Publications by authors named "Alberto Cecconi"

32 Publications

Publisher Correction: Analyzing artificial intelligence systems for the prediction of atrial fibrillation from sinus-rhythm ECGs including demographics and feature visualization.

Sci Rep 2021 Dec 9;11(1):24030. Epub 2021 Dec 9.

Biometrics and Data Pattern Analytics Lab, Escuela Politecnica Superior, Universidad Autonoma de Madrid, Calle Francisco Tomas Y Valiente, 11, C-235, 28049, Madrid, Spain.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-03535-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660788PMC
December 2021

Analyzing artificial intelligence systems for the prediction of atrial fibrillation from sinus-rhythm ECGs including demographics and feature visualization.

Sci Rep 2021 11 23;11(1):22786. Epub 2021 Nov 23.

Biometrics and Data Pattern Analytics Lab, Escuela Politecnica Superior, Universidad Autonoma de Madrid, Calle Francisco Tomas Y Valiente, 11, C-235, 28049, Madrid, Spain.

Atrial fibrillation (AF) is an abnormal heart rhythm, asymptomatic in many cases, that causes several health problems and mortality in population. This retrospective study evaluates the ability of different AI-based models to predict future episodes of AF from electrocardiograms (ECGs) recorded during normal sinus rhythm. Patients are divided into two classes according to AF occurrence or sinus rhythm permanence along their several ECGs registry. In the constrained scenario of balancing the age distributions between classes, our best AI model predicts future episodes of AF with area under the curve (AUC) 0.79 (0.72-0.86). Multiple scenarios and age-sex-specific groups of patients are considered, achieving best performance of prediction for males older than 70 years. These results point out the importance of considering different demographic groups in the analysis of AF prediction, showing considerable performance gaps among them. In addition to the demographic analysis, we apply feature visualization techniques to identify the most important portions of the ECG signals in the task of AF prediction, improving this way the interpretability and understanding of the AI models. These results and the simplicity of recording ECGs during check-ups add feasibility to clinical applications of AI-based models.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-02179-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8610971PMC
November 2021

A Comprehensive Model to Predict Atrial Fibrillation in Cryptogenic Stroke: The Decryptoring Score.

J Stroke Cerebrovasc Dis 2022 Jan 21;31(1):106161. Epub 2021 Oct 21.

Cardiology Department, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid. IIS-IP, CIBER-CV, Madrid, Spain. Electronic address:

Objetive: Cryptogenic stroke (CS) represents up to 30% of ischemic strokes (IS). Since atrial fibrillation (AF) can be detected in up to 30% of CS, there is a clinical need for estimating the probability of underlying AF in CS to guide the optimal secondary prevention strategy. The aim of the study was to develop the first comprehensive predictive score including clinical conditions, biomarkers, and left atrial strain (LAS), to predict AF detection in this setting.

Methods: Sixty-three consecutive patients with IS or transient ischemic attack with ABCD2 scale ≥ 4 of unknown etiology were prospectively recruited. Clinical, laboratory, and echocardiographic variables were collected. All patients underwent 15 days wearable Holter-ECG monitoring. Main objective was the Decryptoring score creation to predict AF in CS. Score variables were selected by a univariate analysis and, thereafter, score points were derived according to a multivariant analysis.

Results: AF was detected in 15 patients (24%). Age > 75 (9 points), hypertension (1 point), Troponin T > 40 ng/L (8.5 points), NTproBNP > 200 pg/ml (0.5 points), LAS reservoir < 25.3% (24.5 points) and LAS conduct < 10.4% (0.5 points) were included in the score. The rate of AF detection was 0% among patients with a score of < 10 and 80% among patients with a score > 35. The comparison of the predictive validity between the proposed score and AF-ESUS score resulted in an AUC of 0.94 for Decryptoring score and of 0.65 for the AF-ESUS score(p < 0.001).

