Publications by authors named "Fernando Arribas Ynsaurriaga"

40 Publications

Potential Role of Natriuretic Response to Furosemide Stress Test During Acute Heart Failure.

Circ Heart Fail 2021 Jun 15;14(6):e008166. Epub 2021 Jun 15.

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).

Background: Poor natriuresis has been associated with a poorer response to diuretic treatment and worse prognosis in acute heart failure. Recommendations on how and when to measure urinary sodium (UNa) are lacking. We aim to evaluate UNa quantification after a furosemide stress test (FST) capacity to predict appropriate decongestion during acute heart failure hospitalization.

Methods: Patients underwent an FST on day-1 of admission, and UNa was measured 2 hours after, dividing patients into low or high UNa based on the sample median value. A semiquantitative composite congestive score (CCS; 0-9) and NT pro-BNP (N-terminal pro-B-type natriuretic peptide) quantification were assessed before the FST and at day 5 after the FST.

Results: Median UNa after FST in the 65 patients included was 113 (97-122) mmol/L. At day 5, a lower proportion of patients with a low UNa reached a 30% decrease in NT-proBNP levels (21 [66%] for low UNa versus 31 [94%] for high UNa; =0.005) and an appropriate grade of decongestion (CCS<3) (20 [62%] for low UNa versus 32 [97%] for high UNa; <0.001). A UNa>83 mmol/L 2 hours after FST had a 96% sensitivity to predict an NT-proBNP reduction ≥30% and 95% to predict a CCS<3 at day 5. Low UNa patients presented a lower cumulative diuresis and weight loss and presented more often with prolonged hospitalization, worsening heart failure, and readmission because of acute heart failure or death at 6 months.

Conclusions: Low natriuresis after an FST identified patients at a higher risk of an inadequate diuretic response and an inappropriate decongestion. FST-guided diuretic treatment might help to improve decongestion, shorten hospitalizations, and to reduce adverse outcomes.
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http://dx.doi.org/10.1161/CIRCHEARTFAILURE.120.008166DOI Listing
June 2021

Cardiovascular effects of mexiletine for treatment of myotonia in myotonic dystrophy type 1.

Rev Esp Cardiol (Engl Ed) 2021 Jun 10. Epub 2021 Jun 10.

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2021.04.016DOI Listing
June 2021

Electrocardiogram Changes in the Spectrum of TTNtv Dilated Cardiomyopathy: Accuracy and Predictive Value of a New Index for LV-Changes Identification.

Heart Lung Circ 2021 May 13. Epub 2021 May 13.

Cardiology Department, 12 de Octubre University Hospital, Madrid, Spain; Research Institute i+12, 12 de Octubre University Hospital, Madrid, Spain; CIBER-CV (Biomedical Research Networking Centres, Cardiovascular Diseases), Institute of Health Carlos III, Madrid, Spain; Faculty of Medicine, Complutense University of Madrid, Spain.

Background: Truncating TTN variants (TTNtv) are the main cause of dilated cardiomyopathy (DCM). The dynamic nature of this entity has previously been described. Based on own empirical observations and previous evidences, this study assessed repolarisation patterns and the possible association with morphological and functional status of TTNtv-DCM patients.

Methods: Electrocardiograms (ECGs) of index patients with TTNtv-DCM and their relatives were included and matched in time with an echocardiogram. All individuals were classified into five phenotype groups: 1) Reduced left ventricle ejection fraction (LVEF <50%); 2) Recovered LVEF: at least 10% increase and LVEF >30% after optimal medical treatment; 3) Borderline phenotype (mildly enlarged ventricle and/or hyper-trabeculation); 4) Genotype positive, phenotype negative; and 5) Non-carriers. All electrocardiograms were evaluated by two blinded observers in qualitative and quantitative terms [T index (mm)=Σ T-wave amplitude (V5, V6, II, aVF)] and these data were compared with demographic and clinical information. The Δ T-index was calculated in those individuals with more than one electrocardiogram.

