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Fijación activa y perforación ventricular: ¿una nueva entidad?

Fri, 31 Dec 2010 23:00:00 GMT

Title: Fijación activa y perforación ventricular: ¿una nueva entidad? Author(s) : Rodriguez-Mañero, M. (Moisés); Bastarrika, G. (Gorka); Macias, A. (Alfonso) Abstract: First, a new active fixation lead was implanted in the interventricular septum; the old lead was then extracted with a Cook stylet. The patient’s clinical course was satisfactory and there were no procedure-related complications. In conclusion, within the battery of diagnostic tests available to investigate suspected cardiac perforation, computed angiotomography of the chest is a highly useful complementary technique for the management of this complication.

Neurohormonas y citocinas en la insuficiencia cardíaca. Correlación con la reserva de flujo coronario

Fri, 31 Dec 2004 23:00:00 GMT

Title: Neurohormonas y citocinas en la insuficiencia cardíaca. Correlación con la reserva de flujo coronario Author(s) : Coma-Canella, I. (Isabel); Macias, A. (Alfonso); Varo, N. (Nerea); Sanchez-Ibarrola, A. (Alfonso) Abstract: Introduction and objectives. In heart failure, the coronary flow reserve (CFR) measured by positron-emission tomography (PET) is reduced. As neurohormone and cytokine levels are also altered in patients with the condition, our aim was to determine whether there is a correlation between CFR and neurohormone and cytokine levels. Patients and method. The study included 40 patients with heart failure but without ischemic heart disease. Myocardial blood flow was measured by PET using nitrogen- 13 ammonia at baseline and during ATP infusion. The CFR was calculated for each patient. In addition, levels of the following were determined: norepinephrine, endothelin- 1, angiotensin-II, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), tumor necrosis factor-alpha, interleukin (IL)-1β, soluble IL-2 receptor, and IL-6. Results. All neurohormone levels were elevated above reference values. The levels of all cytokines, except IL-1β, were also elevated. There was a significant negative correlation between CFR and the levels of several neurohormones: ANP (r=–0.476), BNP (r=–0.442), and IL-6 (r=–0.509). Conclusions. In heart failure, the decrease in CFR is correlated with increases in the levels of certain neurohormones (i.e., ANP and BNP) and cytokines (i.e., IL-6), with vasodilatory effect. These increases are probably are related to compensatory mechanisms that are unable to correct for the endothelial dysfunction present in these patients.

Técnica de primera elección para la valoración de la viabilidad miocárdica. Gammagrafía cardiaca de perfusión

Wed, 31 Dec 1997 23:00:00 GMT

Title: Técnica de primera elección para la valoración de la viabilidad miocárdica. Gammagrafía cardiaca de perfusión Author(s) : Coma-Canella, I. (Isabel) Abstract: Stress echocardiography and perfusion scintigraphy are both useful techniques in the assessment of myocardial viability. The use of one technique or the other as the first choice test depends mainly on each hospital’s experience. Perfusion scintigraphy should be chosen as the first technique in the following situations: a) hospitals with little experience in stress echocardiography and a good Nuclear Medicine department; b) patients with a bad acoustic window in rest echocardiography; c) contraindication of a high dobutamine dose, and d) need of quantification of viable area. When having chosen echocardiography as the first technique, perfusion scintigraphy is indicated when the response to dobutamine of the asynergic area does not allow the confirmation or the rejection of the presence of viability.

Tratamiento de la insuficiencia cardíaca avanzada mediante estimulación biventricular. Experiencia inicial en una serie de 22 casos consecutivos

