Publications by authors named "Díaz-Antón Belen"

21 Publications

  • Page 1 of 1

Additional value of hybrid PET/MR imaging versus MR or PET performed separately to assess cardiovascular disease.

Rev Esp Cardiol (Engl Ed) 2021 Apr 20;74(4):303-311. Epub 2020 Sep 20.

Unidad de Imagen Cardiaca, Departamento de Cardiología, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Departamento de Medicina, Universidad CEU San Pablo, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain. Electronic address:

Introduction And Objectives: Hybrid positron emission tomography (PET) and magnetic resonance (MR) imaging is an emerging technology in the diagnosis of cardiovascular disease; however, there have been no reports of its use in the national clinical setting. Our objective was to evaluate the additional value of integrated PET/MR systems compared with MR and PET performed separately in this setting.

Methods: We prospectively included 49 patients, 30 to assess myocardial viability (coronary group) and 19 to assess inflammatory, infectious, and tumoral diseases (noncoronary heart disease group). All patients underwent cardiac F-fluorodeoxyglucose PET/MR. PET/MR studies included attenuation correction sequences, followed by simultaneous cardiac PET and cardiac MR acquisition, with protocols adapted to the clinical indication (cine, tissue characterization and/or late enhancement imaging).

Results: Most (87.8%) PET/MR studies were initially interpretable. Use of PET/MR improved diagnosis vs PET or MR performed separately in 42.1% of coronary cases and 88.9% of noncoronary cases. PET/MR enabled reclassification of 87.5% of coronary cases initially classified as showing inconclusive results on MR or PET and 70% of noncoronary cases.

Conclusions: In our series, multimodality PET/MR technology provided additional diagnostic value in some patients with cardiovascular disease compared with MR and PET performed separately, especially in cases of noncoronary heart disease and in those with inconclusive results on MR or PET. In our experience, the main benefits of PET/MR include the possibility of simultaneous acquisition, the in vivo integration of anatomical/functional/metabolic aspects, and the interaction of different experts in imaging modalities.
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http://dx.doi.org/10.1016/j.rec.2020.06.034DOI Listing
April 2021

Transradial Secondary Approach During Transfemoral TAVI: Usefulness of Placing a Wire Before Femoral Puncture for Management and Treatment of Vascular Complications.

Cardiovasc Revasc Med 2021 Feb 3;23:94-99. Epub 2020 Aug 3.

Clinical Cardiology, HM Hospitales-Centro Integral de enfermedades Cardiovasculares HM-CIEC, Madrid, Spain.

Vascular complications during transcatheter aortic valve implantation (TAVI) are relatively common, and some of them related to the transfemoral secondary access. The use of the transradial access (TRA) as an alternative vascular approach for transfemoral TAVI could reduce these complications, however, the treatment of potential vascular peripheral issues from this access has been scarcely described. The advance of a wire from the TRA to the primary transfemoral access at the beginning of the procedure could help the management of eventual vascular complications. A new TRA technique during transfemoral TAVI procedures is described, reporting the results in the first forty-two patients in one center.
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http://dx.doi.org/10.1016/j.carrev.2020.07.024DOI Listing
February 2021

Coronary arterial segmental stenosis quantified by MDCT: correlation with quantitative coronary analyses by invasive angiography.

Rev Esp Cardiol (Engl Ed) 2020 12 18;73(12):1068-1070. Epub 2020 Jul 18.

Unidad de Imagen Cardiaca, Hospital Universitario HM Montepríncipe-CIEC, HM Hospitales, Madrid, Spain; Servicio de Cardiología, Hospital Universitario HM Montepríncipe-CIEC, HM Hospitales, Madrid, Spain; Universidad CEU San Pablo, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; CIBER de enfermedades CardioVasculares (CIBERCV), Madrid, Spain. Electronic address:

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http://dx.doi.org/10.1016/j.rec.2020.04.029DOI Listing
December 2020

Diagnostic and Prognostic Value of Coronary Computed Tomography Angiography in Patients with Severe Calcification.

J Cardiovasc Transl Res 2021 Feb 1;14(1):131-139. Epub 2020 Apr 1.

Unidad de Imagen Cardiaca, Departamento de Cardiología, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Madrid, Spain.

Our aim was to analyze its diagnostic and prognostic value in patients with high coronary calcium score (CCS). A total of 113 patients with CCS > 400 were included. Significant coronary artery disease (CAD) was defined as stenosis ≥ 50%. Invasive coronary angiography and major cardiovascular events were recorded. The CCS and heart rate during the acquisition were significantly lower in the diagnostic coronary computed tomography angiography (CCTA) group. The cut-off value of CCS to establish the diagnostic utility of CCTA was 878. The rate of cardiovascular events was 9.3%. The positive predictive value of CCTA to detect significant CAD was 73.5% and the negative predictive value for predicting cardiovascular events was 96%. In patients with high CCS, CCTA is useful to evaluate CAD, especially when the CCS is lower or equal to 878; moreover, the prognostic value of CCTA is better in patients where significant CAD has been ruled out.
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http://dx.doi.org/10.1007/s12265-020-09977-4DOI Listing
February 2021

Percutaneous Closure of Mitral Paravalvular Leaks Generating Refractory Heart Failure in the Immediate Postoperative Period.