Results: Seventy-eight (78) electrocardiograms were included (46% female, mean age 50 years). T-index and prevalence of an abnormal T-wave had significantly different results among the groups (p<0.0001). Age and haemodynamic factors were shown to be ECG-modifiers, especially in phenotype-negative patients. T-index enabled individuals with reduced LVEF (<2.5) to be identified and to differentiate patients with favourable and unfavourable responses to treatment (Δ T index >3.5 and ≤2, respectively).

Conclusion: Repolarisation changes enabled characterisation of the spectrum of TTNtv-DCM. The T-index identified potential carriers and patients with the worst profiles of the spectrum of the disease.
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http://dx.doi.org/10.1016/j.hlc.2021.04.011DOI Listing
May 2021

The role of genetics in pulmonary arterial hypertension associated with congenital heart disease.

Rev Esp Cardiol (Engl Ed) 2021 May 7. Epub 2021 May 7.

Unidad de Hipertensión Pulmonar, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.

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http://dx.doi.org/10.1016/j.rec.2021.04.003DOI Listing
May 2021

First experience of percutaneous Bi-Pella in Spain.

Rev Esp Cardiol (Engl Ed) 2021 Aug 13;74(8):719-721. Epub 2021 Apr 13.

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2021.01.015DOI Listing
August 2021

Recent advances in the pharmacotherapy of pulmonary hypertension: practical considerations.

Kardiol Pol 2021 04 5;79(4):386-392. Epub 2021 Apr 5.

Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.

Pulmonary arterial hypertension (PAH) is a rare disease characterized by pulmonary vascular remodeling leading to increased vascular resistance. The increased afterload contributes to the development of right ventricular dysfunction and heart failure, which is the leading cause of death among patients with PAH. The development of specific treatments has markedly improved the prognosis of this population. However, PAH continues to be an incurable, life‑limiting condition, which creates a major burden for healthcare systems. This review describes the currently used treatments for PAH and provides insight into novel therapeutic targets that aim to reduce vascular remodeling, which ultimately leads to right ventricular failure.
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http://dx.doi.org/10.33963/KP.15928DOI Listing
April 2021

Feasibility of a Noninvasive Operability Assessment in Chronic Thromboembolic Pulmonary Hypertension under Real-World Practice.

Diagnostics (Basel) 2020 Oct 21;10(10). Epub 2020 Oct 21.

Hospital Universitario Doce de Octubre, 28041 Madrid, Spain.

This study aimed to evaluate the feasibility of a noninvasive operability assessment of chronic thromboembolic pulmonary hypertension (CTEPH) based on multidetector computed tomographic angiography (MCTA). Up to 176 patients were evaluated from January 2016 to April 2018. Throughout the first phase, the initial surgical decision was made based on MCTA with further analysis of pulmonary angiography (PA) in order to evaluate in which cases the initial decision was not modified by PA. During the second phase, PA was limited to patients judged inoperable based on MCTA or those whose assessment was not possible. Patients deemed operable (50%) based on MCTA along the first phase had been adequately classified, as PA did not modify the initial decision in all but one patient. Comparable results were obtained throughout the implementation phase. Regarding operated patients, the decision of operability was based solely on MCTA in 94% of those with level I disease, in 75% with level II, and 54% with level III. This approach enabled shorter periods of time to complete surgical assessment and the avoidance of PA-related morbidity. Baseline parameters, postoperative measures, and survival rates at 1 year after surgery were comparable in both phases. Noninvasive operability assessment is feasible in a subset of CTEPH patients and optimizes surgical candidacy evaluation.
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http://dx.doi.org/10.3390/diagnostics10100855DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589509PMC
October 2020

Impact of late-onset cytomegalovirus infection in the development of cardiac allograft vasculopathy in heart transplant recipients.

Transpl Infect Dis 2021 Apr 13;23(2):e13479. Epub 2020 Oct 13.

Cardiology Department, University Hospital 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain.