Tue, 31 Dec 2002 23:00:00 GMT

Title: Tratamiento de la insuficiencia cardíaca avanzada mediante estimulación biventricular. Experiencia inicial en una serie de 22 casos consecutivos Author(s) : Garcia-Bolao, I. (Ignacio); Macias, A. (Alfonso); Alegria, E. (Eduardo); Berenguel, A. (Alejandro); Gavira, J.J. (Juan José); Azcarate, P.M. (Pedro María); Barba, J. (Joaquín) Abstract: Recent data suggest that biventricular pacing may play an important role in treating advanced heart failure in the presence of a significant interventricular and/or intraventricular conduction disorder by correcting cardiac dysynchrony. In this article, we review the initial technical and clinical experience with cardiac resynchronization therapy in an electrophysiology laboratory. METHODS: The first 22 consecutive patients with severe congestive heart failure, ejection fraction < 0.35, NYHA functional class III or IV, and QRS duration > 120 ms who were implanted biventricular pacemakers were studied. Clinical, electrocardiographic, and echocardiographic evaluations were made before and three months after pacemaker implantation. Acute functional capacity testing with peak oxygen uptake was measured during biventricular pacing and during intrinsic rhythm or right ventricular pacing three months after the implantation procedure. RESULTS: The success rate of pacemaker implantation was 95%. Pre-discharge left ventricular pacing was achieved in 91%, with an average pacing threshold of 1.53 (1.04) volts. NYHA functional class improved (p = 0.039) from 3.4 (0.7) to 2.3 (0.78). The rate of hospitalization for heart failure decreased from an average of 3.12 (0.58) three months before the procedure to 1.38 (0.34) three months after the procedure. Peak oxygen uptake was significantly greater (p = 0.028) during biventricular pacing: 14.89 (2.1) ml/min/kg, than during intrinsic rhythm or right ventricular pacing: 12.65 (2.3) ml/min/kg. CONCLUSIONS: Cardiac resynchronization therapy can be performed safely and with a high success rate in the electrophysiology laboratory. Biventricular pacing seems to improve the symptoms of congestive heart failure in patients with evidence of atrioventricular and/or interventricular/intraventricular dysynchrony. An acute benefit in peak oxygen uptake was associated with biventricular pacing after the implantation procedure.

Disminución de la reserva de flujo coronario en pacientes con insuficiencia cardíaca no isquémica

Tue, 31 Dec 2002 23:00:00 GMT

Title: Disminución de la reserva de flujo coronario en pacientes con insuficiencia cardíaca no isquémica Author(s) : Coma-Canella, I. (Isabel); Garcia-Velloso, M.J. (María José); Macias, A. (Alfonso); Villar, L. (Luis); Cosin, J. (Juan); Marti-Climent, J.M. (Josep M.); Artaiz, M. (Miguel) Abstract: Introduction and objectives. Coronary flow reserve (CFR) is impaired not only in ischemic heart disease, but also in cardiac diseases that may or may not course with heart failure. The aim of the present study was to determine if the severity of heart failure can influence CFR impairment. Methods. Forty patients with non-ischemic heart disease and heart failure were studied 41 times. Four groups were established: 1. 10 patients in functional class III-IV; 2. 10 patients in functional class II not taking beta-blockers; 3. 11 patients in class II treated with carvedilol, and 4. 10 patients in class I. These patients had a history of heart failure and systolic dysfunction. Myocardial blood flow (MBF) was measured with positron emission tomography (PET) and N-13 ammonia at rest (r) and during adenosine triphosphate (ATP) infusion. Results. MBF and CFR were significantly higher in group 4 (1.95 ± 0.58 and 2.40 ± 0.95 ml/min/g) than in group 1 (1.02 ± 0.52 and 1.46 ± 0.48 ml/min/g). CFR tended to be higher in groups 2 (1.73 ± 0.72), and 3 (1.89 ± 0.75) vs group 1. No significant correlation was found between CFR and the following variables: age, systolic blood pressure, ventricular mass index, ventricular volume indexes, and ejection fraction. Conclusions. Coronary microvascular function is impaired in non-ischemic heart failure, and the impairment is related to functional class, regardless of the underlying responsible heart disease.

Hematoma pericárdico dos años después de cirugía coronaria

Tue, 31 Dec 1996 23:00:00 GMT

Title: Hematoma pericárdico dos años después de cirugía coronaria Author(s) : Garcia-Fuster, R. (Rafael); Llorens, R. (Rafael); Melero, J.M. (José María); Barba, J. (Joaquín); Stefano, S. (Salvatore) di; Legarra, J.J. (Juan José); Alegria, E. (Eduardo) Abstract: Cardiac tamponade is a life-threatening complication after cardiac surgery which may develop in the early or late postoperative period. The latest have been defined arbitrarily as the ones ocurring after the 7th postoperative day. They are less common than the early ones and most of the cases have been reported up to six months after the operation. They usually determine diagnostic difficulties that can negatively influence the prognosis. Because of its atypical late appearance, a case of a 65 year old man is presented who developed a postpericardiotomy syndrome and subsequently a pericardial clot nearly two years after aortocoronary bypass grafting.

