-old, 3.1 kg, blood group type B and with non-compaction ventricles was awaiting for the heart transplant in our unit. RESULTS Thirty-seven minutes after withdrawal of life-sustaining therapy, the heart arrested. Five minutes afterwards, a sternotomy was performed. The supra-aortic vessels were clamped altogether. Aorta and right appendage were cannulated and connected to heart-lung machine. The innominate artery above the clamp was severed. The heart resumed spontaneous rhythm in less than 1 min. Ventilation was restored and extracorporeal circulation was maintained for 32 min. Upon cardiologic arrest, the graft was harvested as routinely. The heart was cold-stored and transported by plane to our Hospital. An orthotopic bicaval transplant was performed. Overall cold ischaemia was 245 min. Ten weeks later, the child was discharged home in good condition. CONCLUSION Donation in circulatory death could increase the pool in neonates. Extracorporeal circulation proves successful for procurement in neonates. Distant procurement plus cold storage for donation in circulatory death is feasible. Donation in circulatory death and ABO non-compatible strategies are complementary to each other.
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Affiliation(s)
- Juan-Miguel Gil-Jaurena
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ramón Pérez-Caballero
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Uxue Murgoitio
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Carlos Pardo
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ana Pita
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Corazón Calle
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Manuela Camino
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Pediatric Cardiology, Hospital Gregorio Marañón, Madrid, Spain
| | - Constancio Medrano
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Pediatric Cardiology, Hospital Gregorio Marañón, Madrid, Spain
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Norrish G, Cleary A, Field E, Cervi E, Boleti O, Ziółkowska L, Olivotto I, Khraiche D, Limongelli G, Anastasakis A, Weintraub R, Biagini E, Ragni L, Prendiville T, Duignan S, McLeod K, Ilina M, Fernandez A, Marrone C, Bökenkamp R, Baban A, Kubus P, Daubeney PE, Sarquella-Brugada G, Cesar S, Klaassen S, Ojala TH, Bhole V, Medrano C, Uzun O, Brown E, Gran F, Sinagra G, Castro FJ, Stuart G, Yamazawa H, Barriales-Villa R, Garcia-Guereta L, Adwani S, Linter K, Bharucha T, Gonzales-Lopez E, Siles A, Rasmussen TB, Calcagnino M, Jones CB, De Wilde H, Kubo T, Felice T, Popoiu A, Mogensen J, Mathur S, Centeno F, Reinhardt Z, Schouvey S, Elliott PM, Kaski JP. Clinical Features and Natural History of Preadolescent Nonsyndromic Hypertrophic Cardiomyopathy. J Am Coll Cardiol 2022; 79:1986-1997. [PMID: 35589160 PMCID: PMC9125690 DOI: 10.1016/j.jacc.2022.03.347] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Up to one-half of childhood sarcomeric hypertrophic cardiomyopathy (HCM) presents before the age of 12 years, but this patient group has not been systematically characterized. OBJECTIVES The aim of this study was to describe the clinical presentation and natural history of patients presenting with nonsyndromic HCM before the age of 12 years. METHODS Data from the International Paediatric Hypertrophic Cardiomyopathy Consortium on 639 children diagnosed with HCM younger than 12 years were collected and compared with those from 568 children diagnosed between 12 and 16 years. RESULTS At baseline, 339 patients (53.6%) had family histories of HCM, 132 (20.9%) had heart failure symptoms, and 250 (39.2%) were prescribed cardiac medications. The median maximal left ventricular wall thickness z-score was 8.7 (IQR: 5.3-14.4), and 145 patients (27.2%) had left ventricular outflow tract obstruction. Over a median follow-up period of 5.6 years (IQR: 2.3-10.0 years), 42 patients (6.6%) died, 21 (3.3%) underwent cardiac transplantation, and 69 (10.8%) had life-threatening arrhythmic events. Compared with those presenting after 12 years, a higher proportion of younger patients underwent myectomy (10.5% vs 7.2%; P = 0.045), but fewer received primary prevention implantable cardioverter-defibrillators (18.9% vs 30.1%; P = 0.041). The incidence of mortality or life-threatening arrhythmic events did not differ, but events occurred at a younger age. CONCLUSIONS Early-onset childhood HCM is associated with a comparable symptom burden and cardiac phenotype as in patients presenting later in childhood. Long-term outcomes including mortality did not differ by age of presentation, but patients presenting at younger than 12 years experienced adverse events at younger ages.
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Affiliation(s)
- Gabrielle Norrish
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, United Kingdom,Institute of Cardiovascular Sciences, University College London, London, United Kingdom
| | - Aoife Cleary
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, United Kingdom
| | - Ella Field
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, United Kingdom
| | - Elena Cervi
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, United Kingdom
| | - Olga Boleti
- Institute of Cardiovascular Sciences, University College London, London, United Kingdom
| | | | | | | | - Giuseppe Limongelli
- Inherited and Rare Cardiovascular Disease Unit, AO dei Colli Monaldi Hospital, Universita della Campania “Luigi Vanvitelli,” Naples, Italy
| | | | | | - Elena Biagini
- Cardiology Unit, St Orsola Hospital, IRCCS Azienda Ospedalierao–Universitaria di Bologna, Bologna, Italy
| | - Luca Ragni
- Cardiology Unit, St Orsola Hospital, IRCCS Azienda Ospedalierao–Universitaria di Bologna, Bologna, Italy
| | | | | | - Karen McLeod
- Royal Hospital for Children, Glasgow, United Kingdom
| | - Maria Ilina
- Royal Hospital for Children, Glasgow, United Kingdom
| | | | - Chiara Marrone
- Papa Giovanni XXIII Hospital, Bergamo, Italy,Fondazione Toscana G. Monasterio, Massa-Pisa, Italy
| | | | | | - Peter Kubus
- University Hospital Motol, Prague, Czech Republic
| | | | | | | | - Sabine Klaassen
- Department of Pediatric Cardiology, Charite–Universitatsmedizin Berlin, Berlin, Germany,Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück-Center for Molecular Medicine, Charite–Universitatsmedizin Berlin, Berlin, Germany,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Tiina H. Ojala
- Department of Pediatric Cardiology, Pediatric Research Center, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Vinay Bhole
- Birmingham Children’s Hospital, Birmingham, United Kingdom
| | | | - Orhan Uzun
- University Hospital of Wales, Cardiff, United Kingdom
| | | | - Ferran Gran
- Vall d’Hebron University Hospital, Barcelona, Spain
| | | | | | - Graham Stuart
- Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Hirokuni Yamazawa
- Department of Pediatrics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, Sapporo, Japan
| | | | | | | | | | - Tara Bharucha
- Southampton General Hospital, Southampton, United Kingdom
| | | | - Ana Siles
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | | | - Margherita Calcagnino
- Fondazione IRCCS Ca Granda – Ospedale Maggiore Policlinico Milano, Department di Medicina Interna – UOC Cardiologica, Milan, Italy
| | | | | | - Toru Kubo
- Kochi Medical School Hospital, Kochi, Japan
| | | | - Anca Popoiu
- University of Medicine and Pharmacy “Victor Babes” Timisoara, Department of Pediatrics, Children’s Hospital “Louis Turcanu,” Timisoara, Romania
| | | | | | | | | | | | - Perry M. Elliott
- Institute of Cardiovascular Sciences, University College London, London, United Kingdom,St Bartholomew’s Centre for Inherited Cardiovascular Diseases, St Bartholomew’s Hospital, West Smithfield, London, United Kingdom
| | - Juan Pablo Kaski
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, United Kingdom; Institute of Cardiovascular Sciences, University College London, London, United Kingdom.
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6
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Norrish G, Ding T, Field E, Cervi E, Ziółkowska L, Olivotto I, Khraiche D, Limongelli G, Anastasakis A, Weintraub R, Biagini E, Ragni L, Prendiville T, Duignan S, McLeod K, Ilina M, Fernández A, Marrone C, Bökenkamp R, Baban A, Kubus P, Daubeney PEF, Sarquella-Brugada G, Cesar S, Klaassen S, Ojala TH, Bhole V, Medrano C, Uzun O, Brown E, Gran F, Sinagra G, Castro FJ, Stuart G, Vignati G, Yamazawa H, Barriales-Villa R, Garcia-Guereta L, Adwani S, Linter K, Bharucha T, Garcia-Pavia P, Siles A, Rasmussen TB, Calcagnino M, Jones CB, De Wilde H, Kubo T, Felice T, Popoiu A, Mogensen J, Mathur S, Centeno F, Reinhardt Z, Schouvey S, O'Mahony C, Omar RZ, Elliott PM, Kaski JP. Relationship Between Maximal Left Ventricular Wall Thickness and Sudden Cardiac Death in Childhood Onset Hypertrophic Cardiomyopathy. Circ Arrhythm Electrophysiol 2022; 15:e010075. [PMID: 35491873 PMCID: PMC7612749 DOI: 10.1161/circep.121.010075] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Maximal left ventricular wall thickness (MLVWT) is a risk factor for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). In adults, the severity of left ventricular hypertrophy has a nonlinear relationship with SCD, but it is not known whether the same complex relationship is seen in childhood. The aim of this study was to describe the relationship between left ventricular hypertrophy and SCD risk in a large international pediatric HCM cohort. METHODS The study cohort comprised 1075 children (mean age, 10.2 years [±4.4]) diagnosed with HCM (1-16 years) from the International Paediatric Hypertrophic Cardiomyopathy Consortium. Anonymized, noninvasive clinical data were collected from baseline evaluation and follow-up, and 5-year estimated SCD risk was calculated (HCM Risk-Kids). RESULTS MLVWT Z score was <10 in 598 (58.1%), ≥10 to <20 in 334 (31.1%), and ≥20 in 143 (13.3%). Higher MLVWT Z scores were associated with heart failure symptoms, unexplained syncope, left ventricular outflow tract obstruction, left atrial dilatation, and nonsustained ventricular tachycardia. One hundred twenty-two patients (71.3%) with MLVWT Z score ≥20 had coexisting risk factors for SCD. Over a median follow-up of 4.9 years (interquartile range, 2.3-9.3), 115 (10.7%) had an SCD event. Freedom from SCD event at 5 years for those with MLVWT Z scores <10, ≥10 to <20, and ≥20 was 95.6%, 87.4%, and 86.0, respectively. The estimated SCD risk at 5 years had a nonlinear, inverted U-shaped relationship with MLVWT Z score, peaking at Z score +23. The presence of coexisting risk factors had a summative effect on risk. CONCLUSIONS In children with HCM, an inverted U-shaped relationship exists between left ventricular hypertrophy and estimated SCD risk. The presence of additional risk factors has a summative effect on risk. While MLVWT is important for risk stratification, it should not be used either as a binary variable or in isolation to guide implantable cardioverter defibrillator implantation decisions in children with HCM.
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Affiliation(s)
- Gabrielle Norrish
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, United Kingdom (G.N., E.F., E.C., J.P.K.).,Institute of Cardiovascular Sciences (G.N., C.O., P.M.E., J.P.K.), University College London, United Kingdom
| | - Tao Ding
- Department of Statistical Science (T.D., R.Z.O.), University College London, United Kingdom
| | - Ella Field
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, United Kingdom (G.N., E.F., E.C., J.P.K.)
| | - Elena Cervi
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, United Kingdom (G.N., E.F., E.C., J.P.K.)
| | | | | | | | | | | | | | - Elena Biagini
- Cardiology Unit, S. Orsola-Malpighi Hospital, IRCCS Azienda Ospedalierao-Universitaria di Bologna, Italy (E.B., L.R.)
| | - Luca Ragni
- Cardiology Unit, S. Orsola-Malpighi Hospital, IRCCS Azienda Ospedalierao-Universitaria di Bologna, Italy (E.B., L.R.)
| | | | - Sophie Duignan
- Royal Hospital for Children, Glasgow, United Kingdom (K.M., M.I.)
| | - Karen McLeod
- Royal Hospital for Children, Glasgow, United Kingdom (K.M., M.I.)
| | - Maria Ilina
- Royal Hospital for Children, Glasgow, United Kingdom (K.M., M.I.)
| | - Adrián Fernández
- Fundación Favaloro University Hospital, Buenos Aires, Argentina (A.F.)
| | | | | | | | - Peter Kubus
- University Hospital Motol, Prague, Czech Republic (P.K.)
| | - Piers E F Daubeney
- Royal Brompton and Harefield NHS Trust, London, United Kingdom (P.E.F.D.)
| | | | - Sergi Cesar
- Sant Joan de Deu, Barcelona, Spain (G.S.-B., S.C.)
| | - Sabine Klaassen
- Department of Pediatric Cardiology (S.K.), Charite-Universitatsmedizin Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück-Center for Molecular Medicine (S.K.), Charite-Universitatsmedizin Berlin, Germany.,German Centre for Cardiovascular Research, Partner Site Berlin, Germany (S.K.)
| | - Tiina H Ojala
- Department of Pediatric Cardiology, Pediatric Research Center, New Children's Hospital, University of Helsinki, Finland (T.H.O.)
| | - Vinay Bhole
- Birmingham Children's Hospital, United Kingdom (V.B.)
| | - Constancio Medrano
- Fondazione Toscana G. Monasterio, Massa-Pisa, Italy (C.M.).,Hospital General Universitario Gregorio Marañón, Madrid, Spain (C.M.)
| | - Orhan Uzun
- University Hospital of Wales, Cardiff (O.U.)
| | | | - Ferran Gran
- Val d'Hebron University Hospital, Barcelona, Spain (F.G.)
| | - Gianfranco Sinagra
- Heart Muscle Disease Registry Trieste, University of Trieste, Italy (G.S.)
| | | | - Graham Stuart
- Bristol Royal Hospital for Children, United Kingdom (G.S.)
| | | | - Hirokuni Yamazawa
- Department of Pediatrics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, Sapporo, Japan (H.Y.)
| | | | | | | | | | - Tara Bharucha
- Southampton General Hospital, Southampton, United Kingdom (T.B.)
| | - Pablo Garcia-Pavia
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain (P.G.-P., A.S.)
| | - Ana Siles
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain (P.G.-P., A.S.)
| | | | - Margherita Calcagnino
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Dept di Medicina Interna, UOC Cardiologica, Milano, Italy (M.C.)
| | - Caroline B Jones
- Alder Hey Children's Hospital, Liverpool, United Kingdom (C.B.J.)
| | | | - Toru Kubo
- Kochi Medical School Hospital, Japan (T.K.)
| | | | - Anca Popoiu
- Department of Pediatrics, University of Medicine and Pharmacy "Victor Babes" Timisoara, Children's Hospital 'Louis Turcanu,' Romania (A.P.)
| | | | - Sujeev Mathur
- Evelina Children's Hospital, London, United Kingdom (S.M.)
| | | | | | | | - Costas O'Mahony
- Institute of Cardiovascular Sciences (G.N., C.O., P.M.E., J.P.K.), University College London, United Kingdom.,St Bartholomew's Centre for Inherited Cardiovascular Diseases, St Bartholomew's Hospital, West Smithfield, London, United Kingdom (C.O., P.M.E.)
| | - Rumana Z Omar
- Department of Statistical Science (T.D., R.Z.O.), University College London, United Kingdom
| | - Perry M Elliott
- Institute of Cardiovascular Sciences (G.N., C.O., P.M.E., J.P.K.), University College London, United Kingdom.,St Bartholomew's Centre for Inherited Cardiovascular Diseases, St Bartholomew's Hospital, West Smithfield, London, United Kingdom (C.O., P.M.E.)