Conclusion: This novel score offers an accurate AF prediction in patients with CS; however these results will require validation in an independent cohort using this model before they may be translated into clinical practice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.106161DOI Listing
January 2022

Electrocardiographic biomarkers to predict atrial fibrillation in sinus rhythm electrocardiograms.

Heart 2021 11 4;107(22):1813-1819. Epub 2021 Jun 4.

Cardiology Department, Hospital Universitario de la Princesa, Madrid, Spain.

Objective: Early prediction of atrial fibrillation (AF) development would improve patient outcomes. We propose a simple and cheap ECG based score to predict AF development.

Methods: A cohort of 16 316 patients was analysed. ECG measures provided by the computer-assisted ECG software were used to identify patients. A first group included patients in sinus rhythm who showed an ECG with AF at any time later (n=505). A second group included patients with all their ECGs in sinus rhythm (n=15 811). By using a training set (75% of the cohort) the initial sinus rhythm ECGs of both groups were analysed and a predictive risk score based on a multivariate logistic model was constructed.

Results: A multivariate regression model was constructed with 32 variables showing a predictive value characterised by an area under the curve (AUC) of 0.776 (95% CI: 0.738 to 0.814). The subsequent risk score included the following variables: age, duration of P-wave in aVF, V4 and V5; duration of T-wave in V3, mean QT interval adjusted for heart rate, transverse P-wave clockwise rotation, transverse P-wave terminal angle and transverse QRS complex terminal vector magnitude. Risk score values ranged from 0 (no risk) to 5 (high risk). The predictive validity of the score reached an AUC of 0.764 (95% CI: 0.722 to 0.806) with a global specificity of 61% and a sensitivity of 55%.

Conclusions: The automatic assessment of ECG biomarkers from ECGs in sinus rhythm is able to predict the risk for AF providing a low-cost screening strategy for early detection of this pathology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/heartjnl-2021-319120DOI Listing
November 2021

Pericardial late gadolinium enhancement secondary to metastatic recurrence in long-term survivor of breast cancer.

Eur Heart J Cardiovasc Imaging 2021 08;22(9):e141

Department of Cardiology, Hospital Universitario de La Princesa, Diego de Leon 62 28002 Madrid, Spain.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ehjci/jeab048DOI Listing
August 2021

Association of CHADS-VASc Score With Remodeling of Left Atrial Appendage Assessed by Cardiac Computed Tomography.

Cardiol Res 2021 Apr 23;12(2):126-128. Epub 2021 Feb 23.

Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain.

Background: CHADS-VASc score (congestive heart failure; hypertension; ages ≥ 74 years (2 points); diabetes; stroke, transient ischemic attack, or systemic embolism (2 points); vascular disease; ages 65 - 74 years; sex (female)) is a widely used clinical scale to estimate the risk of stroke in patients with non-valvular atrial fibrillation (AF). However, the relationship between the increase in CHADS-VASc score and atrial remodeling remains unsettled.

Methods: Twenty-five consecutive patients undergoing cardiac computed tomography (CT) were recruited. The systolic and diastolic volumes of left atrium and left atrial appendage (LAA) were measured. Risk of stroke was estimated using the CHADS-VASc score. The relationship of the CHADS-VASc score with morphological and functional variables was analyzed by Pearson's correlation.

Results: A positive correlation was documented between the CHADS-VASc score and systolic (r = 0.419, P = 0.037) and diastolic (r = 0.415, P = 0.039) LAA volumes. Atrial volumes and left atrial ejection fraction showed no significant correlations with CHADS-VASc.

Conclusions: This study shows, for the first time, a positive correlation between CHADS-VASc score and LAA remodeling.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14740/cr1192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935638PMC
April 2021

Usefulness of computer-assisted ECG analysis in the pre-operative evaluation of noncardiac surgery.