Background: The impact of late-onset cytomegalovirus (CMV) infection (LOCI) on cardiac allograft vasculopathy (CAV) has yet to be established.

Methods: A retrospective study was performed for patients who had undergone heart transplantation (HT) between January 1995 and October 2017 to analyze epidemiology of LOCI (any positive level of CMV pp65 antigenemia or DNAemia after 100 days, without previous CMV replication) and its association with CAV. Our main hypothesis was that LOCI causes less direct and indirect effects compared to early onset infection (EOCI).

Results: Late-onset cytomegalovirus infection developed in 57 of 410 patients (13.9%) in a median time of 4.7 months post-transplant. CAV at 10 years was diagnosed in 31.6% of patients with LOCI, 34.6% with EOCI, and in 19.3% of CMV-uninfected patients. In the multivariate analysis, EOCI was an independent variable for developing CAV (HR 1.8, 95% CI 1.13-2.82, P = .01). Patients with LOCI showed a trend toward a higher risk of CAV, but the difference was not statistically significant (HR 1.7, 95% CI 0.95-3.08, P = .07). In the complementary log-log model, LOCI and EOCI had a similar CAV-free survival, and a higher probability of developing CAV than CMV-uninfected patients (P = .02).

Conclusions: Cytomegalovirus infection after HT may result in the same long-term events regardless of its onset, with a higher risk of developing CAV at 10 years than patients without CMV.
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http://dx.doi.org/10.1111/tid.13479DOI Listing
April 2021

[Clinical course of COVID-19 in pulmonary arterial hypertension patients].

Rev Esp Cardiol 2020 Sep 28;73(9):775-778. Epub 2020 Jun 28.

Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España.

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http://dx.doi.org/10.1016/j.recesp.2020.05.028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321018PMC
September 2020

Effect of Coronavirus Disease 2019 in Pulmonary Circulation. The Particular Scenario of Precapillary Pulmonary Hypertension.

Diagnostics (Basel) 2020 Jul 31;10(8). Epub 2020 Jul 31.

Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), 28029 Madrid, Spain.

The Coronavirus Disease of 2019 (COVID-19) has supposed a global health emergency affecting millions of people, with particular severity in the elderly and patients with previous comorbidities, especially those with cardiovascular disease. Patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) could represent an especially vulnerable population because of the high mortality rates reported for respiratory infections. However, the number of COVID-19 cases reported among PAH and CTEPH patients is surprisingly low. Furthermore, the clinical picture that has been described in these patients is far from the severity that experts would expect. Endothelial dysfunction is a common feature between patients with PAH/CTEPH and COVID-19, leading to ventilation/perfusion mismatch, vasoconstriction, thrombosis and inflammation. In this picture, the angiotensin-converting enzyme 2 plays an essential role, being directly involved in the pathophysiology of both clinical entities. Some of these common characteristics could explain the good adaptation of PAH and CTEPH patients to COVID-19, who could also have obtained a benefit from the disease's specific treatments (anticoagulant and pulmonary vasodilators), probably due to its protective effect on the endothelium. Additionally, these common features could also lead to PAH/CTEPH as a potential sequelae of COVID-19. Throughout this comprehensive review, we describe the similarities and differences between both conditions and the possible pathophysiological and therapeutic-based mechanisms leading to the low incidence and severity of COVID-19 reported in PAH/CTEPH patients to date. Nevertheless, international registries should look carefully into this population for better understanding and management.
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http://dx.doi.org/10.3390/diagnostics10080548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459745PMC
July 2020

Unexpected Favourable Course of Coronavirus Disease 2019 in Chronic Thromboembolic Pulmonary Hypertension Patients.

Arch Bronconeumol (Engl Ed) 2020 Nov 26;56(11):749-752. Epub 2020 Jun 26.

Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain. Electronic address:

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http://dx.doi.org/10.1016/j.arbres.2020.06.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318953PMC
November 2020

Clinical course of COVID-19 in pulmonary arterial hypertension patients.