J Invasive Cardiol 2019 Aug;31(8):E259-E260

Unidad de Hemodinámica y Cardiología Intervencionista, HM Hospitales-Hospital Universitario HM Montepríncipe, Avenida de Montepríncipe, 25, 28668 Boadilla del Monte, Madrid, Espaņa.

We present two patients with refractory heart failure due to mitral paravalvular leak (PVL) in whom percutaneous PVL closure was performed in the immediate postoperative period.
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August 2019

Percutaneous Closure of a Poorly Tolerated Ventricular Septal Defect After Triple Valvular Prosthesis Surgery.

J Invasive Cardiol 2019 Jun;31(6):E154

Hospital Universitario HM Montepríncipe, Av. de Montepríncipe, 25, 28660 Boadilla del Monte, Madrid, Spain.

We describe the case of an 81-year-old woman with three biological prostheses at the aortic valve, mitral valve, and tricuspid valve with recurrent hospitalizations due to heart failure. To the best of our knowledge, this is the first percutaneous closure of ventricular septal defect in the presence of three valvular prostheses.
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June 2019

Left Bundle Branch Block after Transcatheter Aortic Valve Implantation with Edwards Sapien 3 Valve: Influence of the Valve Depth Implantation.

Cardiovasc Revasc Med 2019 Nov 9;20(11):949-955. Epub 2019 Jan 9.

Clinical Cardiology, Hospital Universitario HM Montepríncipe, Spain.

Objectives: The aim of this study is to determine the relation between the valve depth implantation and the new-onset left bundle branch block (LBBB) in patients treated with transcatheter aortic valve implantation (TAVI) using Edwards Sapien 3 (S3) prosthesis.

Background: LBBB is the most common conduction disturbance after TAVI. The S3 has been associated with a higher incidence of LBBB. A deep valve implant could be related to new-onset LBBB with S3.

Methods: Seventy-six consecutive patients treated with transfemoral TAVI with S3 were included. Electrocardiogram (ECG) registries were recorded at baseline, after the procedure, and before discharge. Valve depth implantation was determined in 40 patients by off-line analysis of the two/three-dimensional transeophageal echocardiogram (TEE) images, with measure of the valve stent percentage under the aortic annulus. Previous and new conduction anomalies were documented; and patient, anatomic and procedural characteristics were retrospectively analyzed.

Results: Complete atrioventricular block (AVB) incidence was 2.9%. LBBB after TAVI appeared in 39% of patients, being transient in almost half of the cases (permanent LBBB rate 20%). Patients with new-onset LBBB after TAVI were older, with a higher STS Score and a wider basal QRS. A deep valve position was associated with new-onset LBBB, with a ROC curve establishing a cut-off point of 34% of depth implant as risk factor for new-onset LBBB (sensitivity and specificity 0.8).

Conclusions: In transfemoral TAVI with S3 prosthesis, a higher valve implantation (<34% of valve stent introduced into the ventricle) may minimize the new-onset LBBB, especially in old and high-risk patients with a wide basal QRS.
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http://dx.doi.org/10.1016/j.carrev.2019.01.006DOI Listing
November 2019

Bioprosthetic mitral valve thrombosis resolved with dabigatran.

Rev Esp Cardiol (Engl Ed) 2020 Jan 19;73(1):86. Epub 2018 Dec 19.

Departamento de Cardiología, Hospital Universitario HM Montepríncipe-CIEC, Boadilla del Monte, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2018.09.017DOI Listing
January 2020

Successful Percutaneous Treatment of an Acute Left Main Coronary Occlusion Due to Iatrogenic Dissection Extending Into the Ascending Aorta.

JACC Cardiovasc Interv 2018 09 29;11(18):1897-1899. Epub 2018 Aug 29.

Interventional Cardiology Unit, Hospital Universitario HM Montepríncipe, Madrid, Spain.

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http://dx.doi.org/10.1016/j.jcin.2018.06.054DOI Listing
September 2018

Electrocardiographic changes and conduction disturbances after transfemoral aortic valve implantation with Edwards Sapien 3 prosthesis.

J Electrocardiol 2018 May - Jun;51(3):416-421. Epub 2018 Feb 20.

Clinical Cardiology Department, Hospital Universitario HM Montepríncipe, Madrid, Spain.