Eur J Anaesthesiol 2020 11;37(11):1075-1077

From the Data Analysis Unit, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa (AS-G, MP-R, GJO), Cardiology Service, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, IIS-IP, CIVER-CV (AC, FA, LJJ-B), Anaesthesiology and Critical Care Service, Hospital Universitario de la Princesa, Madrid, Spain (EA, AP), Department Anaesthesia and Intensive Care Units, IRCCS Istituto Clinico Humanitas, Humanitas University, Milan, Italy (MC), Biostatistics, Methodology Unit, Instituto de Investigación Sanitaria (JMCM), Informatic's Department, Hospital Universitario de la Princesa, Madrid, Spain and The National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina (GJO).

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/EJA.0000000000001256DOI Listing
November 2020

Pulmonary valve in carcinoid disease: be suspicious of functional assessment.

Int J Cardiovasc Imaging 2021 Feb 4;37(2):707-709. Epub 2020 Sep 4.

Department of Cardiology, University Hospital La Princesa, Madrid, Spain.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10554-020-01983-6DOI Listing
February 2021

T1 mapping in the assessment of endomyocardial fibrosis.

Int J Cardiovasc Imaging 2021 Jan 6;37(1):267-268. Epub 2020 Aug 6.

University Hospital La Princesa, Madrid, Spain.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10554-020-01955-wDOI Listing
January 2021

Sex differences in cardiac magnetic resonance features in patients with hypertrophic cardiomyopathy.

Int J Cardiovasc Imaging 2020 Sep 13;36(9):1751-1759. Epub 2020 May 13.

Cardiology Department, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle Diego de León, 62, 28006, Madrid, Spain.

Whether sex differences exist in cardiac magnetic resonance (CMR) findings in patients with hypertrophic cardiomyopathy (HCM) remain unknown. We sought to assess and compare CMR characteristics in male and female patients with HCM. From January-2006 to October-2017, 165 consecutive HCM patients evaluated with CMR were included. All clinical and complementary test information was prospectively collected. At the time of CMR evaluation women were older (70 [57-75] vs. 61 [47-72] years, p = 0.02) and more symptomatic in terms of dyspnea (New York Heart Association class II-IV 47.2 vs. 24.1%, p = 0.003) and palpitations (19.6 vs. 4.6%, p = 0.006) and received more frequently treatment with diuretics (49.1% vs. 23.4%, p = 0.001). On echocardiographic examination more women had obstructive physiology (45.1 vs. 20.6%, p = 0.002). On CMR evaluation, women showed smaller left ventricular end-systolic volume index (13 [10-15] vs. 16 [13-21] ml/m, p < 0.001), higher left ventricular ejection fraction (77 [74-80] vs. 72 [66-78]%, p = 0.004), more marked left ventricular outflow tract acceleration (54.7 vs. 26.4%, p < 0.001) and mitral regurgitation (33.3 vs. 12.7%, p = 0.002). In multivariable analysis, female sex [OR 2.44 (1.04-5.73), p = 0.04] and left ventricular end-systolic volume index [OR 1.60 (1.08-2.38), p = 0.018] were independently associated with obstructive physiology. Women with HCM have more frequently obstructive physiology, a finding that could be related to the smaller left ventricular end-systolic volume.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10554-020-01880-yDOI Listing
September 2020

Plasma Metabolic Signature of Atherosclerosis Progression and Colchicine Treatment in Rabbits.

Sci Rep 2020 04 27;10(1):7072. Epub 2020 Apr 27.

Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, 28660, Madrid, Spain.