| | - Juan Pablo Kaski
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, United Kingdom (G.N., E.F., E.C., J.P.K.).,Institute of Cardiovascular Sciences (G.N., C.O., P.M.E., J.P.K.), University College London, United Kingdom
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Lopes LR, Losi MA, Sheikh N, Laroche C, Charron P, Gimeno J, Kaski JP, Maggioni AP, Tavazzi L, Arbustini E, Brito D, Celutkiene J, Hagege A, Linhart A, Mogensen J, Garcia-Pinilla JM, Ripoll-Vera T, Seggewiss H, Villacorta E, Caforio A, Elliott PM, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Erlinge D, Emberson J, Glikson M, Gray A, Kayikcioglu M, Maggioni A, Nagy KV, Nedoshivin A, Petronio AS, Hesselink JR, Wallentin L, Zeymer U, Caforio A, Blanes JRG, Charron P, Elliott P, Kaski JP, Maggioni AP, Tavazzi L, Tendera M, Komissarova S, Chakova N, Niyazova S, Linhart A, Kuchynka P, Palecek T, Podzimkova J, Fikrle M, Nemecek E, Bundgaard H, Tfelt-Hansen J, Theilade J, Thune JJ, Axelsson A, Mogensen J, Henriksen F, Hey T, Nielsen SK, Videbaek L, Andreasen S, Arnsted H, Saad A, Ali M, Lommi J, Helio T, Nieminen MS, Dubourg O, Mansencal N, Arslan M, Tsieu VS, Damy T, Guellich A, Guendouz S, Tissot CM, Lamine A, Rappeneau S, Hagege A, Desnos M, Bachet A, Hamzaoui M, Charron P, Isnard R, Legrand L, Maupain C, Gandjbakhch E, Kerneis M, Pruny JF, Bauer A, Pfeiffer B, Felix SB, Dorr M, Kaczmarek S, Lehnert K, Pedersen AL, Beug D, Bruder M, Böhm M, Kindermann I, Linicus Y, Werner C, Neurath B, Schild-Ungerbuehler M, Seggewiss H, Pfeiffer B, Neugebauer A, McKeown P, Muir A, McOsker J, Jardine T, Divine G, Elliott P, Lorenzini M, Watkinson O, Wicks E, Iqbal H, Mohiddin S, O'Mahony C, Sekri N, Carr-White G, Bueser T, Rajani R, Clack L, Damm J, Jones S, Sanchez-Vidal R, Smith M, Walters T, Wilson K, Rosmini S, Anastasakis A, Ritsatos K, Vlagkouli V, Forster T, Sepp R, Borbas J, Nagy V, Tringer A, Kakonyi K, Szabo LA, Maleki M, Bezanjani FN, Amin A, Naderi N, Parsaee M, Taghavi S, Ghadrdoost B, Jafari S, Khoshavi M, Rapezzi C, Biagini E, Corsini A, Gagliardi C, Graziosi M, Longhi S, Milandri A, Ragni L, Palmieri S, Olivotto I, Arretini A, Castelli G, Cecchi F, Fornaro A, Tomberli B, Spirito P, Devoto E, Bella PD, Maccabelli G, Sala S, Guarracini F, Peretto G, Russo MG, Calabro R, Pacileo G, Limongelli G, Masarone D, Pazzanese V, Rea A, Rubino M, Tramonte S, Valente F, Caiazza M, Cirillo A, Del Giorno G, Esposito A, Gravino R, Marrazzo T, Trimarco B, Losi MA, Di Nardo C, Giamundo A, Musella F, Pacelli F, Scatteia A, Canciello G, Caforio A, Iliceto S, Calore C, Leoni L, Marra MP, Rigato I, Tarantini G, Schiavo A, Testolina M, Arbustini E, Di Toro A, Giuliani LP, Serio A, Fedele F, Frustaci A, Alfarano M, Chimenti C, Drago F, Baban A, Calò L, Lanzillo C, Martino A, Uguccioni M, Zachara E, Halasz G, Re F, Sinagra G, Carriere C, Merlo M, Ramani F, Kavoliuniene A, Krivickiene A, Tamuleviciute-Prasciene E, Viezelis M, Celutkiene J, Balkeviciene L, Laukyte M, Paleviciute E, Pinto Y, Wilde A, Asselbergs FW, Sammani A, Van Der Heijden J, Van Laake L, De Jonge N, Hassink R, Kirkels JH, Ajuluchukwu J, Olusegun-Joseph A, Ekure E, Mizia-Stec K, Tendera M, Czekaj A, Sikora-Puz A, Skoczynska A, Wybraniec M, Rubis P, Dziewiecka E, Wisniowska-Smialek S, Bilinska Z, Chmielewski P, Foss-Nieradko B, Michalak E, Stepien-Wojno M, Mazek B, Lopes LR, Almeida AR, Cruz I, Gomes AC, Pereira AR, Brito D, Madeira H, Francisco AR, Menezes M, Moldovan O, Guimaraes TO, Silva D, Ginghina C, Jurcut R, Mursa A, Popescu BA, Apetrei E, Militaru S, Coman IM, Frigy A, Fogarasi Z, Kocsis I, Szabo IA, Fehervari L, Nikitin I, Resnik E, Komissarova M, Lazarev V, Shebzukhova M, Ustyuzhanin D, Blagova O, Alieva I, Kulikova V, Lutokhina Y, Pavlenko E, Varionchik N, Ristic AD, Seferovic PM, Veljic I, Zivkovic I, Milinkovic I, Pavlovic A, Radovanovic G, Simeunovic D, Zdravkovic M, Aleksic M, Djokic J, Hinic S, Klasnja S, Mircetic K, Monserrat L, Fernandez X, Garcia-Giustiniani D, Larrañaga JM, Ortiz-Genga M, Barriales-Villa R, Martinez-Veira C, Veira E, Cequier A, Salazar-Mendiguchia J, Manito N, Gonzalez J, Fernández-Avilés F, Medrano C, Yotti R, Cuenca S, Espinosa MA, Mendez I, Zatarain E, Alvarez R, Pavia PG, Briceno A, Cobo-Marcos M, Dominguez F, Galvan EDT, Pinilla JMG, Abdeselam-Mohamed N, Lopez-Garrido MA, Hidalgo LM, Ortega-Jimenez MV, Mezcua AR, Guijarro-Contreras A, Gomez-Garcia D, Robles-Mezcua M, Blanes JRG, Castro FJ, Esparza CM, Molina MS, García MS, Cuenca DL, de Mallorca P, Ripoll-Vera T, Alvarez J, Nunez J, Gomez Y, Fernandez PLS, Villacorta E, Avila C, Bravo L, Diaz-Pelaez E, Gallego-Delgado M, Garcia-Cuenllas L, Plata B, Lopez-Haldon JE, Pena Pena ML, Perez EMC, Zorio E, Arnau MA, Sanz J, Marques-Sule E. Association between common cardiovascular risk factors and clinical phenotype in patients with hypertrophic cardiomyopathy from the European Society of Cardiology (ESC) EurObservational Research Programme (EORP) Cardiomyopathy/Myocarditis registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:42-53. [PMID: 35138368 PMCID: PMC9745665 DOI: 10.1093/ehjqcco/qcac006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 12/15/2022]
Abstract
AIMS The interaction between common cardiovascular risk factors (CVRF) and hypertrophic cardiomyopathy (HCM) is poorly studied. We sought to explore the relation between CVRF and the clinical characteristics of patients with HCM enrolled in the EURObservational Research Programme (EORP) Cardiomyopathy registry. METHODS AND RESULTS 1739 patients with HCM were studied. The relation between hypertension (HT), diabetes (DM), body mass index (BMI), and clinical traits was analysed. Analyses were stratified according to the presence or absence of a pathogenic variant in a sarcomere gene. The prevalence of HT, DM, and obesity (Ob) was 37, 10, and 21%, respectively. HT, DM, and Ob were associated with older age (P<0.001), less family history of HCM (HT and DM P<0.001), higher New York Heart Association (NYHA) class (P<0.001), atrial fibrillation (HT and DM P<0.001; Ob p = 0.03) and LV (left ventricular) diastolic dysfunction (HT and Ob P<0.001; DM P = 0.003). Stroke was more frequent in HT (P<0.001) and mutation-positive patients with DM (P = 0.02). HT and Ob were associated with higher provocable LV outflow tract gradients (HT P<0.001, Ob P = 0.036). LV hypertrophy was more severe in Ob (P = 0.018). HT and Ob were independently associated with NYHA class (OR 1.419, P = 0.017 and OR 1.584, P = 0.004, respectively). Other associations, including a higher proportion of females in HT and of systolic dysfunction in HT and Ob, were observed only in mutation-positive patients. CONCLUSION Common CVRF are associated with a more severe HCM phenotype, suggesting a proactive management of CVRF should be promoted. An interaction between genotype and CVRF was observed for some traits.
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Affiliation(s)
- Luis R Lopes
- Corresponding author. Tel: +447765109343, , Twitter handle: @LuisRLopesDr
| | - Maria-Angela Losi
- Department of Advanced Biomedical Sciences, University Federico II, Corso Umberto I, 40, Naples 80138, Italy
| | - Nabeel Sheikh
- Department of Cardiology and Division of Cardiovascular Sciences, Guy's and St. Thomas’ Hospitals and King's College London, Strand, London WC2R 2LS, UK
| | - Cécile Laroche
- EORP, European Society of Cardiology, Sophia-Antipolis, France
| | | | | | - Juan P Kaski
- Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Aldo P Maggioni
- EORP, European Society of Cardiology, Sophia-Antipolis, France,Maria Cecilia Hospital, GVM Care&Research, Via Corriera, 1, Cotignola 48033 RA, Italy
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care&Research, Via Corriera, 1, Cotignola 48033 RA, Italy
| | | | - Dulce Brito
- Serviço de Cardiologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1169-050, Portugal,CCUL, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz MB, Lisbon 1649-028, Portugal
| | - Jelena Celutkiene
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Universiteto g. 3, Vilnius 01513, Lithuania,State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | | | - Ales Linhart
- 2nd Department of Internal Cardiovascular Medicine, General University Hospital and First Medical Faculty, Charles University, Opletalova 38, Prague 110 00, Czech Republic
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - José Manuel Garcia-Pinilla
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares. Servicio de Cardiología. Hospital Universitario Virgen de la Victoria. IBIMA. Málaga and Ciber-Cardiovascular. Instituto de Salud Carlos III. Madrid, Spain
| | - Tomas Ripoll-Vera
- Inherited Cardiovascular Disease Unit Son Llatzer University Hospital & IdISBa, Palma de Mallorca, Spain
| | - Hubert Seggewiss
- Universitätsklinikum Würzburg, Deutsches Zentrum für Herzinsuffizienz (DZHI), Comprehensive Heart Failure Center (CHFC), Am Schwarzenberg 15, Haus 15A, 97078 Wurzburg, Germany
| | - Eduardo Villacorta
- Member of National Centers of expertise for familial cardiopathies (CSUR), Cardiology Department, University Hospital of Salamanca. Institute of Biomedical Research of Salamanca (IBSAL), CIBERCV, Salamanca, Spain
| | | | - Perry M Elliott
- Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,St. Bartholomew's Hospital, Barts Heart Centre, Barts Health NHS Trust, Whitechapel Rd, London E1 1BB, UK
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Galipienzo J, Otta-Oshiro R, Salvatierra D, Medrano C, López-Rojo I, Linero M. Perioperative management of non-deferrable oncologic surgeries during COVID-19 pandemic in Madrid, Spain. Is it safe? Revista Española de Anestesiología y Reanimación (English Edition) 2022; 69:25-33. [PMID: 35033483 PMCID: PMC8754582 DOI: 10.1016/j.redare.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/04/2021] [Indexed: 12/15/2022]
Abstract
Introduction Surgical treatment during Covid-19 pandemic is controversial. Currently, most clinical guidelines advise to defer surgical patients during the Covid-19 pandemic, although the supporting data is sparse. We assumed that a Covid-19-free hospital, on the back of strong isolation measures and targeted screening, could reduce complications and enable us to continue treating high-risk patients. Methods Prospective study with retrospective analysis of 355 patients who had undergone nondeferrable oncological surgery between March 16th, 2020, and April 14th, 2020, at our institution. The aim of the study was to assess the hospital restructuring and surgical protocols to be able to safely handle non-deferrable surgeries during the first wave of the Covid-19 pandemic. We implemented structural changes and an updated surgical-anesthetic protocol in order to isolate Covid-19 patients from other surgical patients. Comprehensive targeted screening for Covid-19 patients was made. PCR tests were requested for suspected Covid-19 patients. We analyzed mortality and complications related to both surgery and Covid-19 during hospital admission and also 15 and 30 days after surgery. We compared it with a sample of similar patients in the pre-pandemic period. Results Of the 355 patients enrolled in our study, 21 were removed due to Covid-19 infection, leaving a total of 334 patients in our final analysis. Post-operative complications were found in 37 patients (11.07%). Two patients died after surgery (0.6%). At the end of the study, Covid-19-related adverse outcomes were detected in six patients (1.79%). When comparing the complications of our original sample with the complications that occurred in the pre-covid era, we found no statistically significant differences. Conclusions Our results show that the surgical treatment of oncologic patients during the Covid-19 pandemic is safe, as long as the hospital performs surgeries under strict isolation measures and a robust screening method. It is necessary to select Covid-19 free hospitals for this matter in this and future pandemics.
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Méndez I, Fernández AI, Espinosa MÁ, Cuenca S, Lorca R, Rodríguez JF, Tamargo M, García-Montero M, Gómez C, Vilches S, Vázquez N, Álvarez R, Medrano C, Yotti R, Fernández-Avilés F, Bermejo J. Founder mutation in myosin-binding protein C with an early onset and a high penetrance in males. Open Heart 2021; 8:openhrt-2021-001789. [PMID: 34588271 PMCID: PMC8483030 DOI: 10.1136/openhrt-2021-001789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/30/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE One of the challenges in hypertrophic cardiomyopathy (HCM) is to determine the pathogenicity of genetic variants and to establish genotype/phenotype correlations. This study aimed to: (1) demonstrate that MYBPC3 c.2149-1G>A is a founder pathogenic variant, (2) describe the phenotype and clinical characteristics of mutation carriers and (3) compare these patients with those with the most frequent pathogenic HCM variants: MYBPC3 p.Arg502Trp/Gln. METHODS We reviewed genetic tests performed in HCM probands at our institution. We carried out transcript analyses to demonstrate the splicing effect, and haplotype analyses to support the founder effect of MYBPC3 c.2149-1G>A. Carriers with this mutation were compared with those from MYBPC3 p.Arg502Trp/Gln in terms of presentation features, imaging and outcomes. RESULTS MYBPC3 c.2149-1G>A was identified in 8 of 570 probands and 25 relatives. Penetrance was age and sex dependent, 50.0% of the carriers over age 36 years and 75.0% of the carriers over 40 years showing HCM. Penetrance was significantly higher in males: in carriers older than 30 years old, 100.0% of males vs 50.0% of females had a HCM phenotype (p=0.01). Males were also younger at diagnosis (32±13 vs 53±10 years old, p<0.001). MYBPC3 c.2149-1G>A resulted in an abnormal transcript that led to haploinsufficiency and was segregated in two haplotypes. However, both came from one founder haplotype. Affected carriers showed a better functional class and higher left ventricular ejection fraction (LVEF) than patients with MYBPC3 p.Arg502Trp/Gln (p<0.05 for both). Nevertheless, the rate of major adverse outcomes was similar between the two groups. CONCLUSIONS MYBPC3 c.2149-1G>A splicing variant is a founder mutation. Affected males show an early onset of HCM and with higher penetrance than women. Carriers show better functional class and higher LVEF than MYBPC3 p.Arg502Trp/Gln carriers, but a similar rate of major adverse outcomes.
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Affiliation(s)
- Irene Méndez
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain .,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Ana Isabel Fernández
- CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Maria Ángeles Espinosa
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Sofía Cuenca
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Rebeca Lorca
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - José Fernando Rodríguez
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Maria Tamargo
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Marta García-Montero
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Cristina Gómez
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Silvia Vilches
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Nélida Vázquez
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Reyes Álvarez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain.,Pediatric Cardiology, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | - Constancio Medrano
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain.,Pediatric Cardiology, Hospital Materno Infantil Gregorio Marañón, Madrid, Spain
| | | | - Francisco Fernández-Avilés
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Javier Bermejo
- Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,CIBERCV, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
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10
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Pina-Camacho L, Vidal J, Picouto MD, Ortiz EJ, Jääskeläinen FDM, Moreno C, Arango C, Hernández-Sampelayo T, Parellada M, Miranda C, Medrano C, López-Herce J, Luna MS, Blanco MDM, Távora T, Alonso MP, Oria MDC, Vicente MJT, Rubio MAL. Patient care, right to information and consent for minors in situations of parental conflict. Clinical guidelines in the context of Spanish legislation. Anales de Pediatría (English Edition) 2021. [DOI: 10.1016/j.anpede.2020.09.006] [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: 10/21/2022] Open
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11
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Galipienzo J, Otta-Oshiro RJ, Salvatierra D, Medrano C, López-Rojo I, Linero M. Perioperative management of non-deferrable oncologic surgeries during COVID-19 pandemic in Madrid, Spain. Is it safe? Rev Esp Anestesiol Reanim (Engl Ed) 2021; 69:S0034-9356(21)00132-8. [PMID: 34565569 PMCID: PMC8062419 DOI: 10.1016/j.redar.2021.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/01/2021] [Accepted: 03/04/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Surgical treatment during COVID-19 pandemic is controversial. Currently, most clinical guidelines advise to defer surgical patients during the COVID-19 pandemic, although the supporting data is sparse. We assumed that a COVID-19-free hospital, on the back of strong isolation measures and targeted screening, could reduce complications and enable us to continue treating high-risk patients. METHODS Prospective study with retrospective analysis of 355 patients who had undergone nondeferrable oncological surgery between March 16th, 2020, and April 14th, 2020, at our institution. The aim of the study was to assess the hospital restructuring and surgical protocols to be able to safely handle non-deferrable surgeries during the first wave of the COVID-19 pandemic. We implemented structural changes and an updated surgical-anesthetic protocol in order to isolate COVID-19 patients from other surgical patients. Comprehensive targeted screening for COVID-19 patients was made. PCR tests were requested for suspected COVID-19 patients. We analyzed mortality and complications related to both surgery and COVID-19 during hospital admission and also 15 and 30 days after surgery. We compared it with a sample of similar patients in the pre-pandemic period. RESULTS Of the 355 patients enrolled in our study, 21 were removed due to COVID-19 infection, leaving a total of 334 patients in our final analysis. Post-operative complications were found in 37 patients (11.07%). Two patients died after surgery (0.6%). At the end of the study, COVID-19-related adverse outcomes were detected in six patients (1.79%). When comparing the complications of our original sample with the complications that occurred in the pre-COVID era, we found no statistically significant differences. CONCLUSIONS Our results show that the surgical treatment of oncologic patients during the COVID-19 pandemic is safe, as long as the hospital performs surgeries under strict isolation measures and a robust screening method. It is necessary to select COVID-19 free hospitals for this matter in this and future pandemics.