Rev Esp Cardiol (Engl Ed) 2020 09 30;73(9):775-778. Epub 2020 May 30.

Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain. Electronic address:

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http://dx.doi.org/10.1016/j.rec.2020.05.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260569PMC
September 2020

First experience in Spain of cardiac contractility modulation. A new alternative for patients with heart failure.

Rev Esp Cardiol (Engl Ed) 2020 Oct 6;73(10):855-857. Epub 2020 May 6.

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, CIBERCV, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2020.04.003DOI Listing
October 2020

Potential Molecular Pathways Related to Pulmonary Artery Aneurysm Development: Lessons to Learn from the Aorta.

Int J Mol Sci 2020 04 4;21(7). Epub 2020 Apr 4.

Centro de Investigaciones Biomédicas en Red de enfermedades CardioVasculares (CIBERCV), 28029 Madrid, Spain.

Pulmonary arterial hypertension (PAH) is a rare disease caused by pulmonary vascular remodeling. Current vasodilator treatments have substantially improved patients' survival. This improved survival has led to the appearance of complications related to conditions previously underdiagnosed or even ignored, such as pulmonary artery aneurysm (PAA). The presence of a dilated pulmonary artery has been shown to be related to an increased risk of sudden cardiac death among PAH patients. This increased risk could be associated to the development of left main coronary artery compression or pulmonary artery dissection. Nevertheless, very little is currently known about the molecular mechanisms related to PAA. Thoracic aortic aneurysm (TAA) is a well-known condition with an increased risk of sudden death caused by acute aortic dissection. TAA may be secondary to chronic exposure to classic cardiovascular risk factors. In addition, a number of genetic variants have been shown to be related to a marked risk of TAA and dissection as part of multisystemic syndromes or isolated familial TAA. The molecular pathways implied in the development of TAA have been widely studied and described. Many of these molecular pathways are involved in the pathogenesis of PAH and could be involved in PAA. This review aims to describe all these common pathways to open new research lines that could help lead to a better understanding of the pathophysiology of PAH and PAA and their clinical implications.
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http://dx.doi.org/10.3390/ijms21072509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177585PMC
April 2020

Influence of long-standing pulmonary arterial hypertension and its severity on pulmonary artery aneurysm development.

Heart Vessels 2020 Sep 4;35(9):1290-1298. Epub 2020 Apr 4.

CIBER de Enfermedades Cardiovasculars (CIBERCV), Madrid, Spain.

Pulmonary artery aneurysm (PAA) is a common finding in patients with long-term pulmonary arterial hypertension (PAH). The influence of PAH severity in the development of PAA remains unclear. We sought to determine whether PAA development is related to PAH severity and whether treatment optimization based on risk profile estimation is effective to stop pulmonary artery (PA) enlargement. This is a retrospective study of 125 PAH patients who underwent an imaging test (computed tomography or magnetic resonance) combined with a right heart catheterization within a six-month period. A multivariate analysis was performed to identify independent risk factors for PAA. Patients who underwent an additional imaging-test and RHC during follow-up were analyzed to evaluate changes on PA dimensions. PAA was diagnosed in 42 (34%) patients. PAA was more frequent in patients with congenital heart disease and toxic oil syndrome. PAH time-course showed to be an independent risk factor for PAA (HR 1.051, 95% CI 1.013-1.091, p = 0.008) whereas PAH severity did not. Twenty-six patients underwent a follow-up imaging-test and catheterization. After treatment optimization, a non-significant reduction of mean PA pressure was observed (58.5 mmHg [43.5-70.8] vs. 55.5 mmHg [47.5-66.3], p = 0.115) and a higher proportion of patients achieved a low-risk profile (19% vs. 35%, p = 0.157). However, the PA diameter significantly increased (40.4 ± 10.1 mm vs. 42.1 ± 9.6 mm; p = 0.003). PAA is a common condition in long-standing PAH but its development is not necessarily related to PAH severity. Despite stabilization after treatment optimization, a progressive PA dilatation was observed.
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http://dx.doi.org/10.1007/s00380-020-01600-5DOI Listing
September 2020

Levosimendan as bridge to transplant in patients with advanced heart failure.