Balloon catheter endothelial denudation in New Zealand white rabbits fed high cholesterol diet is a validated atherosclerosis model. Well-characterized in terms of atherosclerosis induction and progression, the metabolic changes associated with the atherosclerosis progression remain indeterminate. Non-targeted metabolomics permits to develop such elucidation and allows to evaluate the metabolic consequences of colchicine treatment, an anti-inflammatory drug that could revert these changes. 16 rabbits underwent 18 weeks of atherosclerosis induction by diet and aortic denudation. Thereafter animals were randomly assigned to colchicine treatment or placebo for 18 weeks while on diet. Plasma samples were obtained before randomization and at 36 weeks. Multiplatform (GC/MS, CE/MS, RP-HPLC/MS) metabolomics was applied. Plasma fingerprints were pre-processed, and the resulting matrixes analyzed to unveil differentially expressed features. Different chemical annotation strategies were accomplished for those significant features. We found metabolites associated with either atherosclerosis progression, or colchicine treatment, or both. Atherosclerosis was profoundly associated with an increase in circulating bile acids. Most of the changes associated with sterol metabolism could not be reverted by colchicine treatment. However, the variations in lysine, tryptophan and cysteine metabolism among others, have shown new potential mechanisms of action of the drug, also related to atherosclerosis progression, but not previously described.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-020-63306-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184732PMC
April 2020

Effects of Colchicine on Atherosclerotic Plaque Stabilization: a Multimodality Imaging Study in an Animal Model.

J Cardiovasc Transl Res 2021 02 5;14(1):150-160. Epub 2020 Mar 5.

Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle de Melchor Fernández Almagro, 3, 28029, Madrid, Spain.

Colchicine demonstrated clinical benefits in the treatment of stable coronary artery disease. Our aim was to evaluate the effects of colchicine on atherosclerotic plaque stabilization. Atherosclerosis was induced in the abdominal aorta of 20 rabbits with high-cholesterol diet and balloon endothelial denudation. Rabbits were randomized to receive either colchicine or placebo. All animals underwent MRI, F-FDG PET/CT, optical coherence tomography (OCT), and histology. Similar progression of atherosclerotic burden was observed in the two groups as relative increase of normalized wall index (NWI). Maximum F-FDG standardized uptake value (meanSUVmax) decreased after colchicine treatment, while it increased in the placebo group with a trend toward significance. Animals with higher levels of cholesterol showed significant differences in favor to colchicine group, both as NWI at the end of the protocol and as relative increase in meanSUVmax. Colchicine may stabilize atherosclerotic plaque by reducing inflammatory activity and plaque burden, without altering macrophage infiltration or plaque typology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12265-020-09974-7DOI Listing
February 2021

Epicardial lipomatous hypertrophy with ventricular septum separation and myocardial non-compaction: a new cardiomyopathy?

Eur Heart J Cardiovasc Imaging 2019 May;20(5):600

Department of Cardiology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Calle Diego de León, 62, Madrid, Spain.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ehjci/jey203DOI Listing
May 2019

Anterior ST-segment elevation secondary to right coronary occlusion: The sheep in wolf's clothing.

J Electrocardiol 2018 Nov - Dec;51(6):935-937. Epub 2018 Jul 23.

Department of Cardiology, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain.

We present a case of an anterior ST-segment elevation acute coronary syndrome secondary to occlusion of a non-dominant right coronary artery. Usually, an anterior ST-segment elevation corresponds to a left anterior descending artery occlusion; however, in rare cases it can be secondary to a non-dominant right coronary artery occlusion. The two causal entities may be adequately differentiated by the detailed analysis of the ECG. The electrocardiographic criteria that allow the proper prediction of the culprit artery in anterior ST-segment elevation acute coronary syndrome are reviewed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jelectrocard.2018.07.017DOI Listing
October 2019

Response by Cecconi et al to Letter Regarding Article, "Wide QRS Complex Tachycardia: What the Algorithms Fear".

Circulation 2018 09;138(11):1174-1175

Department of Cardiology, Hospital Universitario de La Princesa, Instituto de Investigacion Sanitaria, Madrid, Spain.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1161/CIRCULATIONAHA.118.036214DOI Listing
September 2018

Temporal Resolution Pattern of Myocardial Edema in Patients With Takotsubo Syndrome.

J Card Fail 2018 05 28;24(5):345-346. Epub 2018 Mar 28.

Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cardfail.2018.03.011DOI Listing
May 2018

Wide QRS Complex Tachycardia: What the Algorithms Fear.