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Affiliation(s)
- J Galipienzo
- Servicio de Anestesia, MD Anderson Cancer Center, Madrid, España.
| | - R J Otta-Oshiro
- Servicio de Urología, MD Anderson Cancer Center, Madrid, España
| | - D Salvatierra
- Servicio de Anestesia, MD Anderson Cancer Center, Madrid, España
| | - C Medrano
- Servicio de Anestesia, MD Anderson Cancer Center, Madrid, España
| | - I López-Rojo
- Servicio de Cirugía General, MD Anderson Cancer Center, Madrid, España
| | - M Linero
- Servicio de Anestesia, MD Anderson Cancer Center, Madrid, España
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12
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Norrish G, Topriceanu C, Qu C, Field E, Walsh H, Ziółkowska L, Olivotto I, Passantino S, Favilli S, Anastasakis A, Vlagkouli V, Weintraub R, King I, Biagini E, Ragni L, Prendiville T, Duignan S, McLeod K, Ilina M, Fernández A, Bökenkamp R, Baban A, Drago F, Kubuš P, Daubeney PEF, Chivers S, Sarquella-Brugada G, Cesar S, Marrone C, Medrano C, Alvarez Garcia-Roves R, Uzun O, Gran F, Castro FJ, Gimeno JR, Barriales-Villa R, Rueda F, Adwani S, Searle J, Bharucha T, Siles A, Usano A, Rasmussen TB, Jones CB, Kubo T, Mogensen J, Reinhardt Z, Cervi E, Elliott PM, Omar RZ, Kaski JP. The role of the electrocardiographic phenotype in risk stratification for sudden cardiac death in childhood hypertrophic cardiomyopathy. Eur J Prev Cardiol 2021; 29:645-653. [PMID: 33772274 PMCID: PMC8967480 DOI: 10.1093/eurjpc/zwab046] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/25/2021] [Accepted: 03/09/2021] [Indexed: 11/13/2022]
Abstract
AIMS The 12-lead electrocardiogram (ECG) is routinely performed in children with hypertrophic cardiomyopathy (HCM). An ECG risk score has been suggested as a useful tool for risk stratification, but this has not been independently validated. This aim of this study was to describe the ECG phenotype of childhood HCM in a large, international, multi-centre cohort and investigate its role in risk prediction for arrhythmic events. METHODS AND RESULTS Data from 356 childhood HCM patients with a mean age of 10.1 years (±4.5) were collected from a retrospective, multi-centre international cohort. Three hundred and forty-seven (97.5%) patients had ECG abnormalities at baseline, most commonly repolarization abnormalities (n = 277, 77.8%); left ventricular hypertrophy (n = 240, 67.7%); abnormal QRS axis (n = 126, 35.4%); or QT prolongation (n = 131, 36.8%). Over a median follow-up of 3.9 years (interquartile range 2.0-7.7), 25 (7%) had an arrhythmic event, with an overall annual event rate of 1.38 (95% CI 0.93-2.04). No ECG variables were associated with 5-year arrhythmic event on univariable or multivariable analysis. The ECG risk score threshold of >5 had modest discriminatory ability [C-index 0.60 (95% CI 0.484-0.715)], with corresponding negative and positive predictive values of 96.7% and 6.7. CONCLUSION In a large, international, multi-centre cohort of childhood HCM, ECG abnormalities were common and varied. No ECG characteristic, either in isolation or combined in the previously described ECG risk score, was associated with 5-year sudden cardiac death risk. This suggests that the role of baseline ECG phenotype in improving risk stratification in childhood HCM is limited.
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Affiliation(s)
- Gabrielle Norrish
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.,Institute of Cardiovascular Sciences, University College London, London, UK
| | | | - Chen Qu
- Department of Statistical Science, University College London, London, UK
| | - Ella Field
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.,Institute of Cardiovascular Sciences, University College London, London, UK
| | - Helen Walsh
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK
| | - Lidia Ziółkowska
- Department of Cardiology, The Children's Memorial Health Institute, Warsaw, Poland
| | | | | | - Silvia Favilli
- Cardiology Unit, A Meyer Pediatric Hospital, Florence, Italy
| | | | | | - Robert Weintraub
- The Royal Children's Hospital, Melbourne, Australia.,The Murdoch Children's Research Institute.,University of Melbourne, Australia
| | | | | | - Luca Ragni
- S. Orsola-Malpighi Hospital, Bologna, Italy
| | | | | | | | | | - Adrian Fernández
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | | | | | | | - Peter Kubuš
- University Hospital Motol, Prague, Czech Republic
| | | | - Sian Chivers
- Royal Brompton and Harefield NHS Trust, London, UK
| | - Georgia Sarquella-Brugada
- Arrhythmia and Inherited Cardiac Diseases Unit, Hospital Sant Joan de Déu, University of Barcelona, Spain.,Medical Sciences Department, School of Medicine, University of Girona
| | - Sergi Cesar
- Arrhythmia and Inherited Cardiac Diseases Unit, Hospital Sant Joan de Déu, University of Barcelona, Spain
| | | | | | | | - Orhan Uzun
- University Hospital of Wales, Cardiff, UK
| | - Ferran Gran
- Val d'Hebron University Hospital, Barcelona, Spain
| | | | - Juan R Gimeno
- University Hospital Virgen de la Arrixaca, Murcia, Spain
| | | | - Fernando Rueda
- Complexo Hospitalario Universitario A Coruña, CIBERCV, A Coruña, Spain
| | | | | | | | - Ana Siles
- Hospital Universitario Puerta de Hierro Majadahonda, CIBERCV, Madrid, Spain.,University Francisco de Vitoria, Pozuelo de Alarcon, Spain
| | - Ana Usano
- Hospital Universitario Puerta de Hierro Majadahonda, CIBERCV, Madrid, Spain.,University Francisco de Vitoria, Pozuelo de Alarcon, Spain
| | | | | | - Toru Kubo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Japan
| | | | | | - Elena Cervi
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.,Institute of Cardiovascular Sciences, University College London, London, UK
| | - Perry M Elliott
- Institute of Cardiovascular Sciences, University College London, London, UK.,St Bartholomew's Centre for Inherited Cardiovascular Diseases, St Bartholomew's Hospital, West Smithfield, London, UK
| | - Rumana Z Omar
- Department of Statistical Science, University College London, London, UK
| | - Juan P Kaski
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.,Institute of Cardiovascular Sciences, University College London, London, UK
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13
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Gil-Jaurena JM, Zunzunegui JL, Pérez-Caballero R, Pita A, Pardo C, Calle C, Murgoitio U, Ballesteros F, Rodríguez A, Medrano C. Hybrid Procedures. Opening Doors for Surgeon and Cardiologist Close Collaboration. Front Pediatr 2021; 9:687909. [PMID: 34386468 PMCID: PMC8353319 DOI: 10.3389/fped.2021.687909] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/23/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Collaboration between cardiac surgeons and cardiologists can offer interventions that each specialist may not be able to offer on their own. This type of collaboration has been demonstrated with the hybrid Stage I in patients with hypoplastic heart syndrome. Since that time, a hybrid approach to cardiac interventions has been expanded to an incredible variety of potential indications. Methods: Seventy-one patients were scheduled for a hybrid procedure along 8 years. This was defined as close collaboration between surgeon and cardiologist working together in the same room, either cath-lab (27 patients) or theater (44 patients). Results: Six groups were arbitrarily defined. A: vascular cut-down in the cath-lab (27 neonates); B: bilateral banding (plus ductal stent) in hypoplastic left heart syndrome or alike (15 children); C: perventricular closure of muscular ventricular septal defect (10 cases); D: balloon/stenting of pulmonary branches along with major surgical procedure (12 kids); E: surgical implantation of Melody valve (six patients) and others (F, one case). Two complications were recorded: left ventricular free wall puncture and previous conduit tearing. Both drawbacks were successfully sort out under cardiopulmonary by-pass. Conclusion: Surgeon and cardiologist partnership can succeed where their isolated endeavors are not enough. Hybrid procedures keep on spreading, overcoming initial expectations. As a bridge to biventricular repair or transplant, bilateral banding plus ductal stent sounds interesting. Novel indications can be classified into different groups. Hybrid procedures are not complication-free.
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Affiliation(s)
- Juan-Miguel Gil-Jaurena
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - José-Luis Zunzunegui
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Pediatric Cardiology, Hospital Gregorio Marañón, Madrid, Spain
| | - Ramón Pérez-Caballero
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ana Pita
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Carlos Pardo
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Corazón Calle
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Uxue Murgoitio
- Pediatric Cardiac Surgery, Hospital Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Fernando Ballesteros
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Pediatric Cardiology, Hospital Gregorio Marañón, Madrid, Spain
| | - Alejandro Rodríguez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Pediatric Cardiology, Hospital Gregorio Marañón, Madrid, Spain
| | - Constancio Medrano
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Pediatric Cardiology, Hospital Gregorio Marañón, Madrid, Spain
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14
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Medrano C, Cointault O, Nogier M, Kamar N, Lavayssiere L, Faguer S. Anticoagulation régionale des circuits de dialyse sans recours au citrate : est-ce possible ? Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.003] [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]
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15
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Norrish G, Ding T, Field E, Ziółkowska L, Olivotto I, Limongelli G, Anastasakis A, Weintraub R, Biagini E, Ragni L, Prendiville T, Duignan S, McLeod K, Ilina M, Fernández A, Bökenkamp R, Baban A, Kubuš P, Daubeney PEF, Sarquella-Brugada G, Cesar S, Marrone C, Bhole V, Medrano C, Uzun O, Brown E, Gran F, Castro FJ, Stuart G, Vignati G, Barriales-Villa R, Guereta LG, Adwani S, Linter K, Bharucha T, Garcia-Pavia P, Rasmussen TB, Calcagnino MM, Jones CB, De Wilde H, Toru-Kubo J, Felice T, Mogensen J, Mathur S, Reinhardt Z, O’Mahony C, Elliott PM, Omar RZ, Kaski JP. Development of a Novel Risk Prediction Model for Sudden Cardiac Death in Childhood Hypertrophic Cardiomyopathy (HCM Risk-Kids). JAMA Cardiol 2019; 4:918-927. [PMID: 31411652 PMCID: PMC6694401 DOI: 10.1001/jamacardio.2019.2861] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/19/2019] [Indexed: 12/16/2022]
Abstract
Importance Sudden cardiac death (SCD) is the most common mode of death in childhood hypertrophic cardiomyopathy (HCM), but there is no validated algorithm to identify those at highest risk. Objective To develop and validate an SCD risk prediction model that provides individualized risk estimates. Design, Setting, and Participants A prognostic model was developed from a retrospective, multicenter, longitudinal cohort study of 1024 consecutively evaluated patients aged 16 years or younger with HCM. The study was conducted from January 1, 1970, to December 31, 2017. Exposures The model was developed using preselected predictor variables (unexplained syncope, maximal left-ventricular wall thickness, left atrial diameter, left-ventricular outflow tract gradient, and nonsustained ventricular tachycardia) identified from the literature and internally validated using bootstrapping. Main Outcomes and Measures A composite outcome of SCD or an equivalent event (aborted cardiac arrest, appropriate implantable cardioverter defibrillator therapy, or sustained ventricular tachycardia associated with hemodynamic compromise). Results Of the 1024 patients included in the study, 699 were boys (68.3%); mean (interquartile range [IQR]) age was 11 (7-14) years. Over a median follow-up of 5.3 years (IQR, 2.6-8.3; total patient years, 5984), 89 patients (8.7%) died suddenly or had an equivalent event (annual event rate, 1.49; 95% CI, 1.15-1.92). The pediatric model was developed using preselected variables to predict the risk of SCD. The model's ability to predict risk at 5 years was validated; the C statistic was 0.69 (95% CI, 0.66-0.72), and the calibration slope was 0.98 (95% CI, 0.59-1.38). For every 10 implantable cardioverter defibrillators implanted in patients with 6% or more of a 5-year SCD risk, 1 patient may potentially be saved from SCD at 5 years. Conclusions and Relevance This new, validated risk stratification model for SCD in childhood HCM may provide individualized estimates of risk at 5 years using readily obtained clinical risk factors. External validation studies are required to demonstrate the accuracy of this model's predictions in diverse patient populations.
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Affiliation(s)
- Gabrielle Norrish
- Centre for Inherited Cardiovascular Diseases, Department of Cardiology, Great Ormond Street Hospital, London, United Kingdom
- Institute of Cardiovascular Sciences, University College London, London, United Kingdom
- European Reference Network for Rare and Complex Diseases of the Heart, Amsterdam, the Netherlands
| | - Tao Ding
- Department of Statistical Science, University College London, London, United Kingdom
| | - Ella Field
- Centre for Inherited Cardiovascular Diseases, Department of Cardiology, Great Ormond Street Hospital, London, United Kingdom
- Institute of Cardiovascular Sciences, University College London, London, United Kingdom
- European Reference Network for Rare and Complex Diseases of the Heart, Amsterdam, the Netherlands
| | - Lidia Ziółkowska
- Department of Cardiology, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Iacopo Olivotto
- Cardiothoracovascular Department, Careggi University Hospital, Florence, Italy
| | - Giuseppe Limongelli
- European Reference Network for Rare and Complex Diseases of the Heart, Amsterdam, the Netherlands
- Department of Cardiothoracic Sciences, Monaldi Hospital, Naples, Italy
| | | | - Robert Weintraub
- Department of Cardiology, The Royal Children’s Hospital, Melbourne, Australia
- Department of Clinical Sciences, The Murdoch Children’s Research Institute, Parkville, Australia
- Department of Medical and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Elena Biagini
- Department of Cardiology, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Luca Ragni
- Department of Cardiology, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Terence Prendiville
- The Children’s Heart Centre, Our Lady’s Children’s Hospital, Dublin, Ireland
| | - Sophie Duignan
- The Children’s Heart Centre, Our Lady’s Children’s Hospital, Dublin, Ireland
| | - Karen McLeod
- Department of Paediatric Cardiology, Royal Hospital for Children, Glasgow, United Kingdom
| | - Maria Ilina
- Department of Paediatric Cardiology, Royal Hospital for Children, Glasgow, United Kingdom
| | - Adrián Fernández
- Department of Ambulatory Cardiology, Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - Regina Bökenkamp
- Department of Paediatric Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Anwar Baban
- European Reference Network for Rare and Complex Diseases of the Heart, Amsterdam, the Netherlands
- Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesu Hospital, Rome, Italy
| | - Peter Kubuš
- Children’s Heart Centre, University Hospital Motol, Prague, Czech Republic
| | - Piers E. F. Daubeney
- Department of Paediatric Cardiology, Royal Brompton and Harefield NHS Trust, London, United Kingdom
| | - Georgia Sarquella-Brugada
- European Reference Network for Rare and Complex Diseases of the Heart, Amsterdam, the Netherlands
- Arrhythmia and Inherited Cardiac Diseases Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Medical Sciences Department, School of Medicine, University of Girona, Girona, Spain
| | - Sergi Cesar
- European Reference Network for Rare and Complex Diseases of the Heart, Amsterdam, the Netherlands
- Arrhythmia and Inherited Cardiac Diseases Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Chiara Marrone
- Department of Paediatric Cardiology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Vinay Bhole
- The Heart Unit, Birmingham Children’s Hospital, Birmingham, United Kingdom
| | - Constancio Medrano
- Department of Paediatric Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Orhan Uzun
- Children’s Heart Unit, University Hospital of Wales, Cardiff, United Kingdom
| | - Elspeth Brown
- Department of Paediatric Cardiology, Leeds General Infirmary, Leeds, United Kingdom
| | - Ferran Gran
- Paediatric Cardiology Department, Val d’Hebron University Hospital, Barcelona, Spain
| | - Francisco J. Castro
- Department of Cardiology, University Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Graham Stuart
- Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | | | - Roberto Barriales-Villa
- Department of Cardiology, Complexo Hospitalario Universitario A Coruña, Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, A Coruña, Spain
| | - Luis G. Guereta
- Department of Cardiology, University Hospital La Paz, Madrid, Spain
| | - Satish Adwani
- Department of Paediatric Cardiology, John Radcliffe Hospital, Oxford, United Kingdom
| | - Katie Linter
- Department of Paediatric Cardiology, Glenfield Hospital, Leicester, United Kingdom
| | - Tara Bharucha
- Department of Paediatric Cardiology, Southampton General Hospital, Southampton, United Kingdom
| | - Pablo Garcia-Pavia
- European Reference Network for Rare and Complex Diseases of the Heart, Amsterdam, the Netherlands
- Department of Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
- Department of Cardiology, University Francisco de Vitoria, Pozuelo de Alarcon, Spain
| | | | - Margherita M. Calcagnino
- Department of Cardiology, University Hospitals Parma, Parma, Italy
- Cardiology Unit, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Caroline B. Jones
- Department of Cardiology, Alder Hey Children’s Hospital, Liverpool, United Kingdom
| | - Hans De Wilde
- Department of Paediatric Cardiology, Ghent University Hospital, Ghent, Belgium
| | - J. Toru-Kubo
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Tiziana Felice
- Department of Paediatric Cardiology, Mater Dei Hospital, Msida, Malta
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Sujeev Mathur
- Children’s Heart Service, Evelina Children’s Hospital, London, United Kingdom
| | - Zdenka Reinhardt
- Department of Paediatric Cardiology, The Freeman Hospital, Newcastle, United Kingdom
| | - Constantinos O’Mahony
- Institute of Cardiovascular Sciences, University College London, London, United Kingdom
- European Reference Network for Rare and Complex Diseases of the Heart, Amsterdam, the Netherlands
- St Bartholomew’s Centre for Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, West Smithfield, London, United Kingdom
| | - Perry M. Elliott
- Institute of Cardiovascular Sciences, University College London, London, United Kingdom
- European Reference Network for Rare and Complex Diseases of the Heart, Amsterdam, the Netherlands
- St Bartholomew’s Centre for Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, West Smithfield, London, United Kingdom
| | - Rumana Z. Omar
- Department of Statistical Science, University College London, London, United Kingdom
| | - Juan P. Kaski
- Centre for Inherited Cardiovascular Diseases, Department of Cardiology, Great Ormond Street Hospital, London, United Kingdom
- Institute of Cardiovascular Sciences, University College London, London, United Kingdom
- European Reference Network for Rare and Complex Diseases of the Heart, Amsterdam, the Netherlands
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Benito Y, Martinez-Legazpi P, Rossini L, Pérez del Villar C, Yotti R, Martín Peinador Y, Rodríguez-Pérez D, Desco MM, Medrano C, Antoranz JC, Fernández-Avilés F, del Álamo JC, Bermejo J. Age-Dependence of Flow Homeostasis in the Left Ventricle. Front Physiol 2019; 10:485. [PMID: 31105588 PMCID: PMC6498893 DOI: 10.3389/fphys.2019.00485] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/08/2019] [Indexed: 11/29/2022] Open
Abstract
Background: Intracardiac flow homeostasis requires avoiding blood stasis and platelet activation during its transit through the cardiac chambers. However, the foundations of intraventricular blood washout and its exposure to shear stresses have been poorly addressed. We aimed to characterize and quantify these features in a wide population of healthy subjects and assess the relationships of these indices with age. Methods: We used color-Doppler echocardiography and custom post-processing methods to study 149 healthy volunteers from 26 days to 80 years old. From the intraventricular flow-velocity fields we obtained personalized maps of (1) the residence time of blood in the LV, and (2) the shear index, a metric accounting for the strongest occurrence of shear stresses inside the chamber. From these maps we derived quantitative indices of the overall intraventricular blood washout and shear exposure. We addressed the age-dependence of these indices and analyzed their relationship with age-related changes in filling-flow. Results: The entire intraventricular blood pool was replaced before 8 cycles. Average residence time of blood inside the LV was <3 cycles in all subjects and followed an inverse U-shape relationship with age, increasing from median (IQR) of 1.0 (0.7 to 1.2) cycles in the 1st year of life to 1.8 (1.4-2.2) cycles in young adults (17-30 years old), becoming shorter again thereafter. Shear index showed no relation with age and was bounded around 20 dyn·s/cm2. Regions with the longest residence time and highest shear index were identified near the apex. Differences in the degree of apical penetration of the filling waves and the duration of the late-filling phase explained the age-dependence of residence time (R adj 2 = 0.48, p < 0.001). Conclusions: In average, blood spends 1 to 3 beats inside the LV with very low shear stress rates. The apical region is the most prone to blood stasis, particularly in mid-aged adults. The washout of blood in the normal LV is age-dependent due to physiological changes in the degree of apical penetration of the filling waves.