Induction of TIMP-1 expression in rat hepatic stellate cells and hepatocytes: a new role for homocysteine in liver fibrosis

Thu, 31 Dec 1998 23:00:00 GMT

Title: Induction of TIMP-1 expression in rat hepatic stellate cells and hepatocytes: a new role for homocysteine in liver fibrosis Author(s) : Torres, L. (Luis); Garcia-Trevijano, E.R. (Elena R.); Rodriguez, J.A. (José A.); Carretero, M.V. (M. Victoria); Bustos, M. (Matilde); Fernandez, E. (Estefanía); Eguinoa, E. (Ezequiel); Mato, J.M. (José María); Avila, M.A. (Matías Antonio) Abstract: Elevated plasma levels of homocysteine have been shown to interfere with normal cell function in a variety of tissues and organs, such as the vascular wall and the liver. However, the molecular mechanisms behind homocysteine effects are not completely understood. In order to better characterize the cellular effects of homocysteine, we have searched for changes in gene expression induced by this amino acid. Our results show that homocysteine is able to induce the expression and synthesis of the tissue inhibitor of metalloproteinases-1 (TIMP-1) in a variety of cell types ranging from vascular smooth muscle cells to hepatocytes, HepG2 cells and hepatic stellate cells. In this latter cell type, homocysteine also stimulated alpha 1(I) procollagen mRNA expression. TIMP-1 induction by homocysteine appears to be mediated by its thiol group. Additionally, we demonstrate that homocysteine is able to promote activating protein-1 (AP-1) binding activity, which has been shown to be critical for TIMP-1 induction. Our findings suggest that homocysteine may alter extracellular matrix homeostasis on diverse tissular backgrounds besides the vascular wall. The liver could be considered as another target for such action of homocysteine. Consequently, the elevated plasma levels of this amino acid found in different pathological or nutritional circumstances may cooperate with other agents, such as ethanol, in the onset of liver fibrosis.

Apoptosis en la cardiopatía hipertensiva

Thu, 31 Dec 1998 23:00:00 GMT

Title: Apoptosis en la cardiopatía hipertensiva Author(s) : Diez, J. (Javier); Fortuño, M.A. (María Antonia); Ravassa, S. (Susana)

Respuestas del miocardio al estrés biomecánico

Sun, 31 Dec 2000 23:00:00 GMT

Title: Respuestas del miocardio al estrés biomecánico Author(s) : Diez, J. (Javier); Lopez, B. (Begoña); Gonzalez, A. (Arantxa); Ardanaz, N. (Noelia); Fortuño, M.A. (María Antonia) Abstract: El estrés biomecánico del miocardio hace referencia a la situación que se genera cuando, debido a la hipertensión, la hipoxia u otras formas de daño miocárdico, están aumentadas las demandas de trabajo cardíaco y/o se ha perdido miocardio funcionante. Como consecuencia del estrés biomecánico se producen diversas respuestas que afectan a todas las células miocárdicas, en particular a los cardiomiocitos. El resultado final de las mismas son distintas modificaciones fenotípicas que inicialmente son compensadoras (p. ej., hipertrofia), pero que si persiste el estrés pueden mediar la transición de la hipertrofia a la insuficiencia cardíaca (p. ej., apoptosis y fibrosis). Esta revisión se centra en la descripción de las distintas fases de las respuestas miocárdicas al estrés, así como en la consideración de los hallazgos más recientes sobre los mecanismos moleculares implicados en el desarrollo de insuficiencia cardíaca.

Increasing trend in the prevalence of morbid obesity in Spain: from 1.8 to 6.1 per thousand in 14 years

Fri, 31 Dec 2010 23:00:00 GMT

Title: Increasing trend in the prevalence of morbid obesity in Spain: from 1.8 to 6.1 per thousand in 14 years Author(s) : Basterra-Gortari, F.J. (Francisco Javier); Beunza, J.J. (Juan José); Bes-Rastrollo, M. (Maira); Toledo, E. (Estefanía); Garcia-Lopez, M. (Martin); Martinez-Gonzalez, M.A. (Miguel Angel) Abstract: Obesity, and especiallymorbid obesity, increases the risk of cardiovascular as well as non-cardiovascular diseases. Our objective was to ascertain the trends in morbid obesity in Spain from 1993 to 2006 using representative data from 106,048 participants in the National Health Surveys. An age-adjusted Poisson regression model stratified by sex was fitted using morbid obesity as the dependent variable. An increasing trend in prevalent morbid obesity from 1.8 to 6.1 per thousand participants was found (increase > 200%). Morbid obesity prevalence was higher in women. After adjusting for age, a monotonically increasing prevalence of morbid obesity was apparent for both men and women: the relative increase was 4% per year in women and 12% per year in men. These trends highlight the importance of preventive actions.

