Publications by authors named "Jose L Zamorano"

93 Publications

Mid-term outcomes of percutaneous tricuspid annuloplasty with the Cardioband device.

Rev Esp Cardiol (Engl Ed) 2021 May 14. Epub 2021 May 14.

Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain. Electronic address:

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http://dx.doi.org/10.1016/j.rec.2021.03.013DOI Listing
May 2021

Practical guidance for combination lipid-modifying therapy in high- and very-high-risk patients: A statement from a European Atherosclerosis Society Task Force.

Atherosclerosis 2021 05 13;325:99-109. Epub 2021 Apr 13.

Department of Pharmacological and Biomolecular Sciences, Universita' degli Studi di Milano, Milan, and IRCCS MultiMedica, Milan, Italy. Electronic address:

Background And Aims: This European Atherosclerosis Society (EAS) Task Force provides practical guidance for combination therapy for elevated low-density lipoprotein cholesterol (LDL-C) and/or triglycerides (TG) in high-risk and very-high-risk patients.

Methods: Evidence-based review.

Results: Statin-ezetimibe combination treatment is the first choice for managing elevated LDL-C and should be given upfront in very-high-risk patients with high LDL-C unlikely to reach goal with a statin, and in primary prevention familial hypercholesterolaemia patients. A proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor may be added if LDL-C levels remain high. In high and very-high-risk patients with mild to moderately elevated TG levels (>2.3 and < 5.6 mmol/L [>200 and < 500 mg/dL) on a statin, treatment with either a fibrate or high-dose omega-3 fatty acids (icosapent ethyl) may be considered, weighing the benefit versus risks. Combination with fenofibrate may be considered for both macro- and microvascular benefits in patients with type 2 diabetes mellitus.

Conclusions: This guidance aims to improve real-world use of guideline-recommended combination lipid modifying treatment.
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http://dx.doi.org/10.1016/j.atherosclerosis.2021.03.039DOI Listing
May 2021

Metformin in the era of new antidiabetics.

Future Cardiol 2021 05 23;17(3):475-485. Epub 2021 Mar 23.

Department of Cardiology, University Hospital Ramon y Cajal, Madrid, Spain.

Type II diabetes mellitus is a known cardiovascular risk factor and its prevalence continues to increase. A revolution in the Type II diabetes mellitus treatment has occurred with the arrival of new antidiabetic drugs, which are thought to compromise metformin place. We aim to review the pharmacology, available evidence and clinical aspects of metformin use in the era of new antidiabetics.
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http://dx.doi.org/10.2217/fca-2020-0195DOI Listing
May 2021

Advanced cancer is also a heart failure syndrome: a hypothesis.

J Cachexia Sarcopenia Muscle 2021 Jun 18;12(3):533-537. Epub 2021 Mar 18.

Department of Cardiology & Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Charité-Universitätsmedizin Berlin (Campus CVK), Berlin, Germany.

We present the hypothesis that advanced stage cancer is also a heart failure syndrome. It can develop independently of or in addition to cardiotoxic effects of anti-cancer therapies. This includes an increased risk of ventricular arrhythmias. We suggest the pathophysiologic link for these developments includes generalized muscle wasting (i.e. sarcopenia) due to tissue homeostasis changes leading to cardiac wasting associated cardiomyopathy. Cardiac wasting with thinning of the ventricular wall increases ventricular wall stress, even in the absence of ventricular dilatation. In addition, arrhythmias may be facilitated by cellular wasting processes affecting structure and function of electrical cells and conduction pathways. We submit that in some patients with advanced cancer (but not terminal cancer), heart failure therapy or defibrillators may be relevant treatment options. The key points in selecting patients for such therapies may be the predicted life expectancy, quality of life at intervention time, symptomatic burden, and consequences for further anti-cancer therapies. The cause of death in advanced cancer is difficult to ascertain and consensus on event definitions in cancer is not established yet. Clinical investigations on this are called for. Broader ethical considerations must be taken into account when aiming to target cardiovascular problems in cancer patients. We suggest that focused attention to evaluating cardiac wasting and arrhythmias in cancer will herald a further evolution in the rapidly expanding field of cardio-oncology.
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http://dx.doi.org/10.1002/jcsm.12694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8200419PMC
June 2021

Improving lipid management in patients with acute coronary syndrome: The ACS Lipid EuroPath tool.

Atheroscler Suppl 2020 Dec;42:e65-e71

Servicio de Cardiología, Hospital Ramón y Cajal, Madrid, Spain.

Post-acute coronary syndrome (ACS) patients are at very high risk for recurrent events and mortality, despite the availability of effective pharmacological approaches. In 2018, the ACS EuroPath Survey, performed in collaboration with 555 European cardiologists, identified a sub-optimal LDL-C management in post-ACS patients. Based on these premises, the ACS EuroPath II project led to the development of a self-assessment tool to improve lipid management in these very high risk patients, taking into consideration the new 2019 ESC/EAS guidelines. This tool is built in 3 sections. The first is a questionnaire to assess the lipid management practice from the acute phase up to 12 months of follow-up. The main topics covered in this section relate to 1) acute phase (lipid management of ACS patients during hospitalization; 2) discharge (lipid management at discharge, with focus on follow-up plan); 3) follow-up (lipid management at the time of first and subsequent follow-ups); 4) referral pathway for definitive lipid management care of post-ACS patients; 5) evaluation of the achieved goal at 6 months to 1 year and key implications. The second section is a brief report to position the results against other European Union clinical practice and European guidelines. The last section allows the physician to evaluate and consider the implementation of one or more strategies, successfully developed in leading European centers, in order to optimize their own clinical practice.
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http://dx.doi.org/10.1016/j.atherosclerosissup.2021.01.011DOI Listing
December 2020

Advanced cancer is also a heart failure syndrome: a hypothesis.