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Affiliation(s)
- Yolanda Benito
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERCV, Madrid, Spain
| | - Pablo Martinez-Legazpi
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERCV, Madrid, Spain
| | - Lorenzo Rossini
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, United States
| | - Candelas Pérez del Villar
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERCV, Madrid, Spain
| | - Raquel Yotti
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERCV, Madrid, Spain
| | - Yolanda Martín Peinador
- Centro de Salud Goya, Dirección Asistencial Centro, Atención Primaria de Madrid, Madrid, Spain
| | - Daniel Rodríguez-Pérez
- Department of Mathematical Physics and Fluids, Facultad de Ciencias, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - M. Mar Desco
- Department of Mathematical Physics and Fluids, Facultad de Ciencias, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Constancio Medrano
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERCV, Madrid, Spain
| | - Jose Carlos Antoranz
- Department of Mathematical Physics and Fluids, Facultad de Ciencias, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Francisco Fernández-Avilés
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERCV, Madrid, Spain
| | - Juan C. del Álamo
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, United States
- Institute for Engineering in Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Javier Bermejo
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERCV, Madrid, Spain
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Rodriguez V, Medrano C, Plaza I, Corella C, Abarca A, Julian J. Comparison of Several Algorithms to Estimate Activity Counts with Smartphones as an Indication of Physical Activity Level. Ing Rech Biomed 2019. [DOI: 10.1016/j.irbm.2018.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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Martínez-González MA, Buil-Cosiales P, Corella D, Bulló M, Fitó M, Vioque J, Romaguera D, Martínez JA, Wärnberg J, López-Miranda J, Estruch R, Bueno-Cavanillas A, Arós F, Tur JA, Tinahones F, Serra-Majem L, Martín V, Lapetra J, Vázquez C, Pintó X, Vidal J, Daimiel L, Delgado-Rodríguez M, Matía P, Ros E, Fernández-Aranda F, Botella C, Portillo MP, Lamuela-Raventós RM, Marcos A, Sáez G, Gómez-Gracia E, Ruiz-Canela M, Toledo E, Alvarez-Alvarez I, Díez-Espino J, Sorlí JV, Basora J, Castañer O, Schröder H, Navarrete-Muñoz EM, Zulet MA, García-Rios A, Salas-Salvadó J, Corella D, Estruch R, Fitó M, Martínez-González MA, Ros E, Salas-Salvadó J, Babio N, Ros E, Sánchez-Tainta A, Martínez-González MA, Fitó M, Schröder H, Marcos A, Corella D, Wärnberg J, Martínez-González MA, Estruch R, Fernández-Aranda F, Botella C, Salas-Salvadó J, Razquin C, Bes-Rastrollo M, Sanchez Tainta A, Vázquez Z, SanJulian Aranguren B, Goñi E, Goñi L, Barrientos I, Canales M, Sayón-Orea MC, Rico A, Basterra Gortari J, Garcia Arellano A, Lecea-Juarez O, Carlos Cenoz-Osinaga J, Bartolome-Resano J, Sola-Larraza† A, Lozano-Oloriz E, Cano-Valles B, Eguaras S, Güeto V, Pascual Roquet-Jalmar E, Galilea-Zabalza I, Lancova H, Ramallal R, Garcia-Perez ML, Estremera-Urabayen V, Ariz-Arnedo MJ, Hijos-Larraz C, Fernandez Alfaro C, Iñigo-Martinez B, Villanueva Moreno R, Martin-Almendros S, Barandiaran-Bengoetxea L, Fuertes-Goñi C, Lezaun-Indurain A, Guruchaga-Arcelus MJ, Olmedo-Cruz O, Iñigo-Martínez B, Escriche-Erviti L, Ansorena-Ros R, Sanmatin-Zabaleta R, Apalategi-Lasa J, Villanueva-Telleria J, Hernández-Espinosa MM, Arroyo-Bergera I, Herrera-Valdez L, Dorronsoro-Dorronsoro L, González JI, Sorlí JV, Portolés O, Fernández-Carrión R, Ortega-Azorín C, Barragán R, Asensio EM, Coltell O, Sáiz C, Osma R, Férriz E, González-Monje I, Giménez-Fernández F, Quiles L, Carrasco P, San Onofre N, Carratalá-Calvo A, Valero-Barceló C, Antón F, Mir C, Sánchez-Navarro S, Navas J, González-Gallego I, Bort-Llorca L, Pérez-Ollero L, Giner-Valero M, Monfort-Sáez R, Nadal-Sayol J, Pascual-Fuster V, Martínez-Pérez M, Riera C, Belda MV, Medina A, Miralles E, Ramírez-Esplugues MJ, Rojo-Furió M, Mattingley G, Delgado MA, Pages MA, Riofrío Y, Abuomar L, Blasco-Lafarga N, Tosca R, Lizán L, Guillem-Saiz P, Valcarce AM, Medina MD, Monfort R, de Valcárcel S, Tormo N, Felipe-Román O, Lafuente S, Navío EI, Aldana G, Crespo JV, Llosa JL, González-García L, Raga-Marí R, Pedret Llaberia R, Gonzalez R, Sagarra Álamo R, París Palleja F, Balsells J, Roca JM, Basora Gallisa T, Vizcaino J, Llobet Alpizarte P, Anguera Perpiñá C, Llauradó Vernet M, Caballero C, Garcia Barco M, Morán Martínez MD, García Rosselló J, Del Pozo A, Poblet Calaf C, Arcelin Zabal P, Floresví X, Ciutat Benet M, Palau Galindo A, Cabré Vila JJ, Dolz Andrés F, Boj Casajuana J, Ricard M, Saiz F, Isach A, Sanchez Marin Martinez M, Bulló M, Babio N, Becerra-Tomás N, Mestres G, Basora J, Mena-Sánchez G, Barrubés Piñol L, Gil Segura M, Papandreou C, Rosique Esteban N, Chig S, Abellán Cano I, Ruiz García V, Salas-Huetos A, Hernandez P, Canudas S, Camacho-Barcia L, García-Gavilán J, Diaz A, Castañer O, Muñoz MA, Zomeño MD, Hernaéz A, Torres L, Quifer M, Llimona R, Gal LA, Pérez A, Farràs M, Elosua R, Marrugat J, Vila J, Subirana I, Pérez S, Muñoz MA, Goday A, Chillaron Jordan JJ, Flores Lerroux JA, Benaiges Boix D, Farré M, Menoyo E, Muñoz-Aguayo D, Gaixas S, Blanchart G, Sanllorente A, Soria M, Valussi J, Cuenca A, Forcano L, Pastor A, Boronat A, Tello S, Cabañero M, Franco L, Schröder H, De la Torre R, Medrano C, Bayó J, García MT, Robledo V, Babi P, Canals E, Soldevila N, Carrés L, Roca C, Comas MS, Gasulla G, Herraiz X, Martínez A, Vinyoles E, Verdú JM, Masague Aguade M, Baltasar Massip E, Lopez Grau M, Mengual M, Moldon V, Vila Vergaz M, Cabanes Gómez Ciurana R, Gili Riu M, Palomeras Vidal A, Garcia de la Hera M, González Palacios S, Torres Collado L, Valera Gran D, Compañ Gabucio L, Oncina Canovas A, Notario Barandiaran L, Orozco Beltran D, Pertusa Martínez S, Cloquell Rodrigo B, Hernándis Marsán MV, Asensio A, Altozano Rodado MC, Ballester Baixauli JJ, Fernándis Brufal N, Martínez Vergara MC, Román Maciá J, Candela García I, Pedro Cases Pérez E, Tercero Maciá C, Mira Castejón LA, de los Ángeles García García I, Zazo JM, Gisbert Sellés C, Sánchez Botella C, Fiol M, Moñino M, Colom A, Konieczna J, Morey M, Zamanillo R, Galmés AM, Pereira V, Martín MA, Yáñez A, Llobera J, Ripoll J, Prieto R, Grases F, Costa A, Fernández-Palomeque C, Fortuny E, Noris M, Munuera S, Tomás F, Fiol F, Jover A, Janer JM, Vallespir C, Mattei I, Feuerbach N, del Mar Sureda M, Vega S, Quintana L, Fiol A, Amador M, González S, Coll J, Moyá A, Abete I, Cantero I, Cristobo C, Ibero-Baraibar I, Lezáun Burgui MD, Goñi Ruiz N, Bartolomé Resano R, Cano Cáceres E, Elcarte López T, Echarte Osacain E, Pérez Sanz B, Blanco Platero I, Andueza Azcárate SA, Gimeno Aznar A, Ursúa Sesma E, Ojeda Bilbao B, Martinez Jarauta J, Ugalde Sarasa L, Rípodas Echarte B, Güeto Rubio MV, Fernández-Crehuet Navajas J, Gutiérrez Bedmar M, García Rodriguez A, Mariscal Larrubia A, Carnero Varo M, Muñoz Bravo C, Barón-López FJ, Fernández García JC, Pérez-Farinós N, Moreno-Morales N, del C Rodríguez-Martínez M, Pérez-López J, Benavente-Marín JC, Crespo Oliva E, Contreras Fernández E, Carmona González FJ, Carabaño Moral R, Torres Moreno S, Martín Ruíz MV, Alcalá Cornide M, Fuentes Gómez V, Criado García J, Jiménez Morales AI, Delgado Casado N, Ortiz Morales A, Torres Peña JD, Gómez Delgado FJ, Rodríguez Cantalejo F, Caballero Villaraso J, Alcalá JF, Peña Orihuela PJ, Quintana Navarro G, Casas R, Domenech M, Viñas C, Castro-Barquero S, Ruiz-León AM, Sadurní M, Frontana G, Villanueva P, Gual M, Soriano R, Camafort M, Sierra C, Sacanella E, Sala-Vila A, Cots JM, Sarroca I, García M, Bermúdez N, Pérez A, Duaso I, de la Arada A, Hernández R, Simón C, de la Poza MA, Gil I, Vila M, Iglesias C, Assens N, Amatller M, Rams LL, Benet T, Fernández G, Teruel J, Azorin A, Cubells M, López D, Llovet JM, Gómez ML, Climente P, de Paula L, Soto J, Carbonell C, Llor C, Abat X, Cama A, Fortuny M, Domingo C, Liberal AI, Martínez T, Yañez E, Nieto MJ, Pérez A, Lloret E, Carrazoni C, Belles AM, Olmos C, Ramentol M, Capell MJ, Casas R, Giner I, Muñoz A, Martín R, Moron E, Bonillo A, Sánchez G, Calbó C, Pous J, Massip M, García Y, Massagué MC, Ibañez R, Llaona J, Vidal T, Vizcay N, Segura E, Galindo C, Moreno M, Caubet M, Altirriba J, Fluxà G, Toribio P, Torrent E, Anton JJ, Viaplana A, Vieytes G, Duch N, Pereira A, Moreno MA, Pérez A, Sant E, Gené J, Calvillo H, Pont F, Puig M, Casasayas M, Garrich A, Senar E, Martínez A, Boix I, Sequeira E, Aragunde V, Riera S, Salgado M, Fuentes M, Martín E, Ubieto A, Pallarés F, Sala C, Abilla A, Moreno S, Mayor E, Colom T, Gaspar A, Gómez A, Palacios L, Garrigosa R, García Molina L, Riquelme Gallego B, Cano Ibañez N, Maldonado Calvo A, López Maldonado A, Garrido EM, Baena Dominguez A, García Jiménez F, Thomas Carazo E, Jesús Turnes González A, González Jiménez F, Padilla Ruiz F, Machado Santiago J, Martínez Bellón MD, Pueyos Sánchez A, Arribas Mir L, Rodríguez Tapioles R, Dorador Atienza F, Baena Camus L, Osorio Martos C, Rueda Lozano D, López Alcázar M, Ramos Díaz F, Cruz Rosales Sierra M, Alguacil Cubero P, López Rodriguez A, Guerrero García F, Tormo Molina J, Ruiz Rodríguez F, Rekondo J, Salaverria I, Alonso-Gómez A, Belló MC, Loma-Osorio A, Tojal L, Bruyel P, Goicolea L, Sorto C, Casi Casanellas A, Arnal Otero ML, Ortueta Martínez De Arbulo J, Vinagre Morgado J, Romeo Ollora J, Urraca J, Sarriegui Carrera MI, Toribio FJ, Magán E, Rodríguez A, Castro Madrid S, Gómez Merino MT, Rodríguez Jiménez M, Gutiérrez Jodra M, López Alonso B, Iturralde Iriso J, Pascual Romero C, Izquierdo De La Guerra A, Abbate M, Aguilar I, Angullo E, Arenas A, Argelich E, Bibiloni MM, Bisbal Y, Bouzas C, Busquets C, Capó X, Carreres S, De la Peña A, Gallardo L, Gámez JM, García B, García C, Julibert A, Llompart I, Mascaró CM, Mateos D, Montemayor S, Pons A, Ripoll T, Rodríguez T, Salaberry E, Sureda A, Tejada S, Ugarriza L, Valiño L, Bernal López MR, Macías González M, Ruiz Nava J, Fernández García JC, Muñoz Garach A, Vilches Pérez A, González Banderas A, Alcaide Torres J, Vargas Candela A, León Fernández M, Hernández Robles R, Santamaría Fernández S, Marín JM, Valdés Hernández S, Villalobos JC, Ortiz A, Álvarez-Pérez J, Díaz Benítez EM, Díaz-Collado F, Sánchez-Villegas A, Pérez-Cabrera J, Casañas-Quintana LT, García-Guerra RB, Bautista-Castaño I, Ruano-Rodríguez C, Sarmiento de la Fe F, García-Pastor JA, Macías-Gutiérrez B, Falcón-Sanabria I, Simón-García C, Santana-Santana AJ, Álvarez-Álvarez JB, Díaz-González BV, Castillo Anzalas JM, Sosa-Also RE, Medina-Ponce J, Abajo Olea S, Adlbi Sibai A, Aguado Arconada A, Álvarez L, Carriedo Ule E, Escobar Fernández M, Ferradal García JI, Fernández Vázquez JP, García González M, González Donquiles C, González Quintana C, González Rivero F, Lavinia Popescu M, López Gil JI, López de la Iglesia J, Marcos Delgado A, Merino Acevedo C, Reguero Celada S, Rodríguez Bul M, Vilorio-Marqués L, Santos-Lozano JM, Miró-Moriano L, Domínguez-Espinaco C, Vaquero-Díaz S, García-Corte FJ, Santos-Calonge A, Toro-Cortés C, Pelegrina-López N, Urbano-Fernández V, Ortega-Calvo M, Lozano-Rodríguez J, Rivera-Benítez I, Caballero-Valderrama M, Iglesias-Bonilla P, Román-Torres P, Corchado-Albalat Y, Mayoral-Sánchez E, de Cos AI, Gutierrez S, Artola S, Galdon A, Gonzalo I, Más S, Sierra R, Luca B, Prieto L, Galera A, Gimenez-Gracia M, Figueras R, Poch M, Freixedas R, Trias F, Sarasa I, Fanlo M, Lafuente H, Liceran M, Rodriguez-Sanchez A, Pallarols C, Monedero J, Corbella X, Corbella E, Altés A, Vinagre I, Mestres C, Viaplana J, Serra M, Vera J, Freitas T, Ortega E, Pla I, Ordovás JM, Micó V, Berninches L, Concejo MJ, Muñoz J, Adrián M, de la Fuente Y, Albertos C, Villahoz E, Cornejo ML, Gaforio JJ, Moraleda S, Liétor N, Peis JI, Ureña T, Rueda M, Ballesta MI, Moreno Lopera C, Aragoneses Isabel C, Sirur Flores MA, Ceballos de Diego M, Bescos Cáceres T, Peña Cereceda Y, Martínez Abad M, Cabrera Vela R, González Cerrajero M, Rubio Herrera MA, Torrego Ellacuría M, Barabash Bustelo A, Ortiz Ramos M, Garin Barrutia U, Baños R, García-Palacios A, Cerdá Micó C, Estañ Capell N, Iradi A, Fandos Sánchez M. Cohort Profile: Design and methods of the PREDIMED-Plus randomized trial. Int J Epidemiol 2018; 48:387-388o. [PMID: 30476123 DOI: 10.1093/ije/dyy225] [Citation(s) in RCA: 159] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 01/04/2023] Open
Affiliation(s)
- Miguel A Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Pilar Buil-Cosiales
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Monica Bulló
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Clinical Epidemiology and Public Health Department, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - J Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
| | - Julia Wärnberg
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - Jose López-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Cardiology, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Josep A Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Francisco Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Las Palmas de Gran Canaria, Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Jose Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Clotilde Vázquez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Eating Disorders Unit, Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain
| | - Cristina Botella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - María Puy Portillo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition and Food Science, Faculty of Pharmacy and Lucio Lascaray Research Center, Universidad del País Vasco (UPV/EHU), Vitoria, Spain
| | - Rosa M Lamuela-Raventós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, -UB, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Ascensión Marcos
- Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Guillermo Sáez
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Odontology, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
| | | | - Miguel Ruiz-Canela
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Estefania Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Ismael Alvarez-Alvarez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Javier Díez-Espino
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - José V Sorlí
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Josep Basora
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Olga Castañer
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Helmut Schröder
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Eva María Navarrete-Muñoz
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Maria Angeles Zulet
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
| | - Antonio García-Rios
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
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19
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Miera O, Schmitt KL, Akintuerk H, Boet A, Cesnjevar R, Chila T, Fleck T, Goldwasser R, Guereta LG, Heineking B, Hoerer J, Horke A, Hsia TY, Huebler M, Kansy A, Karimova A, Maruszewski B, Medrano C, Pawlak S, Reinhardt Z, Romlin B, Sandica E, Schmidt F, Schramm R, Schweiger M, Śliwka J, Stiller B, Thul J, Amodeo A. Antithrombotic therapy in pediatric ventricular assist devices: Multicenter survey of the European EXCOR Pediatric Investigator Group. Int J Artif Organs 2018; 41:385-392. [DOI: 10.1177/0391398818773040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objectives: Mechanical circulatory support for pediatric heart failure patients with the Berlin Heart EXCOR ventricular assist system is the only approved and established bridging strategy for recovery or heart transplantation. In recent years, the burden of thromboembolic events has led to modifications of the recommended antithrombotic therapy. Therefore, we aimed to assess modifications of antithrombotic practice among the European EXCOR Pediatric Investigator Group members. Methods: We sent a questionnaire assessing seven aspects of antithrombotic therapy to 18 European hospitals using the EXCOR device for children. Returned questionnaires were analyzed and identified antithrombotic strategies were descriptively compared to “Edmonton protocol” recommendations developed for the US EXCOR pediatric approval study. Results: Analysis of 18 received surveys revealed substantial deviations from the Edmonton protocol, including earlier start of heparin therapy at 6–12 h postoperatively and in 50% of surveyed centers, monitoring of heparin effectiveness with aPTT assay, administering vitamin K antagonists before 12 months of age. About 39% of centers use higher international normalized ratio targets, and platelet inhibition is changed in 56% including the use of clopidogrel instead of dipyridamole. Significant inter-center variability with multiple deviations from the Edmonton protocol was discovered with only one center following the Edmonton protocol completely. Conclusion: Current antithrombotic practice among European EXCOR users representing the treatment of more than 600 pediatric patients has changed over time with a trend toward a more aggressive therapy. There is a need for systematic evidence-based evaluation and harmonization of developmentally adjusted antithrombotic management practices in prospective studies toward revised recommendations.