Increasing trend in the prevalence of morbid obesity in Spain: from 1.8 to 6.1 per thousand in 14 years

Fri, 31 Dec 2010 23:00:00 GMT

Obesity, metabolic syndrome and diabetes: cardiovascular implications and therapy

Mon, 31 Dec 2007 23:00:00 GMT

Title: Obesity, metabolic syndrome and diabetes: cardiovascular implications and therapy Author(s) : Alegria, E. (Eduardo); Castellano, J.M. (José M.); Alegria-Barrero, A. (Ana) Abstract: Obesity, metabolic syndrome, and type-2 diabetes mellitus are 3 interrelated conditions that share a number of pathophysiological mechanisms and that are frequently observed to lead, in succession, to cardiovascular complications. The fact that their prevalence is increasing alarmingly should prompt all healthcare professionals urgently to implement measures to prevent these complications. The most effective, though also the least adopted, are those related to lifestyle modification. Drug treatment targeted at controlling risk factors (eg, hypertension, dyslipidemia, and thrombophilia), metabolic abnormalities, and excess weight is also necessary.

Effect of smoking on body weight: longitudinal analysis of the SUN cohort

Thu, 31 Dec 2009 23:00:00 GMT

Title: Effect of smoking on body weight: longitudinal analysis of the SUN cohort Author(s) : Basterra-Gortari, F.J. (Francisco Javier); Forga, L. (Luis); Bes-Rastrollo, M. (Maira); Toledo, E. (Estefanía); Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Angel) Abstract: Our aim was to investigate prospectively the association between two major cardiovascular risk factors: smoking and weight gain. METHODS: We prospectively evaluated 7565 individuals taking part in a dynamic cohort study over a median follow-up period of 50 months. Self-reported weight and physical activity levels had been validated previously. The adjusted mean difference in weight gain relative to never-smokers (the reference group) was estimated for different levels of tobacco exposure. RESULTS: After adjusting for age, baseline body mass index, sedentary lifestyle, changes in physical activity level, total energy intake, fiber intake, food consumption between meals, and sugary soft drink, fast food and alcohol consumption, it was found that individuals who stopped smoking during follow-up had a greater relative weight gain: men 1.63 kg (95% confidence interval [CI], 1.07-2.19 kg), and women 1.51 kg (95% CI, 1.11-1.91 kg). In addition, active smokers had a greater weight gain than never-smokers: men 0.49 kg (95% CI, 0.11-0.87 kg), and women 0.36 kg (95% CI, 0.07-0.65 kg). CONCLUSIONS: Individuals who stopped smoking during follow-up and active smokers both experienced significantly greater weight gains than never-smokers. This association between cardiovascular risk factors should be taken into account when developing prevention programs.

Blockade of TGF-β 1 Signalling Inhibits Cardiac NADPH Oxidase Overactivity in Hypertensive Rats

Sat, 31 Dec 2011 23:00:00 GMT

Title: Blockade of TGF-β 1 Signalling Inhibits Cardiac NADPH Oxidase Overactivity in Hypertensive Rats Author(s) : Miguel-Carrasco, J.L. (José Luis); Baltanas, A. (Ana); Cebrian, C. (Carolina); Moreno, M.U. (María Ujué); Lopez, B. (Begoña); Hermida, N. (Nerea); Gonzalez, A. (Arantxa); Dotor, J. (Javier); Borras-Cuesta, F. (Francisco); Diez, J. (Javier); Fortuño, A. (A.); Zalba, G. (Guillermo) Abstract: NADPH oxidases constitute a major source of superoxide anion (·O(2) (-)) in hypertension. Several studies suggest an important role of NADPH oxidases in different effects mediated by TGF-β 1. In this study we show that chronic administration of P144, a peptide synthesized from type III TGF-β 1 receptor, significantly reduced the cardiac NADPH oxidase expression and activity as well as in the nitrotyrosine levels observed in control spontaneously hypertensive rats (V-SHR) to levels similar to control normotensive Wistar Kyoto rats. In addition, P144 was also able to reduce the significant increases in the expression of collagen type I protein and mRNA observed in hearts from V-SHR. In addition, positive correlations between collagen expression, NADPH oxidase activity, and nitrotyrosine levels were found in all animals. Finally, TGF-β 1-stimulated Rat-2 exhibited significant increases in NADPH oxidase activity that was inhibited in the presence of P144. It could be concluded that the blockade of TGF-β 1 with P144 inhibited cardiac NADPH oxidase in SHR, thus adding new data to elucidate the involvement of this enzyme in the profibrotic actions of TGF-β 1.