Rev Esp Cardiol (Engl Ed) 2020 May 13;73(5):422-424. Epub 2020 Feb 13.

Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2019.10.026DOI Listing
May 2020

Truncating titin variants in dilated cardiomyopathy: not only LVEF recovery, but also maintenance.

Rev Esp Cardiol (Engl Ed) 2020 Jul 5;73(7):589-592. Epub 2020 Feb 5.

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2019.12.005DOI Listing
July 2020

Patient-Associated Predictors of 15- and 30-Day Readmission After Hospitalization for Acute Heart Failure.

Curr Heart Fail Rep 2019 12;16(6):304-314

Cardiology Department, University Hospital 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Av de Córdoba sn, 28041, Madrid, Spain.

Background: Identifying readmission predictors in heart failure (HF) patients may help guide preventative efforts and save costs. We aimed to identify 15- and 30-day readmission predictors due to cardiovascular reasons.

Methods And Results: A total of 1831 patients with acute HF admission were prospectively followed during a year. Patient-associated variables were gathered at admission/discharge and events during follow-up. A multivariate Fine and Gray competing risk regression model and a cumulative incidence function were used to identify predictors and build a risk score model for 15- and 30-day readmission. The 15- and 30-day readmission rates due to cardiovascular reasons were 7.1% and 13.9%. Previous acute myocardial infarction, congestive signs at discharge, and length of stay > 9 days were predictors of 15- and 30-day readmission, while much weight loss and large NT-ProBNP reduction were protective factors. The NT-ProBNP reduction was larger at 30 days (> 55%) vs 15 days (> 40%) to protect from readmission. Glomerular filtration rate at discharge < 60 mL/min/1.73m and > 1 previous admissions due to HF were predictors of 30-day readmission, while first post-discharge control at an HF unit was a protective factor.

Conclusions: Previous identified factors for early readmission were confirmed. The NT-ProBNP reduction should be increased (> 55%) to protect from 30-day readmission.
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http://dx.doi.org/10.1007/s11897-019-00442-1DOI Listing
December 2019

A novel complex structural genetic variant in DSP causing a form of arrhythmogenic cardiomyopathy.

Rev Esp Cardiol (Engl Ed) 2020 Mar 29;73(3):269-271. Epub 2019 Aug 29.

Unidad de Cardiopatías Heredables, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de investigación 12 de Octubre i+12, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2019.07.011DOI Listing
March 2020

A new mutation affecting the converter region of the beta-myosin heavy chain related to hypertrophic cardiomyopathy with poor prognosis.

Rev Esp Cardiol (Engl Ed) 2020 Feb 12;73(2):180-183. Epub 2019 Aug 12.

Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain; Centro de Investigación Biomédica en Red de enfermedades CardioVasculares (CIBERCV), Spain. Electronic address:

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http://dx.doi.org/10.1016/j.rec.2019.07.001DOI Listing
February 2020

Response by Roldan-Sevilla to Letter Regarding Article, "Missense Mutations in the FLNC Gene Causing Familial Restrictive Cardiomyopathy".

Circ Genom Precis Med 2019 07 15;12(7):e002622. Epub 2019 Jul 15.

Cardiology department, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12 (Á.R.-S., R.S.-B., M.V.-G., J.D., F.A.-Y., J.P.-D.).

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http://dx.doi.org/10.1161/CIRCGEN.119.002622DOI Listing
July 2019

Frequency, Predictors, and Prognostic Impact of Pulmonary Artery Aneurysms in Patients With Pulmonary Arterial Hypertension.

Am J Cardiol 2019 02 6;123(3):474-481. Epub 2018 Nov 6.