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Affiliation(s)
- Oliver Miera
- Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Katharina L Schmitt
- Department of Congenital Heart Disease—Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Hakan Akintuerk
- Pediatric Heart Center, University Hospital Giessen, Justus Liebig University, Giessen, Germany
| | - Angele Boet
- Cardiac ICU, “Marie Lannelongue” Surgical Center, South Paris University Hospitals, Paris, France
| | - Robert Cesnjevar
- Department of Pediatric Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany
| | - Teresa Chila
- Department of Pediatric Cardiology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - Thilo Fleck
- Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Center Freiburg, Freiburg, Germany
| | - Ranny Goldwasser
- Department of Pediatric Cardiology/Congenital Heart Disease, Heidelberg University Hospital, Heidelberg, Germany
| | - Luis G Guereta
- Pediatric Cardiology, University Hospital La Paz, Madrid, Spain
| | - Beatrice Heineking
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Juergen Hoerer
- Cardiac ICU, “Marie Lannelongue” Surgical Center, South Paris University Hospitals, Paris, France
| | - Alexander Horke
- Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany
| | - Tain Y Hsia
- Department of Pediatric Cardiology, Great Ormond Street Hospital for Children, London, UK
| | - Michael Huebler
- Department of Congenital Pediatric Surgery, Zurich Children’s Hospital, Zurich, Switzerland
| | - Andrzej Kansy
- Department of Cardiothoracic Surgery, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Ann Karimova
- Department of Pediatric Cardiology, Great Ormond Street Hospital for Children, London, UK
| | - Bohdan Maruszewski
- Department of Cardiothoracic Surgery, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Constancio Medrano
- Pediatric Cardiology Division, Hospital Materno Infantil, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Szymon Pawlak
- Department of Cardiac Surgery and Transplantology, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Zdenka Reinhardt
- Department of Pediatric Cardiology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - Birgitta Romlin
- Department of Pediatric Anesthesia and Intensive Care, Queen Silvia Children’s Hospital, Gothenburg, Sweden
| | - Eugen Sandica
- Center for Congenital Heart Defects, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - Florian Schmidt
- Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany
| | - René Schramm
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Martin Schweiger
- Department of Congenital Pediatric Surgery, Zurich Children’s Hospital, Zurich, Switzerland
| | - Joanna Śliwka
- Department of Cardiac Surgery and Transplantology, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Brigitte Stiller
- Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Center Freiburg, Freiburg, Germany
| | - Josef Thul
- Pediatric Heart Center, University Hospital Giessen, Justus Liebig University, Giessen, Germany
| | - Antonio Amodeo
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Rome, Italy
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20
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Bernaldo de Quirós E, Camino M, Gil N, Panadero E, Medrano C, Gil-Jaurena J, Clemente M, Pérez V, Pion M, Correa-Rocha R. Employment of the Human Thymus as an Alternative Source of Regulatory T Cells to develop an immunotherapy to prevent rejection in transplanted children. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.293] [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: 10/17/2022]
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21
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Alonso-García A, Atienza F, Ávila P, Ugueto C, Centeno M, Álvarez R, Datino T, González-Torrecilla E, Castellanos E, Loughlin G, Medrano C, Arenal Á, Fernández-Avilés F. Pediatric Catheter Ablation: Characteristics and Results of a Series in a Tertiary Referral Hospital. ACTA ACUST UNITED AC 2018; 71:794-800. [PMID: 29482981 DOI: 10.1016/j.rec.2018.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/10/2017] [Indexed: 10/17/2022]
Abstract
INTRODUCTION AND OBJECTIVES Catheter ablation has become the treatment of choice in an increasing number of arrhythmias in children and adolescents. There is still limited evidence of its use at a national level in Spain. The aim was to describe the characteristics and results of a modern monocentric series form a referral tertiary care centre. METHODS Retrospective register of invasive procedures between 2004 and 2016 performed in patients under 17 years and recorded clinical characteristic, ablation methodology and acute and chronic results of the procedure. RESULTS A total of 291 procedures in 224 patients were included. Median age was 12.2 years, 60% male. Overall, 46% patients were referred from other autonomous communities. The most frequent substrates were accessory pathways (AP) (70.2%,>50% septal AP localization) and atrioventricular nodal reentrant tachycardia (AVNRT) (15.8%). Congenital and acquired heart disease was frequent (16.8%). Cryoablation was used in 35.5% of the cases. Overall acute success of the primary procedure was 93.5% (AP 93.8%; AVNRT 100%). Redo procedures after recurrence were performed in 18.9% of all substrates, with a long-term cumulative efficacy of 98.4% (AP 99.3%; AVNRT 100%). One (0.37%) serious complication occurred, a case of complete atrioventricular block. CONCLUSIONS Our study replicated previous international reports of high success rates with scarce complications in a high complexity series, confirming the safety and efficacy of pediatric catheter ablation in our environment performed at highly experienced referral centers.
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Affiliation(s)
- Andrés Alonso-García
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Felipe Atienza
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
| | - Pablo Ávila
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Clara Ugueto
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Miriam Centeno
- Servicio de Pediatría, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Reyes Álvarez
- Servicio de Pediatría, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Tomás Datino
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Esteban González-Torrecilla
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Evaristo Castellanos
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Gerard Loughlin
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Constancio Medrano
- Servicio de Pediatría, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Ángel Arenal
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco Fernández-Avilés
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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22
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Charron P, Elliott PM, Gimeno JR, Caforio ALP, Kaski JP, Tavazzi L, Tendera M, Maupain C, Laroche C, Rubis P, Jurcut R, Calò L, Heliö TM, Sinagra G, Zdravkovic M, Kavoliūnienė A, Felix SB, Grzybowski J, Losi MA, Asselbergs FW, García-Pinilla JM, Salazar-Mendiguchia J, Mizia-Stec K, Maggioni AP, Anastasakis A, Biagini E, Bilinska Z, Castro FJ, Celutkiene J, Chakova N, Chmielewski P, Drago F, Frigy A, Frustaci A, Garcia-Pavia P, Hinic S, Kindermann I, Limongelli G, Medrano C, Monserrat L, Olusegun-Joseph A, Ripoll-Vera T, Rocha Lopes L, Saad A, Sala S, Seferovic PM, Sepp R, Urbano-Moral JA, Villacorta E, Wybraniec M, Yotti R, Zachara E, Zorio E. The Cardiomyopathy Registry of the EURObservational Research Programme of the European Society of Cardiology: baseline data and contemporary management of adult patients with cardiomyopathies. Eur Heart J 2018; 39:1784-1793. [DOI: 10.1093/eurheartj/ehx819] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [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: 08/28/2017] [Accepted: 01/09/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Philippe Charron
- Centre de Référence des Maladies Cardiaques Héréditaires, Assistance Publique-Hôpitaux de Paris, ICAN, Hôpital Pitié-Salpêtrière, 47 Bvd de l’hôpital, 75013 Paris, France
- Université Versailles Saint Quentin & AP-HP, CESP, INSERM U1018, Hôpital Ambroise Paré, 9, Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
| | - Perry M Elliott
- University College London and Inherited Cardiac Diseases Unit, Barts Heart Centre, St Bartholomew’s Hospital, West Smithfield, EC1A 7BE London, UK
| | - Juan R Gimeno
- Cardiac Department, Hospital Universitario Virgen de la Arrixaca, Ctra. Murcia-Cartagena s/n, 30120 El Palmar Murcia, Spain
- CIBER in Cardiovascular Diseases, Instituto Carlos III, Av. de Monforte de Lemos 5, 28029 Madrid, Spain
| | - Alida L P Caforio
- Division of Cardiology, Department of Cardiological Thoracic and Vascular Sciences, University of Padova, via N Giustiniani 2, 35100 Padova, Italy
| | - Juan Pablo Kaski
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Great Ormond Street, WC1N 3JH London, UK
| | - Luigi Tavazzi
- GVM Care and Research, E.S. Health Science Foundation, Maria Cecilia Hospital, Via Corriera, 1, 48010 Cotignola, Italy
| | - Michal Tendera
- Department of Cardiology and Structural Heart Diseases, School of Medicine in Katowice, Medical University of Silesia, Ziolowa Street 45/47, 40-635 Katowice, Poland
| | - Carole Maupain
- Centre de Référence des Maladies Cardiaques Héréditaires, Assistance Publique-Hôpitaux de Paris, ICAN, Hôpital Pitié-Salpêtrière, 47 Bvd de l’hôpital, 75013 Paris, France
| | - Cécile Laroche
- EURObservational Research Programme, European Society of Cardiology, 2035 Route des colles, CS 80179 Biot, 06903 Sophia-Antipolis Cedex, France
| | - Pawel Rubis
- Department of Cardiac and Vascular Diseases, John Paul II Hospital, Institute of Cardiology, Jagiellonian University Medical College, Pradnicka street 80, 31-202 Krakow, Poland
| | - Ruxandra Jurcut
- Institute of Emergency for Cardiovascular Diseases “Prof.dr.C.C.Iliescu”, UMF “Carol Davila”, Sos. Fundeni 258, 22328 Bucharest, Romania
| | - Leonardo Calò
- Policlinico Casilino, U.O. Cardiologia, Via Casilina, 1049, 00169 Roma, Italy
| | - Tiina M Heliö
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Gianfranco Sinagra
- Cardiovascular Department, Center for Cardiomyopathies, Azienda Sanitaria Universitaria Integrata, University of Trieste, Via P. Valdoni 7, 34100 Trieste, Italy
| | - Marija Zdravkovic
- University Hospital Medical Center Bezanijska kosa, Faculty of Medicine, University of Belgrade, Dragise Brasovana 13/8, 11077 Belgrade, Serbia
| | - Aušra Kavoliūnienė
- Lithuanian University of Health Sciences, Eiveniu Str. 2, 50009 Kaunas, Lithuania
| | - Stephan B Felix
- Department for Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch Strasse, 17475 Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Jacek Grzybowski
- Department of Cardiomyopathies, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
| | - Maria-Angela Losi
- Department of Advanced Biomedical Sciences, University Federico II of Naples, Via S. Pansini 5, 80131 Naples, Italy
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, UMC Utrecht, 3508 GA Utrecht, The Netherlands
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, Gower Street, WC1E 6BT London, UK
| | - José Manuel García-Pinilla
- CIBER in Cardiovascular Diseases, Instituto Carlos III, Av. de Monforte de Lemos 5, 28029 Madrid, Spain
- Heart failure and familial cardiomyopathies division, Cardiology department, Hospital Universitario Virgen de la Victoria, IBIMA, Campus Universitario Teatinos, 29010 Málaga, Spain
| | - Joel Salazar-Mendiguchia
- Cardiomyopathy, Heart Failure and Transplant Program, Hospital Universistari de Bellvitge, Heart Diseases Institute, Av. Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Katarzyna Mizia-Stec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Ochojec, Ziolowa Street 45/47, 40-635 Katowice, Poland
| | - Aldo P Maggioni
- EURObservational Research Programme, European Society of Cardiology, 2035 Route des colles, CS 80179 Biot, 06903 Sophia-Antipolis Cedex, France
- ANMCO Research Center, Via La Marmora, 34 50121 Firenze, Italy
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Gil-Jaurena JM, González-López MT, Pita-Fernández A, Pérez-Caballero R, Prieto R, Medrano C. The Cone Technique for Ebstein Repair. First Cases. ACTA ACUST UNITED AC 2017; 71:490-491. [PMID: 28528887 DOI: 10.1016/j.rec.2017.04.019] [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] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 02/28/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Juan-Miguel Gil-Jaurena
- Servicio de Cirugía Cardiaca Infantil, Hospital Universitario, Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - María-Teresa González-López
- Servicio de Cirugía Cardiaca Infantil, Hospital Universitario, Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ana Pita-Fernández
- Servicio de Cirugía Cardiaca Infantil, Hospital Universitario, Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ramón Pérez-Caballero
- Servicio de Cirugía Cardiaca Infantil, Hospital Universitario, Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Raquel Prieto
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Constancio Medrano
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Servicio de Cardiología Pediátrica, Hospital Universitario Gregorio Marañón, Madrid, Spain
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Miera O, Schmitt K, Menon A, Ersel S, Reiprich A, Akintürk H, Thul J, Karimova A, Cesnjevar R, Reinhardt Z, Goldwasser R, Heineking B, Schramm R, Romlin B, Kansy A, Maruszewski B, Sandica E, Pawlak S, Sliwka J, Schweiger M, Huebler M, Stiller B, Fleck T, Hoerer J, Boet A, Medrano C, Guereta L, Amodeo A. (733)Current Practice of Anticoagulation for Pediatric VAD Therapy - A Multi-Institutional European Survey of the EXCOR Pediatric Investigator Group (EEPIG). J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.745] [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: 10/19/2022] Open
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25
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Sánchez‐Luna M, Medrano C, Lirio J. Down syndrome as risk factor for respiratory syncytial virus hospitalization: A prospective multicenter epidemiological study. Influenza Other Respir Viruses 2017; 11:157-164. [PMID: 27611835 PMCID: PMC5304568 DOI: 10.1111/irv.12431] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) infection in childhood, particularly in premature infants, is associated with significant morbidity and mortality. OBJECTIVES To compare the hospitalization rates due to RSV infection and severity of disease between infants with and without Down syndrome (DS) born at term and without other associated risk factors for severe RSV infection. PATIENTS/METHODS In a prospective multicentre epidemiological study, 93 infants were included in the DS cohort and 68 matched by sex and data of birth (±1 week) and were followed up to 1 year of age and during a complete RSV season. RESULTS The hospitalization rate for all acute respiratory infection was significantly higher in the DS cohort than in the non-DS cohort (44.1% vs 7.7%, P<.0001). Hospitalizations due to RSV were significantly more frequent in the DH cohort than in the non-DS cohort (9.7% vs 1.5%, P=.03). RSV prophylaxis was recorded in 33 (35.5%) infants with DS. The rate of hospitalization according to presence or absence of RSV immunoprophylaxis was 3.0% vs 15%, respectively. CONCLUSIONS Infants with DS showed a higher rate of hospitalization due to acute lower respiratory tract infection and RSV infection compared to non-DS infants. Including DS infants in recommendations for immunoprophylaxis of RSV disease should be considered.