Prevalencia del síndrome metabólico en población laboral española: registro MESYAS

Fri, 31 Dec 2004 23:00:00 GMT

Title: Prevalencia del síndrome metabólico en población laboral española: registro MESYAS Author(s) : Alegria, E. (Eduardo); Cordero, A. (Alberto); Laclaustra, M. (Martín); Grima, A. (Alberto); Leon, M. (Montserrat); Casasnovas, J.A. (José A.); Luengo, E. (Emilio); Rio, A. (Alfonso) del; Ferreira, I. (Ignacio) Abstract: Introducción y objetivos. Estudiar la prevalencia del síndrome metabólico (SM) en la población laboral activa española y analizar sus diferencias según las categorías laborales. Sujetos y método. Se recogieron los datos de 7.256 trabajadores activos (un 82,4% varones), con una edad media de 45,4 ± 9,8 años, empleados en una factoría de coches y unos grandes almacenes. El diagnóstico del SM se realizó mediante los criterios modificados del ATP-III (se utilizó el índice de masa corporal en lugar del perímetro abdominal). Resultados. La prevalencia bruta del SM fue del 10,2%. Ajustada por edad y sexo en una población plana (20-60 años) fue del 5,8% (intervalo de confianza [IC] del 95%, 4,1-7,6%), significativamente más alta en varones que en mujeres (el 8,7%; IC del 95%, 7,3-10,0 frente al 3,0%; IC del 95%, 0,8-5,1). Todos los componentes del SM fueron significativamente más prevalentes en varones, excepto las concentraciones de lipoproteínas de alta densidad, que fueron más bajas. La prevalencia aumentó con la edad y el sexo masculino (odds ratio [OR] = 1,7), la obesidad (OR = 9,6), la hipertensión (OR = 3,4) y la diabetes (OR = 15,4). Los trabajadores manuales presentaron la mayor prevalencia de SM (11,8%), seguidos por EPIDEMIOLOGÍA Y PREVENCIÓN Prevalencia del síndrome metabólico en población laboral española: registro MESYAS Eduardo Alegríaa, Alberto Corderoa, Martín Laclaustrab, Alberto Grimac, Montserrat Leónb, José A. Casasnovasb, Emilio Luengod, Alfonso del Ríob e Ignacio Ferreirab, en representación de los investigadores del registro MESYAS* aDepartamento de Cardiología. Clínica Universitaria de Navarra. Pamplona. Navarra. España. bUnidad de Investigación Cardiovascular. Hospital Clínico Universitario. Zaragoza. España. cServicio de Cardiología Preventiva. Asepeyo. Valencia. España. dServicio de Cardiología. Hospital Militar. Zaragoza. España. *Al final del artículo se relacionan los miembros del equipo de investigación MESYAS. Martín Laclaustra está contratado como investigador en el Instituto Aragonés de Ciencias de la Salud dentro del programa de ayudas a contratos para investigadores que han finalizado su formación médica especializada del Instituto de Salud Carlos III. El registro MESYAS cuenta con una beca de la Sociedad Española de Cardiología (Sevilla, 2003) y la Sección de Cardiología Preventiva y Rehabilitadora. Correspondencia: Dr. E. Alegría Ezquerra. Departamento de Cardiología. Clínica Universitaria de Navarra. Avda. Pío XII, 36. 31008 Pamplona. Navarra. España. Correo electrónico: ealegria@unav.es Recibido el 5 de octubre de 2004. Aceptado para su publicación el 18 de marzo de 2005. los trabajadores de oficina (9,3%) y los directivos (7,7%) (gradiente social inverso). Los trabajadores manuales tienen un riesgo superior de presentar SM, con independencia de la edad y el sexo (OR = 1,3); este efecto parece depender de las concentraciones de triglicéridos. Conclusiones. Uno de cada 10 trabajadores activos tiene SM; la prevalencia aumenta con la edad y el sexo masculino. La obesidad y la diabetes suponen gran incremento de la prevalencia. Los trabajadores manuales son el colectivo con mayor prevalencia.