Department of Cardiology, Hospital Universitario 12 de Octubre, Madrid, Spain; CIBER de enfermedades CardioVasculares (CIBERCV), Spain. Electronic address:

Detection of pulmonary artery aneurysms (PAA) in pulmonary arterial hypertension (PAH) is increasing. We sought to determine the frequency of PAA in a PAH cohort, variables related to its development and its prognostic impact. We conducted a retrospective analysis of PAH patients who underwent a computed tomography or magnetic resonance. PAA was defined as a pulmonary artery >40 mm. Baseline, echocardiographic, and hemodynamic findings at PAH diagnosis were compared. Freedom from death or lung transplant was estimated by Kaplan-Meier method and compared by log-rank test. Predictors of PAA development were analyzed with multivariate models. Two-hundred patients underwent a computed tomography and/or magnetic resonance. In 77 (38%), a PAA (48.3 ± 7.2 mm) was detected. Time-course (months) of PAH was an independent risk factor for PAA (hazard ratio 1.01; 95% confidence interval 1.002 to 1.019; p = 0.016) whilst connective tissue disease was associated with a lower risk (hazard ratio 0.236; 95% confidence interval 0.060 to 0.920; p = 0.037). PAA patients showed lower rates of death and lung transplant from PAH diagnosis (p = 0.005), but no differences appeared when survival analysis was performed from first imaging test (p = 0.269). PAA patients presented a nonsignificant higher rate of sudden death (5% PAA vs 1% no-PAA; p = 0.073). In conclusion, the frequency of PAA was 38%. PAH time-course was an independent risk factor for PAA development whereas connective tissue disease -related PAH patients showed a lower risk. PAA patients showed lower rates of death or lung transplant from PAH diagnosis but no differences were found from imaging test. PAA patients had a nonsignificant higher rate of sudden death.
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http://dx.doi.org/10.1016/j.amjcard.2018.10.028DOI Listing
February 2019

Evaluation of a nurse-led intervention program in heart failure: A randomized trial.

Med Clin (Barc) 2019 06 9;152(11):431-437. Epub 2018 Oct 9.

Department of Cardiology, Hospital Universitario 12 de Octubre, CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Facultad de Medicina, Universidad Complutense, Madrid, Spain. Electronic address:

Background And Objective: Several trials have evaluated the effect of disease management programs in heart failure (HF) with diverse results. The aim of this study was to develop a simple nurse-led clinic intervention program for patients with HF and assess whether this intervention positively affects the prognosis of patients, their care costs and perceived quality of life (QoL).

Methods: Between 2011 and 2013, 127 patients with reduced ejection fraction were prospectively randomly allocated (1:2) to standard care or intervention program. Primary composite endpoint was all-cause mortality and hospital readmissions. Secondary endpoints were all-cause mortality, all-cause hospital readmissions, readmissions for HF, time to first readmission and QoL improvements assessed by "Minnesota Living with Heart Failure Questionnaire" (MLHFQ). An intention-to-treat analysis was performed.

Results: After a median follow-up of 2-years, no differences were found in the primary composite endpoint. Likewise, there were no differences between groups in the predefined secondary endpoints of mortality and readmissions from any cause. However, in the intervention group, readmissions for HF were significantly reduced (35% vs. 18%; p=0.04) and QoL significantly improved (MLHFQ±SD: 2.29±14 vs. 10.9±14.75; p=0.04).

Conclusions: In patients with HF, the use of a nurse-led intervention program significantly improves perceived QoL and reduce HF hospital readmissions.
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http://dx.doi.org/10.1016/j.medcli.2018.08.005DOI Listing
June 2019

Association Between Mutations in the NKX2.5 Homeobox, Atrial Septal Defects, Ventricular Noncompaction and Sudden Cardiac Death.

Rev Esp Cardiol (Engl Ed) 2018 Jan 17;71(1):53-55. Epub 2017 Mar 17.

Unidad de Cardiopatías Familiares, Hospital Universitario 12 de Octubre, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2017.02.032DOI Listing
January 2018
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