Objectives: The aim of this study is to describe electrocardiographic changes and conduction abnormalities in patients undergoing transcatheter aortic valve implantation (TAVI).

Methods: 76 patients who underwent TAVI using Edwards Sapien 3 prosthesis were included, comparing electrocardiographic registries at admission, post-procedure and before discharge.

Results: Patients after TAVI presented a longer PR interval, a wider QRS, and a longer corrected QT, with a left deviation of QRS axis and T waves; reversible changes that tended to correct in the following days after TAVI. Complete atrioventricular block incidence was 2.9%. New-onset left bundle branch block (LBBB) incidence was 39%, although solved in almost half of patients before discharge.

Conclusions: TAVI was associated with different reversible electrocardiographic changes that suggest a transient impact on the conduction system. One of every five patients presented permanent LBBB after valve implant.
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http://dx.doi.org/10.1016/j.jelectrocard.2018.02.009DOI Listing
March 2019

Intra-atrial Right Coronary Artery: An Unknown Disorder.

Rev Esp Cardiol (Engl Ed) 2018 Jun 14;71(6):486. Epub 2017 Oct 14.

Unidad de Imagen Cardiaca, Departamento de Cardiología, Hospital Universitario HM Montepríncipe-CIEC, Boadilla del Monte, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2017.07.014DOI Listing
June 2018

Recurrent Cardiac Fibroelastoma. Is It Really a Benign Tumor?

Rev Esp Cardiol (Engl Ed) 2018 Aug 11;71(8):685-687. Epub 2017 Jul 11.

Servicio de Cardiología, Hospital Universitario Madrid Montepríncipe, Boadilla del Monte, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2017.04.031DOI Listing
August 2018

Percutaneous closure of a giant coronary artery fistula after surgical pericardiectomy. Review of the literature.

Cardiovasc Revasc Med 2017 Jul - Aug;18(5):384-389. Epub 2017 Mar 9.

Anesthesiology, Hospital Universitario Madrid Montepríncipe, Madrid, Spain.

Coronary artery fistulae (CAF) are uncommon heart defects defined as a communication between a coronary artery and a cardiac chamber or vascular structure. They are frequently asymptomatic; nevertheless, they can produce angina, dyspnea or cardiac failure. CAF are believed to be congenital; however, isolated cases of CAF have been described as rare complications of cardiac surgery. We report the percutaneous closure of a giant CAF in an adult patient with angina and previous pericardiectomy.
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http://dx.doi.org/10.1016/j.carrev.2017.03.002DOI Listing
May 2018

'Jamaican Stone': A potentially lethal remedy for delaying ejaculation.

Rev Port Cardiol 2017 Feb 1;36(2):143.e1-143.e4. Epub 2017 Feb 1.

Department of Cardiology, Hospital 12 octubre, Madrid, Spain.

Poisoning by ingestion of 'Jamaican Stone', a kind of cardioactive steroid, is extremely rare. However, mortality is very high. For this reason, when it occurs, an early and accurate diagnosis represents a critical challenge for clinicians. We present an unusual case of electrical storm caused by this substance.
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http://dx.doi.org/10.1016/j.repc.2016.04.016DOI Listing
February 2017

Percutaneous Repair of a Complex Periprosthetic Aortic Leak.

Rev Esp Cardiol (Engl Ed) 2017 Sep 23;70(9):771. Epub 2016 Nov 23.

Unidad de Imagen Cardiaca, Hospital Universitario Madrid Montepríncipe, Boadilla del Monte, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2016.10.011DOI Listing
September 2017

Late Phrenic Nerve Stimulation in a Super-responder to Cardiac Resynchronization Therapy. The Toll of Success?

Rev Esp Cardiol (Engl Ed) 2016 Sep 12;69(9):868-70. Epub 2016 Jul 12.

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2016.04.035DOI Listing
September 2016

Pregnancy in Women With Structural Heart Disease: Experience in a Centre.

Rev Esp Cardiol (Engl Ed) 2015 Dec 2;68(12):1189-90. Epub 2015 Nov 2.

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2015.08.014DOI Listing
December 2015

Anomalous bilateral pulmonary veins with normal drainage into the left atrium.

Eur Heart J Cardiovasc Imaging 2015 Dec 28;16(12):1408. Epub 2015 Sep 28.

Hospital Beata María Ana de Jesús, Madrid, Spain.

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http://dx.doi.org/10.1093/ehjci/jev239DOI Listing
December 2015

[Clozapine-associated myocarditis].

Med Clin (Barc) 2015 Nov 24;145(9):e19-20. Epub 2015 Feb 24.

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, España.

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http://dx.doi.org/10.1016/j.medcli.2015.01.004DOI Listing
November 2015