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Affiliation(s)
- Manuel Sánchez‐Luna
- Neonatology DivisionHospital Materno InfantilHospital General Universitario Gregorio MarañónUniversidad ComplutenseMadridSpain
| | - Constancio Medrano
- Cardiology DivisionHospital Materno InfantilHospital General Universitario Gregorio MarañónUniversidad ComplutenseMadridSpain
| | - Julián Lirio
- Social Pediatric DivisionHospital Infantil Universitario Niño JesúsMadridSpain
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26
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DeMichele AM, Clark AS, Holmes R, Volpe M, Medrano C, Troxel A, Fox K, Domchek S, Matro J, Bradbury A, Shih N, Feldman M, Hexner E, Bromberg J. Abstract P2-08-03: Targeting inflammatory pathways: A phase 2 trial of the JAK-inhibitor ruxolitinib in combination with exemestane for aromatase inhibitor-resistant, estrogen receptor-positive breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-08-03] [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: 11/16/2022]
Abstract
Abstract
Background: In vitro mechanisms link IL-6 to poor outcome in breast cancer via inflammatory pathways, activated JAK/STAT tumor signaling and upregulation of aromatase, leading to an aggressive tumor phenotype. Epidemiological data from our group and others support these mechanisms in women with ER-positive (+) disease. We therefore hypothesized that the JAK inhibitor, ruxolitinib (RUX, INCB018424; Incyte), would enhance activity of exemestane (EXE) in women with ER+ breast cancer who relapsed after non-steroidal aromatase inhibitor therapy, particularly among carriers of a germ-line polymorphism in IL-6, conferring elevated levels of IL-6 in the tumor microenvironment.
Methods: The “JAKEE trial” is a phase II trial to determine the safety and efficacy of RUX + EXE in postmenopausal women with relapsed, ER+ advanced breast cancer. Eligible patients were required to have progressed on a non-steroidal AI and either measureable or bone-only disease. CRP, a putative biomarker of tumor microenvironment inflammation, was measured at baseline and serially during treatment. Using a Simon 2-stage design, we treated 15 patients with RUX at 25 mg BID and EXE at 25mg daily on a continuous 28-day schedule. First stage results were previously presented (AACR, 2014). Accrual proceeded to second stage after no patient met the pre-defined stopping rule of grade (G) 3/4 toxicity requiring discontinuation from the study within the first treatment cycle. Due to the substantial rate of anemia requiring dose reductions, however, RUX dose was reduced to 15 mg BID in second stage.
Results: A total of 25 patients were enrolled; 24/25 had progressed on AI in metastatic setting; 1 relapsed on adjuvant AI. RUX+EXE was well-tolerated overall, with only 2 G4 events (creatinine elevation, hepatic failure); both were due to disease progression. 16% had G3 fatigue, anemia or hypertension; 12% had G3 neutropenia or depression. Other lower grade toxicities in >20% included musculoskeletal pain, increased ALT, and headache. Overall, patients stayed on therapy for a median of 3 cycles (range 2 – 21). There were no CR or PR, but 6/25 (24%) had prolonged disease control (SD> 6 months). Median CRP at study entry was 6.4 (range 0.3-38.9), with 8/25 (32%) having CRP>10. Achieving SD>6 months was not associated with baseline CRP (CRP>10 in 32% with vs. 33% without SD>6 months, p(exact)=1.0). A novel pharmacodynamic assay to assess STAT3 phosphorylation in peripheral blood mononuclear cells after RUX exposure demonstrated differential effects in patients with response.
Conclusions: Targeting JAK/STAT signaling in AI-resistant breast cancer with RUX+EXE was safe and well-tolerated. 24% of patients had prolonged SD, but baseline CRP level did not predict response. Correlative studies to determine whether host and/or tumor biomarkers predict response to therapy, including germline IL-6 genotype, immune profiles, p-STAT3 and estradiol levels, are currently underway.
Citation Format: DeMichele AM, Clark AS, Holmes R, Volpe M, Medrano C, Troxel A, Fox K, Domchek S, Matro J, Bradbury A, Shih N, Feldman M, Hexner E, Bromberg J. Targeting inflammatory pathways: A phase 2 trial of the JAK-inhibitor ruxolitinib in combination with exemestane for aromatase inhibitor-resistant, estrogen receptor-positive breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-08-03.
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Affiliation(s)
- AM DeMichele
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - AS Clark
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - R Holmes
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Volpe
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - C Medrano
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Troxel
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - K Fox
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - S Domchek
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Matro
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Bradbury
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - N Shih
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Feldman
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - E Hexner
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Bromberg
- University of Pennsylvania, Philadelphia, PA; Memorial Sloan Kettering Cancer Center, New York, NY
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Gil-Jaurena JM, Camino M, Pérez-Caballero R, Pita A, González-López MT, Zunzunegui JJ, Gil-Villanueva N, Medrano C. Trasplante después del Fontan. Aspectos quirúrgicos. Cirugía Cardiovascular 2016. [DOI: 10.1016/j.circv.2016.03.005] [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: 10/21/2022] Open
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28
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Camean A, Garcia PM, Quijada LD, Medrano C, Prieto A, Pichardo S, Puerto M. In vitro genotoxicity assessment by micronucleus test and comet assay using an orgasulfur compound. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1611] [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] [Indexed: 11/15/2022]
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29
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Gil-Jaurena JM, Zunzunegui JL, Pérez-Caballero R, Pita A, González-López MT, Ballesteros F, Rodríguez A, Medrano C. Surgical Management of Vascular Stents in Pediatric Cardiac Surgery: Clues for a Staged Partnership. Pediatr Cardiol 2015; 36:1685-91. [PMID: 26111746 DOI: 10.1007/s00246-015-1218-1] [Citation(s) in RCA: 9] [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: 05/05/2015] [Accepted: 06/10/2015] [Indexed: 11/29/2022]
Abstract
Complex cases undergo step surgical and percutaneous procedures, including stent deployment. Concerns arise on stent removal at latest surgery. Our initial experience is presented. Forty-six stents in 35 patients were partially or totally removed at surgery. Univentricular heart was diagnosed in 20 patients. Stents were previously deployed in: ductus (6), right ventricle outflow tract (12), atrial septal defect (4), right pulmonary artery (4), left pulmonary artery (16), inferior vena cava (2), superior vena cava (1) and ascending aorta (1). Surgical procedures performed: 9 transplants, 6 Fontan, 4 Glenn, 1 comprehensive repair (Norwood + Glenn), 1 Glenn takedown, 8 conduit replacement, 2 Fallot, 2 Rastelli, 1 ventricular septal defect closure and 1 iatrogenic aortopulmonary window. Five ductal stents were clipped. Eleven stents in right ventricle, four ones in atrial septal defect, two in right pulmonary artery, seven in the left pulmonary artery and two in inferior vena cava were completely removed. Two stents in right pulmonary artery, one in superior vena cava, one in ascending aorta and nine in the left pulmonary artery were partially retrieved. Handling the stents in ductus, right ventricle and atrial septal defect was straightforward. On the contrary, stent removal in the ductus (comprehensive case), pulmonary branches, both vena cavae or aorta required short periods of deep hypothermia with circulatory arrest. Surgery over stents is increasing in complex, step procedures. Univentricular hearts are most prevalent. Congenital transplant surgery faces new challenges. Stent removal at the time of surgery may require deep hypothermic circulatory arrest.
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Affiliation(s)
- Juan-Miguel Gil-Jaurena
- Pediatric Cardiac Surgery, Hospital General Universitario Gregorio Marañón, C/O´Donnell 50, 28009, Madrid, Spain.
| | - José-Luis Zunzunegui
- Pediatric Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ramón Pérez-Caballero
- Pediatric Cardiac Surgery, Hospital General Universitario Gregorio Marañón, C/O´Donnell 50, 28009, Madrid, Spain
| | - Ana Pita
- Pediatric Cardiac Surgery, Hospital General Universitario Gregorio Marañón, C/O´Donnell 50, 28009, Madrid, Spain
| | - María-Teresa González-López
- Pediatric Cardiac Surgery, Hospital General Universitario Gregorio Marañón, C/O´Donnell 50, 28009, Madrid, Spain
| | - Fernando Ballesteros
- Pediatric Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Alejandro Rodríguez
- Pediatric Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Constancio Medrano
- Pediatric Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Yuste-Checa P, Medrano C, Gámez A, Desviat LR, Matthijs G, Ugarte M, Pérez-Cerdá C, Pérez B. Antisense-mediated therapeutic pseudoexon skipping in TMEM165-CDG. Clin Genet 2014; 87:42-8. [PMID: 24720419 DOI: 10.1111/cge.12402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 04/08/2014] [Accepted: 04/08/2014] [Indexed: 01/18/2023]
Abstract
Deficiencies in glycosyltransferases, glycosidases or nucleotide-sugar transporters involved in protein glycosylation lead to congenital disorders of glycosylation (CDG), a group of genetic diseases mostly showing multisystem phenotype. Despite recent advances in the biochemical and molecular knowledge of these diseases, no effective therapy exists for most. Efforts are now being directed toward therapies based on identifying new targets, which would allow to treat specific patients in a personalized way. This work presents proof-of concept for the antisense RNA rescue of the Golgi-resident protein TMEM165, a gene involved in a new type of CDG with a characteristic skeletal phenotype. Using a functional in vitro splicing assay based on minigenes, it was found that the deep intronic change c.792+182G>A is responsible for the insertion of an aberrant exon, corresponding to an intronic sequence. Antisense morpholino oligonucleotide therapy targeted toward TMEM165 mRNA recovered normal protein levels in the Golgi apparatus of patient-derived fibroblasts. This work expands the application of antisense oligonucleotide-mediated pseudoexon skipping to the treatment of a Golgi-resident protein, and opens up a promising treatment option for this specific TMEM165-CDG.
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Affiliation(s)
- P Yuste-Checa
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Campus de Cantoblanco, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), IDIPaz, Madrid, Spain; Instituto de Investigación Biomedica, IDIPaz, Madrid
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31
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Muñoz-Mahamud E, Soriano A, Combalia A, Medrano C, Bosch J, García S, Bori G. Comparison of bacterial results from conventional cultures of the periprosthetic membrane and the synovial or pseudocapsule during hip revision arthroplasty. Arch Orthop Trauma Surg 2014; 134:577-83. [PMID: 24419331 DOI: 10.1007/s00402-014-1921-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Bacterial identification is essential to diagnose and treat a revision for prosthetic loosening of an infected hip. The purpose of this study was to determine whether conventional cultures from the periprosthetic membrane are superior to synovial/pseudocapsule samples in the diagnosis of infection in hip revision arthroplasty. MATERIALS AND METHODS We performed a prospective study including all hip revisions from October 2009 to October of 2011. Once the implants were removed and prior to the administration of the antibiotic prophylaxis, six periprosthetic samples from different sites were sent to the laboratory for culturing: two periprosthetic fluid samples, two solid material (synovial/pseudocapsule) samples and two swabs. Once the six samples were taken, antibiotic prophylaxis was administered and just as the implant was removed, two more solid samples of the periprosthetic membrane were obtained. RESULTS Of a total of 86 hip revision surgeries, 22 were considered septic revisions postoperatively, of which 16 resulted in positive cultures. Of these 16 revisions, 14 obtained the same microbiologic diagnostic when considering either the synovial/pseudocapsule culture results or the solid membrane sample. CONCLUSIONS We conclude that the membrane sample for a conventional culture is not superior to the synovial/pseudocapsule sample in detecting microorganisms.
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Affiliation(s)
- E Muñoz-Mahamud
- Bone and Joint Infectious Diseases Unit, Department of Orthopaedics and Trauma Surgery, Hospital Clinic of Barcelona, University of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain,
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32
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Luxán G, Casanova JC, Martínez-Poveda B, Prados B, D'Amato G, MacGrogan D, Gonzalez-Rajal A, Dobarro D, Torroja C, Martinez F, Izquierdo-García JL, Fernández-Friera L, Sabater-Molina M, Kong YY, Pizarro G, Ibañez B, Medrano C, García-Pavía P, Gimeno JR, Monserrat L, Jiménez-Borreguero LJ, de la Pompa JL. Mutations in the NOTCH pathway regulator MIB1 cause left ventricular noncompaction cardiomyopathy. Nat Med 2013; 19:193-201. [PMID: 23314057 DOI: 10.1038/nm.3046] [Citation(s) in RCA: 240] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 11/26/2012] [Indexed: 02/07/2023]
Abstract
Left ventricular noncompaction (LVNC) causes prominent ventricular trabeculations and reduces cardiac systolic function. The clinical presentation of LVNC ranges from asymptomatic to heart failure. We show that germline mutations in human MIB1 (mindbomb homolog 1), which encodes an E3 ubiquitin ligase that promotes endocytosis of the NOTCH ligands DELTA and JAGGED, cause LVNC in autosomal-dominant pedigrees, with affected individuals showing reduced NOTCH1 activity and reduced expression of target genes. Functional studies in cells and zebrafish embryos and in silico modeling indicate that MIB1 functions as a dimer, which is disrupted by the human mutations. Targeted inactivation of Mib1 in mouse myocardium causes LVNC, a phenotype mimicked by inactivation of myocardial Jagged1 or endocardial Notch1. Myocardial Mib1 mutants show reduced ventricular Notch1 activity, expansion of compact myocardium to proliferative, immature trabeculae and abnormal expression of cardiac development and disease genes. These results implicate NOTCH signaling in LVNC and indicate that MIB1 mutations arrest chamber myocardium development, preventing trabecular maturation and compaction.