Circulation 2018 03;137(13):1407-1409

Department of Cardiology, Hospital Universitario de La Princesa, Instituto de Investigacion Sanitaria, Madrid, Spain.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1161/CIRCULATIONAHA.118.033936DOI Listing
March 2018

Spike or not a spike? That is the question in a patient with single lead pacemaker.

J Electrocardiol 2017 Nov - Dec;50(6):937-938. Epub 2017 Jun 8.

Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain; School of Medicine, Universidad Autonoma, Madrid, Spain.

Dual-chamber pacing is feasible via the floating atrial sensor electrodes of a single-pass VDD lead but the atrial lead threshold is higher than the accepted clinical standard. Furthermore, due to the floating nature of the system, atrial sensing and pacing thresholds may vary during the follow up. For these reasons this strategy is seldom considered a common pacing solution in routine clinical practice. Alternatively, this phenomenon is likely to be observed as a result of incorrect generator configuration. As shown in our case, this inadequate setting can be suspected just by the analysis of the surface ECG and the post implantation chest X-ray.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jelectrocard.2017.06.018DOI Listing
August 2018

Helical distribution of hypertrophy in patients with hypertrophic cardiomyopathy: prevalence and clinical implications.

Int J Cardiovasc Imaging 2017 Nov 23;33(11):1771-1780. Epub 2017 May 23.

Cardiology Department, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle Diego de León, 62, 28006, Madrid, Spain.

Recently a novel pattern of helical distribution of hypertrophy has been described in patients with hypertrophic cardiomyopathy (HCM). Our aim was to determine its prevalence and potential implications in an unselected cohort. One-hundred- and eight consecutive patients diagnosed with HCM by cardiac magnetic resonance (CMR) were included (median clinical follow up of 1718 days). All clinical and complementary test information was prospectively collected. The presence of a helical pattern was assessed by a simple measurement of the maximal left ventricle (LV) wall thickness (LVWT) for each of the 17 classical LV segments and it was classified in one of three types according to its extension. A helical distribution was detected in 58% of patients, and was associated to a higher incidence of left ventricular outflow tract obstruction (LVOT; 35% vs. 10%; p = 0.005) and systolic anterior motion of the mitral valve (SAM; 30% vs. 13%, p = 0.053). No significant difference in the maximal LVWT was observed. However, the presence of a helical pattern showed a significant association with non sustained ventricular tachycardia (NSVT; 22% vs. 7%; p = 0.029) and was associated to a higher risk of sudden cardiac death (SCD) calculated with the European society of cardiology (ESC) calculator (p = 0.006). Notably, patients with a more extense spiral had a higher incidence of heart failure (75% vs. 34%, p = 0.012) and all-cause death (21 vs. 3%, p = 0.049). A helical pattern is frequent in HCM and can be readily assessed on CMR standard cine sequences. In conclusion, a helical pattern carries negative clinical implications and is associated to a higher estimated risk of SCD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10554-017-1161-8DOI Listing
November 2017

Finding the groove: The groove sign in scleroderma and related disorders.

Vasc Med 2017 04 21;22(2):161. Epub 2017 Mar 21.

2 Cardiology Department, Hospital Universitario de La Princesa, Madrid, Spain.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1358863X16686411DOI Listing
April 2017

Myocardial crystallization arising from a mitral annulus calcification.

Eur Heart J 2017 09;38(35):2690

Servicio de Cardiología, Instituto Cardiovascular, Hospital Universitario Clínico San Carlos, Madrid, Spain.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/eurheartj/ehw545DOI Listing
September 2017

Accurate quantification of atherosclerotic plaque volume by 3D vascular ultrasound using the volumetric linear array method.

Atherosclerosis 2016 May 15;248:230-7. Epub 2016 Mar 15.

Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; Mount Sinai Heart, Icahn School of Medicine, 1 Gustave L. Levy Place, Box 1030, New York City, NY 10029, USA. Electronic address:

Introduction: Direct quantification of atherosclerotic plaque volume by three-dimensional vascular ultrasound (3DVUS) is more reproducible than 2DUS-based three-dimensional (2D/3D) techniques that generate pseudo-3D volumes from summed 2D plaque areas; however, its accuracy has not been reported. We aimed to determine 3DVUS accuracy for plaque volume measurement with special emphasis on small plaques (a hallmark of early atherosclerosis).

Methods: The in vitro study consisted of nine phantoms of different volumes (small and medium-large) embedded at variable distances from the surface (superficial vs. >5 cm-depth) and comparison of 3DVUS data generated using a novel volumetric-linear array method with the real phantom volumes. The in vivo study was undertaken in a rabbit model of atherosclerosis in which 3DVUS and 2D/3D volume measurements were correlated against gold-standard histological measurements.

Results: In the in vitro setting, there was a strong correlation between 3DVUS measures and real phantom volume both for small (3.0-64.5 mm(3) size) and medium-large (91.1-965.5 mm(3) size) phantoms embedded superficially, with intraclass correlation coefficients (ICC) of 0.99 and 0.98, respectively; conversely, when phantoms were placed at >5 cm, the correlation was only moderate (ICC = 0.67). In the in vivo setting there was strong correlation between 3DVUS-measured plaque volumes and the histological gold-standard (ICC = 0.99 [4.02-92.5 mm(3) size]). Conversely, the correlation between 2D/3D values and the histological gold standard (sum of plaque areas) was weaker (ICC = 0.87 [49-520 mm(2) size]), with large dispersion of the differences between measurements in Bland-Altman plots (mean error, 79.2 mm(2)).

Conclusions: 3DVUS using the volumetric-linear array method accurately measures plaque volumes, including those of small plaques. Measurements are more accurate for superficial arterial territories than for deep territories.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.atherosclerosis.2016.03.002DOI Listing
May 2016

Cause and Long-Term Outcome of Cardiac Tamponade.

Am J Cardiol 2016 Feb 7;117(4):664-669. Epub 2015 Dec 7.

Cardiology Department, Hospital Clínico San Carlos, Madrid, Spain.

Cardiac tamponade is a life-threatening condition, whose current specific cause and outcome are unknown. Our purpose was to analyze it. We performed a retrospective observational study with prospective follow-up data including 136 consecutive patients admitted with diagnosis of cardiac tamponade, from 2003 to 2013. We thoroughly recorded variables as clinical features, drainage/pericardiocentesis, fluid characteristics, and long-term events (new cardiac tamponade ± death). The median age was 65 ± 17 years (55% men). In the baseline characteristics, 70% were no smokers, 12% were on anticoagulation, and 13 had suffered a previous myocardial infarction. In the preceding month, 15 patients had undergone a cardiac catheterization, 5 cardiac surgery, and 5 pacemaker insertion. Fever was observed in 16% of patients and 21% displayed other inflammatory symptoms. In 81% of patients, pericardiocentesis was needed. The fluid was hemorrhagic or a transudate in the majority, with positive cytology in 15% and bacteria in 3.7%. Main causes were malignancy (32%), infection (24%), idiopathic (16%), iatrogenic (15%), postmyocardial infarction (7%), uremic (4%), and other causes (2%). After a maximum follow-up of 10.4 years, cardiac tamponade recurred in 10% of the cases (62% in the neoplastic group) and the 48% of patients died (89% in the neoplastic cohort). In conclusion, most cardiac tamponades are due to malignancy, having this specific cause a poorer outcome, probably as a manifestation of an advanced disease. The rest of causes, after an aggressive intensive management, have a good prognosis, especially the iatrogenic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amjcard.2015.11.023DOI Listing
February 2016

Hyponatremia-induced stress cardiomyopathy due to psychogenic polydipsia.

Int J Cardiol 2016 Jan 6;202:618-20. Epub 2015 Oct 6.

Department of Cardiology, Hospital Universitario Clínico San Carlos, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijcard.2015.09.123DOI Listing
January 2016
-->