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Affiliation(s)
- Guillermo Luxán
- Program of Cardiovascular Developmental Biology, Department of Cardiovascular Development and Repair, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
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33
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Altman M, Bergerot C, Thibault H, Aussoleil A, Skuldadt Davidsen E, Barthelet M, Derumeaux GA, Grapsa J, Zimbarra Cabrita I, Afilalo J, Paschou S, Dawson D, Durighel G, O'regan D, Howard L, Gibbs J, Nihoyannopoulos P, Morenate Navio M, Mesa Rubio M, Ortega MD, Ruiz Ortiz M, Castillo Bernal F, Del Pino CL, Toledano F, Alvarez-Ossorio MP, Ojeda Pineda S, Lezo Cruz-Conde JSD, Jasaityte R, Claus P, Teske A, Herbots L, Verheyden B, Rademakers F, D'hooge J, Tocchetti CG, Coppola C, Rea D, Quintavalle C, Guarino L, Castaldo N, De Lorenzo C, Condorelli G, Arra C, Maurea N, Voilliot D, Huttin O, Camara Y, Djaballah W, Carillo S, Zinzius P, Sellal J, Angioi M, Juilliere Y, Selton-Suty C, Dobrowolski P, Klisiewicz A, Florczak E, Prejbisz A, Szwench E, Rybicka J, Januszewicz A, Hoffman P, Jurado Roman A, De Dios Perez S, De Nicolas JMM, Diaz Anton B, Rubio Alonso B, Martin Asenjo R, Mayordomo Gomez S, Villagraz Tecedor L, Blazquez L, De Meneses RT, Bernard A, Hernandez AI, Reynaud A, Lerclercq C, Daubert J, Donal E, Arjan Singh R, Sivarani S, Lim S, Azman W, Almeida M, Cardim N, Fonseca V, Carmelo V, Santos S, Santos T, Toste J, Kosmala W, Orda A, Karolko B, Mysiak A, Przewlocka-Kosmala M, Farsalinos K, Tsiapras D, Kyrzopoulos S, Avramidou E, Vassilopoulou D, Voudris V, Hayrapetyan H, Adamyan K, Jurado Roman A, De Dios Perez S, Rubio Alonso B, De Nicolas JMM, Diaz Anton B, Martin Asenjo R, Montero Cabezas J, Granda Nistal C, Garcia Aranda B, Sanchez Sanchez V, Sestito A, Lamendola P, Di Franco A, Lauria C, Lanza G, Kukucka M, Unbehaun A, Buz S, Mladenow A, Kuppe H, Pasic M, Habazettl H, Gemma D, Montoro Lopez N, De Celix MGR, Lopez Fernandez T, De Torres Alba F, Del Valle DI, Ramirez U, Mesa J, Moreno Yanguela M, Lopez Sendon J, Eveborn GW, Schirmer H, Lunde P, Heggelund G, Rasmussen K, Wang Z, Lasota B, Mizia-Stec K, Mizia M, Chmiel A, Adamczyk T, Chudek J, Gasior Z, Venkatesh A, Johnson J, Sahlen A, Brodin L, Winter R, Shahgaldi K, Manouras A, Valbuena S, Iniesta A, Lopez T, De Torres F, Salinas P, Garcia S, Ramirez U, Mesa J, Moreno M, Lopez-Sendon J, Lebid I, Kobets T, Kuzmenko T, Katsanos S, Yiu K, Clavel M, Nina Ajmone N, Van Der Kley F, Rodes Cabau J, Schalij M, Bax J, Pibarot P, Delgado V, Fusini L, Tamborini G, Muratori M, Gripari P, Marsan N, Cefalu' C, Ewe S, Maffessanti F, Delgado V, Pepi M, Hasselberg N, Haugaa K, Petri H, Berge K, Leren T, Bundgaard H, Edvardsen T, Ancona R, Comenale Pinto S, Caso P, Coppola M, Rapisarda O, Cavallaro C, Vecchione F, D'onofrio A, Calabro' R, Rimbas R, Mihaila S, Enescu O, Patrascu N, Dragoi R, Rimbas M, Pop C, Vinereanu D, Gustafsson S, Morner S, Gronlund C, Suhr O, Lindqvist P, Di Bella G, Zito C, Minutoli F, Madaffari A, Cusma Piccione M, Mazzeo A, Massimo R, Pasquale M, Vita G, Carerj S, Rangel I, Goncalves A, Sousa C, Correia A, Martins E, Silva-Cardoso J, Macedo F, Maciel M, Pfeiffer B, Rigopoulos A, Seggewiss H, Alvarez Fuente M, Sainz Costa T, Medrano C, Navarro M, Blazquez Gamero D, Ramos J, Mellado M, De Jose M, Munoz M, Maroto E, Gargani L, Gosciniak P, Pratali L, Agoston G, Bruni C, Guiducci S, Matucci Cerinic M, Varga A, Sicari R, Picano E, Yiu K, Zhao C, Mei M, Yeung C, Siu C, Tse H, Florescu M, Enescu O, Magda L, Mincu R, Vinereanu D, Daha I, Stanescu CM, Chirila L, Baicus C, Vlase A, Dan G, Montoro Lopez M, Florez Gomez R, Alonso Ladreda A, Itziar Soto C, Rios Blanco J, Gemma D, De Torres Alba F, Moreno Yanguela M, Lopez Sendon J, Guzman Martinez G, Lichodziejewska B, Kurnicka K, Goliszek S, Kostrubiec M, Dzikowska-Diduch O, Ciurzynski M, Labyk A, Krupa M, Palczewski P, Pruszczyk P, De Sousa CC, Rangel I, Correia A, Martins E, Vigario A, Pinho T, Silva Cardoso J, Goncalves A, Macedo F, Maciel M, Park SJ, Song JE, Lee YJ, Ha MR, Chang SA, Choi JO, Lee SC, Park S, Oh J, Van De Bruaene A, De Meester P, Buys R, Vanhees L, Delcroix M, Voigt J, Budts W, Blundo A, Buccheri S, Monte IP, Leggio S, Tamburino C, Sotaquira M, Fusini L, Maffessanti F, Pepi M, Lang R, Caiani E, Floria M, De Roy L, Xhaet O, Blommaert D, Jamart J, Gerard M, Deceuninck O, Marchandise B, Seldrum S, Schroeder E, Unsworth B, Sohaib S, Kulwant-Kaur K, Malcolme-Lawes L, Kanagaratnam P, Malik I, Ren B, Mulder H, Haak A, Van Stralen M, Szili-Torok T, Pluim J, Geleijnse M, Bosch J, Baglini R, Amaducci A, D'ancona G, Van Den Oord S, Akkus Z, Bosch J, Ten Kate G, Renaud G, Sijbrands E, De Jong N, Van Der Lugt A, Van Der Steen A, Schinkel A, Bjallmark A, Larsson M, Grishenkov D, Brodin LA, Brismar T, Paradossi G, Sveen KA, Nerdrum T, Hanssen K, Dahl-Jorgensen K, Steine K, Cimino S, Pedrizzetti G, Tonti G, Canali E, Petronilli V, Cicogna F, Arcari L, De Luca L, Iacoboni C, Agati L, Abdel Moneim SS, Eifert Rain S, Bernier M, Bhat G, Hagen M, Bott-Kitslaar D, Castello R, Wilansky S, Pellikka P, Mulvagh S, Delithanasis I, Celutkiene J, Kenny C, Monaghan M, Park W, Hong G, Son J, Lee S, Kim U, Park J, Shin D, Kim Y, Toutouzas K, Drakopoulou M, Aggeli C, Felekos I, Nikolaou C, Synetos A, Stathogiannis K, Tsiamis E, Siores E, Stefanadis C, Plicht B, Kahlert P, Grave T, Buck T, Konorza T, Gursoy M, Gokdeniz T, Astarcioglu M, Bayram Z, Cakal B, Karakoyun S, Kalcik M, Acar R, Kahveci G, Ozkan M, Maffessanti F, Tamborini G, Tsang W, Weinert L, Gripari P, Fusini L, Muratori M, Caiani E, Lang R, Pepi M, Yurdakul S, Avci B, Sahin S, Dilekci B, Aytekin S, Ancona R, Comenale Pinto S, Caso P, Arenga F, Coppola M, Rapisarda O, Calabro' R, Hascoet S, Martin R, Dulac Y, Peyre M, Benzouid C, Hadeed K, Acar P, Celutkiene J, Zakarkaite D, Skorniakov V, Zvironaite V, Grabauskiene V, Burca J, Ciparyte L, Laucevicius A, Di Salvo G, Rea A, D'aiello A, Del Gaizo F, Pergola V, D'andrea A, Caso P, Pacileo G, Calabro R, Russo M, Dedobbeleer C, Hadefi A, Naeije R, Unger P, Mornos C, Cozma D, Ionac A, Mornos A, Valcovici M, Pescariu S, Petrescu L, Hu K, Liu D, Niemann M, Herrmann S, Cikes M, Stoerk S, Knop S, Ertl G, Bijnens B, Weidemann F, De Knegt M, Biering-Sorensen T, Sogaard P, Sivertsen J, Jensen J, Mogelvang R, Dedobbeleer C, Hadefi A, Unger P, Naeije R, Lam W, Tang M, Chan K, Yang Y, Fang F, Sun J, Yu C, Lam Y, Panoulas V, Sulemane S, Bratsas A, Konstantinou K, Nihoyannopoulos P, Cimino S, Canali E, Petronilli V, Cicogna F, Arcari L, De Luca L, Francone M, Iacoboni C, Agati L, Schau T, Seifert M, Ridjab D, Schoep M, Gottwald M, Neuss M, Meyhoefer J, Zaenker M, Butter C, Tarr A, Stoebe S, Pfeiffer D, Hagendorff A, Maret E, Ahlander BM, Bjorklund PG, Engvall J, Staskiewicz G, Czekajska-Chehab E, Adamczyk P, Siek E, Przybylski P, Maciejewski R, Drop A, Jimenez Rubio C, Isasti Aizpurua G, Miralles Ibarra J, Al-Mallah M, Somg T, Alam S, Chattahi J, Zweig B, Dhanalakota K, Boedeker S, Ananthasubramaniam K, Park C, March K, Jones S, Mayet J, Tillin T, Chaturvedi N, Hughes A, Hamodraka E, Kallistratos E, Karamanou A, Tsoukas T, Mavropoulos D, Kouremenos N, Zaharopoulou I, Nikolaidis N, Kremastinos D, Manolis A, Loboz-Rudnicka M, Jaroch J, Bociaga Z, Kruszynska E, Ciecierzynska B, Dziuba M, Dudek K, Uchmanowicz I, Loboz-Grudzien K, Silva D, Magalhaes A, Jorge C, Cortez-Dias N, Carrilho-Ferreira P, Silva Marques J, Portela I, Pascoa C, Nunes Diogo A, Brito D, Roosens B, Bala G, Droogmans S, Hostens J, Somja J, Delvenne E, Schiettecatte J, Lahoutte T, Van Camp G, Cosyns B. Poster Session: Right ventricular systolic function. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cikes M, Tong L, Jasaityte R, Hamilton J, Sutherland G, D'hooge J, Yurdakul S, Oner F, Avci BK, Sahin S, Direskeneli H, Aytekin S, Fang F, Chan A, Zhang Q, Sanderson J, Kwong J, Yu C, Zaidi A, Raju H, Ghani S, Gati S, Cox A, Sheikh N, Sharma R, Sharma S, Kutty S, Kottam A, Padiyath A, Gao S, Drvol L, Lof J, Li L, Rangamani S, Danford D, Kuehne T, Rosner A, Avenarius D, Malm S, Iqbal A, Baltabaeva A, Schirmer H, Bijnens B, Myrmel T, Magalhaes A, Silva Marques J, Martins S, Carrilho Ferreira P, Jorge C, Silva D, Placido R, Goncalves S, Almeida A, Nunes Diogo A, Poulidakis E, Aggeli C, Sideris S, Dilaveris P, Gatzoulis K, Felekos I, Koutagiar I, Sfendouraki E, Roussakis G, Stefanadis C, Zhang Q, Sun J, Gao R, Feng Y, Liu X, Sheng W, Liu F, Yu C, Hallioglu O, Citirik D, Buyukakilli B, Ozeren M, Gurgul S, Tasdelen B, Rodriguez Lopez A, Rodriguez Lopez A, Garcia Cuenllas L, Garcia Cuenllas L, Medrano C, Medrano C, Granja S, Granja S, Marin C, Marin C, Maroto E, Maroto E, Alvarez T, Alvarez T, Ballesteros F, Ballesteros F, Camino M, Camino M, Centeno M, Centeno M, Alraies M, Aljaroudi W, Halley C, Rodriguez L, Grimm R, Thomas J, Jaber W, Knight D, Coghlan J, Muthurangu V, Grasso A, Toumpanakis C, Caplin M, Taylor A, Davar J, Mohlkert LA, Halvorsen C, Hallberg J, Sjoberg G, Norman M, Cameli M, Losito M, Lisi M, Natali B, Massoni A, Maccherini M, Chiavarelli M, Massetti M, Mondillo S, Sljivic A, Stojcevski B, Celic V, Pencic B, Majstorovic A, Cosic Z, Backovic S, Ilic-Djordjevic I, Muraru D, Gripari P, Esposito R, Tamborini G, Galderisi M, Ermacora D, Maffessanti F, Santoro C, Pepi M, Badano L, Bombardini T, Cini D, Picano E, Shahgaldi K, Gunyeli E, Sahlen A, Manouras A, Winter R, Banovic M, Vukcevic V, Ostojic M, Markovic Z, Mladenovic A, Trifunovic D, Stojkovic S, Bacic D, Dedovic D, Seferovic P, Huttin O, Coulibaly S, Mercy M, Schwartz J, Zinzius P, Sellal J, Popovic B, Marie P, Juilliere Y, Selton-Suty C, Gurzun MM, Ionescu A, Bahlay B, Jones G, Rimbas R, Enescu O, Mihaila S, Ciobanu A, Vinereanu D, Vlasseros I, Koumoulidis A, Tousoulis D, Veioglanis S, Avgeropoulou A, Katsi V, Stefanadis C, Kallikazaros I, Kiviniemi T, Ylitalo A, Airaksinen K, Lehtinen T, Saraste A, Pietila M, Karjalainen P, Trifunovic D, Ostojic M, Stankovic S, Vujisic-Tesic B, Petrovic M, Banovic M, Boricic M, Draganic G, Petrovic M, Stepanovic J, Kuznetsov V, Yaroslavskaya E, Pushkarev G, Krinochkin D, Zyrianov I, Dekleva M, Stevanovic A, Kleut M, Suzic Lazic J, Markovic Nikolic N, Akhunova S, Saifullina G, Sadykov A, Loudon M, D'arcy J, Arnold L, Reynolds R, Mabbet C, Prendergast B, Dahl J, Videbaek L, Poulsen M, Rudbaek T, Pellikka P, Rasmussen L, Moller J, Lowery C, Frenneaux M, Dawson D, Dwivedi G, Singh S, Rudd A, Mahadevan D, Srinivasan J, Jiminez D, Sahinarslan A, Vecchio F, Maccarthy P, Wendler O, Monaghan M, Harimura Y, Seo Y, Ishizu T, Noguchi Y, Aonuma K, Urdaniz MM, Palomares JFR, Rius JB, Surribas IB, Tura GT, Garcia-Moreno LG, Alujas TG, Masip AE, Mas PT, Dorado DG, Meimoun P, Germain A, Clerc J, Elmkies F, Zemir H, Luycx-Bore A, Nasr GM, Erraki A, Dulgheru R, Magne J, Capoulade R, Elhonsali Z, Pierard LA, Pibarot P, Lancellotti P, Wrideier S, Butz T, Schilling I, Gkiouras G, Sasko B, Van Bracht M, Prull M, Trappe HJ, Castillo Bernal F, Mesa Rubio M, Ruiz Ortiz M, Delgado Ortega M, Morenate Navio M, Baeza Garzon M, Del Pino ML, Toledano Delgado F, Mazuelos F, Suarez de Lezo Herreros de Tejada J, Prinz C, Schumann M, Burghardt A, Seggewiss H, Oldenburg O, Horstkotte D, Faber L, Bistola V, Banner N, Hedger M, Simon A, Rahman Haley S, Baltabaeva A, Adamyan K, Tumasyan LR, Chilingaryan A, Makavos G, Kouris N, Kostopoulos V, Stamatelatou M, Damaskos D, Kartsagoulis E, Olympios C, Sade L, Eroglu S, Bircan A, Pirat B, Sezgin A, Aydinalp A, Muderrisoglu H, Sargento L, Satendra M, Sousa C, Longo S, Lousada N, Dos Reis RP, Kuznetsov V, Krinochkin D, Gapon L, Vershinina A, Shurkevich N, Bessonova M, Yaroslavskaya E, Kolunin G, Sargento L, Satendra M, Sousa C, Lousada N, Dos Reis RP, Azevedo O, Lourenco M, Machado I, Guardado J, Medeiros R, Pereira A, Quelhas I, Lourenco A, Duman D, Sargin F, Kilicaslan B, Inan A, Ozgunes N, Goktas P, Ikonomidis I, Tzortzis S, Paraskevaidis I, Andreadou I, Katseli C, Katsimbri P, Papadakis I, Pavlidis G, Anastasiou-Nana M, Lekakis J, Charalampopoulos A, Howard L, Davies R, Gin-Sing W, Tzoulaki I, Grapsa I, Gibbs J, Dobson RA, Cuthbertson DJ, Burgess M, Lichodziejewska B, Kurnicka K, Goliszek S, Kostrubiec M, Dzikowska-Diduch O, Ciurzynski M, Krupa M, Grudzka K, Palczewski P, Pruszczyk P, Mansencal N, Marcadet D, Montalvan B, Dubourg O, Matveeva N, Nartsissova G, Chernjavskiy A, Eicher JC, Berthier S, Lorcerie B, Philip JL, Wolf JE, Wiesen P, Ledoux D, Massion P, Piret S, Canivet JL, Cusma-Piccione M, Zito C, Imbalzano E, Saitta A, Donato D, Madaffari A, Luzza G, Pipitone V, Tripodi R, Carerj S, Bombardini T, Gherardi S, Arpesella G, Maccherini M, Serra W, Del Bene R, Sicari R, Picano E, Al-Mallah M, Ananthasubramaniam K, Alam M, Chattahi J, Zweig B, Boedeker S, Song T, Khoo J, Davies J, Ang KL, Galinanes M, Chin D, Papamichael ND, Karassavidou D, Mpougialkli M, Antoniou S, Giannitsi S, Chachalos S, Gouva C, Naka K, Katopodis K, Michalis L, Tsang W, Cui V, Ionasec R, Takeuchi M, Houle H, Weinert L, Roberson D, Lang R, Altman M, Aussoleil A, Bergerot C, Sibellas F, Bonnefoy-Cudraz E, Derumeaux GA, Thibault H, Mohamed A, Omran A, Hussein M, Shahgaldi K, Gunyeli E, Sahlen A, Manouras A, Winter R, Squeri A, Binno S, Ferdenzi E, Reverberi C, Baldelli M, Barbieri A, Iaccarino D, Naldi M, Bosi S, Kalinowski M, Szulik M, Streb W, Stabryla J, Nowak J, Rybus-Kalinowska B, Kukulski T, Kalarus Z, Ouss A, Riezebos R, Nestaas E, Skranes J, Stoylen A, Brunvand L, Fugelseth D, Magalhaes A, Silva Marques J, Martins S, Carrilho Ferreira P, Placido R, Jorge C, Silva D, Goncalves S, Almeida A, Nunes Diogo A, Nagy A, Kovats T, Apor A, Nagy A, Vago H, Toth A, Toth M, Merkely B, Ranjbar S, Karvandi M, Hassantash S, Da Silva SG, Marin C, Rodriguez A, Marcos C, Rodriguez-Ogando A, Maroto E, Medrano C, Del Valle DI, Lopez-Fernandez T, Gemma D, Gomez-Rubin M, De Torres F, Feliu J, Canales M, Buno A, Ramirez E, Lopez-Sendon J, Magalhaes A, Silva Marques J, Martins S, Placido R, Silva D, Jorge C, Calisto C, Goncalves S, Almeida A, Nunes Diogo A, Jorge C, Cortez-Dias N, Goncalves S, Ribeiro S, Santos L, Silva D, Barreiros C, Bernardes A, Carpinteiro L, Sousa J, Kim SH, Choi W, Chidambaram S, Arunkumar R, Venkatesan S, Gnanavelu G, Dhandapani V, Ravi M, Karthikeyan G, Meenakshi K, Muthukumar D, Swaminathan N, Vitarelli A, Barilla F, Capotosto L, Truscelli G, Dettori O, Caranci F, D-Angeli I, De Maio M, De Cicco V, Bruno P, Doesch C, Sueselbeck T, Haghi D, Streitner F, Borggrefe M, Papavassiliu T, Laser K, Schaefer F, Fischer M, Habash S, Degener F, Moysich A, Haas N, Kececioglu D, Burchert W, Koerperich H, Dwivedi G, Al-Shehri H, Dekemp R, Ali I, Alghamdi A, Klein R, Scullion A, Beanlands R, Ruddy T, Chow B, Lipiec P, Szymczyk E, Michalski B, Wozniakowski B, Rotkiewicz A, Stefanczyk L, Szymczyk K, Kasprzak J, Angelov A, Yotov Y, Mircheva L, Kisheva A, Kunchev O, Ikonomidis I, Tsantes A, Triantafyllidi H, Tzortzis S, Dima K, Trivilou P, Papadopoulos C, Travlou A, Anastasiou-Nana M, Lekakis J, Bader R, Agoston-Coldea L, Lupu S, Mocan T, Loegstrup B, Hofsten D, Christophersen T, Moller J, Bjerre M, Flyvbjerg A, Botker H, Egstrup K, Park Y, Choi J, Yun K, Lee S, Han D, Kim J, Kim J, Kim J, Chun K. Poster Session Wednesday 5 December all day Display * Determinants of left ventricular performance. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bouzas-Mosquera A, Rueda F, Aldama G, Medrano C, Portela F, Zavanella C, Castro-Beiras A. Perventricular pulmonary valvuloplasty under echocardiographic guidance. Int J Cardiol 2008; 130:e102-4. [PMID: 17764769 DOI: 10.1016/j.ijcard.2007.06.110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Accepted: 06/23/2007] [Indexed: 10/22/2022]
Abstract
We report the case of a small neonate with a complex congenital heart disease who successfully underwent a perventricular pulmonary valvuloplasty during the early postoperative period, using echocardiographic guidance alone without fluoroscopy. We describe the technique and the advantages of this novel procedure.
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Medrano C, Garcia-Guereta L, Grueso J, Insa B, Ballesteros F, Casaldaliga J, Cuenca V, Escudero F, de la Calzada LG, Luis M, Luque M, Mendoza A, Prada F, del Mar Rodríguez M, Suarez P, Quero C, Guilera M. Respiratory infection in congenital cardiac disease. Hospitalizations in young children in Spain during 2004 and 2005: the CIVIC Epidemiologic Study. Cardiol Young 2007; 17:360-71. [PMID: 17662160 DOI: 10.1017/s104795110700042x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To evaluate the rate of hospitalization for acute respiratory tract infection in children less than 24 months with haemodynamically significant congenital cardiac disease, and to describe associated risk factors, preventive measures, aetiology, and clinical course. MATERIALS AND METHODS We followed 760 subjects from October 2004 through April 2005 in an epidemiological, multicentric, observational, follow-up, prospective study involving 53 Spanish hospitals. RESULTS Of our cohort, 79 patients (10.4%, 95% CI: 8.2%-12.6%) required a total of 105 admissions to hospital related to respiratory infections. The incidence rate was 21.4 new admissions per 1000 patients-months. Significant associated risk factors for hospitalization included, with odds ratios and 95% confidence intervals shown in parentheses: 22q11 deletion (8.2, 2.5-26.3), weight below the 10th centile (5.2, 1.6-17.4), previous respiratory disease (4.5, 2.3-8.6), incomplete immunoprophylaxis against respiratory syncytial virus (2.2, 1.2-3.9), trisomy 21 (2.1, 1.1-4.2), cardiopulmonary bypass (2.0, 1.1-3.4), and siblings aged less than 11 years old (1.7, 1.1-2.9). Bronchiolitis (51.4%), upper respiratory tract infections (25.7%), and pneumonia (20%) were the main diagnoses. An infectious agent was found in 37 cases (35.2%): respiratory syncytial virus in 25, Streptococcus pneumoniae in 5, and Haemophilus influenzae in 4. The odds ratio for hospitalization due to infection by the respiratory syncytial virus increases by 3.05 (95% CI: 2.14 to 4.35) in patients with incomplete prophylaxis. The median length of hospitalization was 7 days. In 18 patients (17.1%), the clinical course of respiratory infection was complicated and 2 died. CONCLUSIONS Hospital admissions for respiratory infection in young children with haemodynamically significant congenital cardiac disease are mainly associated with non-cardiac conditions, which may be genetic, malnutrition, or respiratory, and to cardiopulmonary bypass. Respiratory syncytial virus was the most commonly identified infectious agent. Incomplete immunoprophylaxis against the virus increased the risk of hospitalization.
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Deluca E, Eufemio G, Montanelli M, Giangrande M, Medrano C, Moscardi A y Retaco F. Emergencias Ginecoobstetricas de la Embarazada. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2006.10.036] [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]
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Deluca E, Montanelli M, Eufemio G, Medrano C, Giangrande M y Retaco F. Laparoscopia en el Traumatismo Penetrante Abdominal. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2006.10.037] [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]
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Torrado M, López E, Centeno A, Medrano C, Castro-Beiras A, Mikhailov AT. Myocardin mRNA is augmented in the failing myocardium: expression profiling in the porcine model and human dilated cardiomyopathy. J Mol Med (Berl) 2003; 81:566-77. [PMID: 12920479 DOI: 10.1007/s00109-003-0470-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [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: 06/14/2003] [Accepted: 07/07/2003] [Indexed: 01/08/2023]
Abstract
The implication of myocardin and homeodomain only protein (HOP) in combinatorial molecular pathways that guide heart development and cardio-specific gene expression has recently been reported. However, expression of these genes in the failing heart has not yet been investigated. This study was designed to elaborate a molecular profile of myocardin and HOP expression in the failing ventricular myocardium through the use of both explanted human heart samples and heart biopsies from neonatal piglets with doxorubicin-induced cardiomyopathy (Dox-CM). Myocardin and HOP mRNA levels were estimated by both northern blot hybridization and semiquantitative RT-PCR in human ventricular preparations in end-stage failure due to dilated cardiomyopathy (DCM), as well as in nonfailing donor hearts. Similar experiments were performed with ventricular samples from normal and Dox-treated neonatal piglets. The gene expression of brain natriuretic peptide (BNP) was used as a molecular marker of myocardial damage and failure. The study revealed the following novel findings: (1) myocardin transcripts are detected in neonatal human and pig hearts at lower levels than in mature cardiac tissues, (2) the myocardin transcript pool is significantly augmented in the failing human and porcine myocardium as compared to that in nonfailing heart samples, (3) in the failing human myocardium, increased levels of myocardin mRNA are associated with a diminished HOP transcript content, and (4) the inverse proportion in cardiac myocardin/HOP mRNA pools observed in explanted human hearts is also traceable in normal human heart and aorta. A possible dual consequence of increased myocardin and decreased HOP expression levels on serum response factor-dependent cardiac-specific expression in the normal heart and at heart failure is discussed. Therefore, increased abundance of the myocardin mRNA pool is judged to be a novel CM-related feature which, alone or in association with decreased HOP transcript levels, can be responsible for dysregulation of myocardin-mediated gene expression in failing myocardium.
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Affiliation(s)
- Mario Torrado
- Developmental Biology Unit, Institute of Health Sciences, University of La Coruña, Campus de Oza, Bldg. El Fortín, As Xubias s/n, 15006, La Coruña, Spain
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Rueda F, Bermúdez-Cañete R, Herraiz I, Medrano C, Vázquez N, Díez Balda JI. Balloon pulmonary valvuloplasty. Rev Port Cardiol 2003; 22 Suppl 1:I45-51. [PMID: 12621993] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Affiliation(s)
- F Rueda
- Hospital Juan Canalejo, A. Coruña, Spain
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Abstract
A case of C6-C7 vertebral osteomyelitis due to Pasteurella aerogenes in a previously healthy 62-y-old man in the absence of any history of animal exposure, debilitating disease or immunosuppression is reported. Culture testing of biopsy samples of the vertebral body using the panels and database of the BBL Crystal enteric/non-fermenter system revealed that the infecting bacterium was P. aerogenes. Treatment with cloxacillin and gentamicin was followed by resolution of bone infection on serial follow-up magnetic resonance imaging scans. Pasteurellae are primarily animal pathogens but are capable of producing a variety of local and systemic diseases in humans.
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Affiliation(s)
- I Quiles
- Service of Internal Medicine, Hospital de San Vicente, San Vicente del Raspeig, Alicante, Spain
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Abstract
BACKGROUND The vast majority of parathyroid glands in hyperparathyroidism can be resected through a cervical approach. In approximately 2% of the cases, the ectopic gland is in the mediastinum in a location that requires a thoracic approach. METHODS We report 7 such cases that were resected using video-assisted thoracic surgery to avoid the need for an open surgical procedure. RESULTS All glands were successfully identified preoperatively and subsequently resected. Hospital stay averaged less than 3 days with only one minor complication. CONCLUSIONS Ectopic mediastinal parathyroid glands may be safely and accurately resected using video-assisted thoracic surgery to avoid open approaches.
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Affiliation(s)
- C Medrano
- Division of Cardiothoracic Surgery, Southern Illinois University School of Medicine, Springfield 62794-9638, USA
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de Agustín JC, Zabala JI, Zunzunegui JL, Medrano C, Maroto E, Maroto C, Blanco T, Luque-Mialdea R, Cerdá J, Aguilar F, Vázquez J. [Hemodynamic changes during laparoscopic surgery. Preliminary study]. Cir Pediatr 1999; 12:30-2. [PMID: 10198547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The haemodynamic changes produced by laparoscopic surgery in children have been evaluated. A transesophageal echocardiographic study on 13 patients (7 males and 6 females, 10.8 +/- 2.7 years old) has been performed before, during and after peritoneal CO2 gas insufflation. A change on the Doppler waves pattern of the infradiaphragmatic veins along with an increase in blood flow velocity were observed. Pulmonary veins suffered minimal changes showing an increase on either the systolic pressure and on atrial contraction. Diastolic retrograde flow in aorta reflected an increase in peripheral vascular resistance. Cardiac output increased minimally. All haemodynamic changes returned to basal after gas peritoneal desufflation. These data show that laparoscopic surgery could produce important cardiac derangements in children with ventricular dysfunction or in patients presenting left ventricular outlet obstruction. In these patients laparoscopic surgery might be precluded.
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Affiliation(s)
- J C de Agustín
- Servicio de Cirugía Pediátrica, Hospital Infantil Universitario Gregorio Marañón, Madrid
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Medrano C, Heyroth F, Schlenker M, Baruchel J, Espeso J. Two- and Three-Beam X-ray Diffraction Imaging of Domains in Magnetite. J Appl Crystallogr 1998. [DOI: 10.1107/s0021889898004403] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The X-ray diffraction topographic imaging process for ferrimagnetic domains in magnetite Fe3O4at room temperature is investigated, in two- and three-beam cases, for incident synchrotron radiation beams differing in angular divergence and energy spread. In the usual two-beam configuration, domain or wall contrast is obtained from the difference in Bragg conditions, or from the slight difference in the direction of the beams diffracted by neighbouring domains, revealed by the large crystal-to-film distance that can be used at a third-generation synchrotron radiation facility. A three-beamUmweganregungcase involving the weak 171 and the strong 131 reflections shows unusual domain contrast on the 171 topographs, even on images involving energy or angle integration; this contrast is particularly evident on white-beam topographs. The high angular sensitivity this implies is associated with the difference in dispersion relation between the two reflections.
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Ferrari I, Lorenzi H, Santos MR, Brandariz S, Requena JM, Schijman A, Vázquez M, da Silveira JF, Ben-Dov C, Medrano C, Ghío S, López Bergami P, Cano I, Zingales B, Urmenyi TP, Rondinelli E, González A, Cortes A, Lopez MC, Thomas MC, Alonso C, Ramírez JL, Chiurrillo MA, Aldao RR, Levin MJ. Towards the physical map of the Trypanosoma cruzi nuclear genome: construction of YAC and BAC libraries of the reference clone T. cruzi CL-Brener. Mem Inst Oswaldo Cruz 1997; 92:843-52. [PMID: 9566217 DOI: 10.1590/s0074-02761997000600021] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [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: 02/07/2023] Open
Abstract
Strategies to construct the physical map of the Trypanosoma cruzi nuclear genome have to capitalize on three main advantages of the parasite genome, namely (a) its small size, (b) the fact that all chromosomes can be defined, and many of them can be isolated by pulse field gel electrophoresis, and (c) the fact that simple Southern blots of electrophoretic karyotypes can be used to map sequence tagged sites and expressed sequence tags to chromosomal bands. A major drawback to cope with is the complexity of T. cruzi genetics, that hinders the construction of a comprehensive genetic map. As a first step towards physical mapping, we report the construction and partial characterization of a T. cruzi CL-Brener genomic library in yeast artificial chromosomes (YACs) that consists of 2,770 individual YACs with a mean insert size of 365 kb encompassing around 10 genomic equivalents. Two libraries in bacterial artificial chromosomes (BACs) have been constructed, BACI and BACII. Both libraries represent about three genome equivalents. A third BAC library (BAC III) is being constructed. YACs and BACs are invaluable tools for physical mapping. More generally, they have to be considered as a common resource for research in Chagas disease.
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Affiliation(s)
- I Ferrari
- Instituto de Investigaciones en Ingeniería Genética y Biología Molecular (INGEBI, CONICET, FCYEN-UBA), Buenos Aires, Argentina
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46
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Ewart M, Ryf R, Medrano C, Wüest H, Zgonik M, Günter P. High photorefractive sensitivity at 860 nm in reduced rhodium-doped KNbO(3). Opt Lett 1997; 22:781-783. [PMID: 18185660 DOI: 10.1364/ol.22.000781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We show that high-temperature reduction in a CO-CO(2) atmosphere increases the photorefractive sensitivity of KNbO(3):Rh at 860nm by 4 orders of magnitude compared with that of the as-grown crystal. The effective trap density is increased by a factor of 3, and the photoconductivity by a factor of 30, and the photorefractive response at a grating spacing of 0.15 mu;m is accelerated by a factor of 400. The grating buildup time at a grating spacing of 0.7 microm and an intensity of 1Wcm(-2) is 0.5 s, a value comparable with that of as-grown KNbO(3):Fe at visible wavelengths. The optical and photorefractive parameters of Rh-doped KNbO(3) subjected to reduction treatment are characterized for wavelengths of 0.48-1.064 microm .
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47
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Furukawa Y, Kitamura K, Ji Y, Montemezzani G, Zgonik M, Medrano C, Günter P. Photorefractive properties of iron-doped stoichiometric lithium niobate. Opt Lett 1997; 22:501-503. [PMID: 18183247 DOI: 10.1364/ol.22.000501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The photorefractive properties of stoichiometric LiNbO(3) crystals with a small number of defect densities grown by the double-crucible Czochralski method are investigated and compared with the defect densities of commercially available congruent Fe-doped LiNbO(3) crystals. Two-wave-mixing experiments show that novel stoichiometric crystals exhibit larger photorefractive gain and considerably faster response times than congruent ones. The results indicate that the nonstoichiometry defect control of photorefractive crystals is of key importance for the improvement of their properties.
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Fanning J, Hilgers RD, Kane C, Medrano C. Sequential granulocyte colony-stimulating factor increases cisplatin cytotoxicity in human epithelial ovarian cancer cell lines. Gynecol Oncol 1996; 60:450-3. [PMID: 8774656 DOI: 10.1006/gyno.1996.0072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 02/02/2023]
Abstract
BACKGROUND To determine the effect of granulocyte colony-stimulating factor (G-CSF) on tumor growth and cisplatin cytotoxicity in human epithelial ovarian cancer. METHODS Six human epithelial ovarian cancer cell lines were treated with media (control) for 24 hr, G-CSF for 24 hr, cisplatin for 24 hr, simultaneous cisplatin and G-CSF for 24 hr, media (control) for 48 hr, cisplatin for 24 hr and sequential media for 24 hr, cisplatin for 24 hr, and sequential G-CSF for 24 hr. Following incubation, the percentage cell lysis was determined by particle concentration fluorescein immunoassay chemosensitivity assay. RESULTS G-CSF resulted in tumor cell growth (7-19%) in three cell lines. Simultaneous G-CSF decreased cisplatin cytotoxicity in five cell lines (7-45%). Sequential G-CSF increased cisplatin cytotoxicity in all six cell lines (5-108%). CONCLUSIONS G-CSF may result in ovarian cancer proliferation. Simultaneous G-CSF may decrease cisplatin cytotoxicity, while sequential G-CSF appears to increase cisplatin cytotoxicity.
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Affiliation(s)
- J Fanning
- Division of Gynecologic Oncology, Medical College of Ohio, Toledo 43699-0008, USA
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Pascual E, Trenor P, Medrano C. Management of gout in patients with renal insufficiency and a gastrointestinal bleed--an answer to Dr Dunne's letter. Br J Rheumatol 1995; 34:481-2. [PMID: 7788184 DOI: 10.1093/rheumatology/34.5.481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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50
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Martinez-Lopez MA, Gomez-Cerezo G, Villasante C, Molina F, Diaz S, Cobo J, Medrano C. Pulmonary alveolar proteinosis: prolonged spontaneous remission in two patients. Eur Respir J 1991. [DOI: 10.1183/09031936.93.04030377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pulmonary alveolar proteinosis is a rare idiopathic diffuse airspace disease characterized by intra-alveolar accumulation of large quantities of lipoproteinaceous material, with preservation of the lung interstitium. The clinical course of pulmonary alveolar proteinosis is variable. Spontaneous resolution is known to occur in up to a quarter of the cases. We describe two patients with untreated pulmonary alveolar proteinosis who experienced complete clinical, functional and radiographic resolution. In follow-up periods of fourteen and six years, both patients have remained asymptomatic.
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