Eur J Heart Fail 2021 01;23(1):140-144

Department of Cardiology & Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Charité-Universitätsmedizin Berlin (Campus CVK), Berlin, Germany.

We present the hypothesis that advanced stage cancer is also a heart failure syndrome. It can develop independently of or in addition to cardiotoxic effects of anti-cancer therapies. This includes an increased risk of ventricular arrhythmias. We suggest the pathophysiologic link for these developments includes generalized muscle wasting (i.e. sarcopenia) due to tissue homeostasis changes leading to cardiac wasting associated cardiomyopathy. Cardiac wasting with thinning of the ventricular wall increases ventricular wall stress, even in the absence of ventricular dilatation. In addition, arrhythmias may be facilitated by cellular wasting processes affecting structure and function of electrical cells and conduction pathways. We submit that in some patients with advanced cancer (but not terminal cancer), heart failure therapy or defibrillators may be relevant treatment options. The key points in selecting patients for such therapies may be the predicted life expectancy, quality of life at intervention time, symptomatic burden, and consequences for further anti-cancer therapies. The cause of death in advanced cancer is difficult to ascertain and consensus on event definitions in cancer is not established yet. Clinical investigations on this are called for. Broader ethical considerations must be taken into account when aiming to target cardiovascular problems in cancer patients. We suggest that focused attention to evaluating cardiac wasting and arrhythmias in cancer will herald a further evolution in the rapidly expanding field of cardio-oncology.
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http://dx.doi.org/10.1002/ejhf.2071DOI Listing
January 2021

Transcatheter tricuspid annuloplasty with the Cardioband device to treat severe functional tricuspid regurgitation.

Rev Esp Cardiol (Engl Ed) 2020 Jun 20;73(6):507-508. Epub 2020 Jan 20.

Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2019.10.024DOI Listing
June 2020

CIBER-CLAP (CIBERCV Cardioprotection Large Animal Platform): A multicenter preclinical network for testing reproducibility in cardiovascular interventions.

Sci Rep 2019 12 30;9(1):20290. Epub 2019 Dec 30.

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

Despite many cardioprotective interventions have shown to protect the heart against ischemia/reperfusion injury in the experimental setting, only few of them have succeeded in translating their findings into positive proof-of-concept clinical trials. Controversial and inconsistent experimental and clinical evidence supports the urgency of a disruptive paradigm shift for testing cardioprotective therapies. There is a need to evaluate experimental reproducibility before stepping into the clinical arena. The CIBERCV (acronym for Spanish network-center for cardiovascular biomedical research) has set up the "Cardioprotection Large Animal Platform" (CIBER-CLAP) to perform experimental studies testing the efficacy and reproducibility of promising cardioprotective interventions based on a pre-specified design and protocols, randomization, blinding assessment and other robust methodological features. Our first randomized, control-group, open-label blinded endpoint experimental trial assessing local ischemic preconditioning (IPC) in a pig model of acute myocardial infarction (n = 87) will be carried out in three separate sets of experiments performed in parallel by three laboratories. Each set aims to assess: (A) CMR-based outcomes; (B) histopathological-based outcomes; and (C) protein-based outcomes. Three core labs will assess outcomes in a blinded fashion (CMR imaging, histopathology and proteomics) and 2 methodological core labs will conduct the randomization and statistical analysis.
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http://dx.doi.org/10.1038/s41598-019-56613-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937304PMC
December 2019

Prognostic implications of left ventricular global longitudinal strain in patients with bicuspid aortic valve disease and preserved left ventricular ejection fraction.

Eur Heart J Cardiovasc Imaging 2020 07;21(7):759-767

Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands.

Aims: In patients with bicuspid aortic valve (BAV) and preserved left ventricular (LV) ejection fraction (EF), the frequency of impaired LV global longitudinal strain (GLS) and its prognostic implications are unknown. The present study evaluated the proportion and prognostic value of impaired LV GLS in patients with BAV and preserved LVEF.

Methods And Results: Five hundred and thirteen patients (68% men; mean age 44 ± 18 years) with BAV and preserved LVEF (>50%) were divided into five groups according to the type of BAV dysfunction: (i) normal function BAV, (ii) mild aortic stenosis (AS) or aortic regurgitation (AR), (iii) ≥moderate isolated AS, (iv) ≥moderate isolated AR, and (v) ≥moderate mixed AS and AR. LV systolic dysfunction based on 2D speckle-tracking echocardiography was defined as a cut-off value of LVGLS (-13.6%). The primary outcome was aortic valve intervention or all-cause mortality. The proportion of patients with LVGLS ≤-13.6% was the highest in the normal BAV group (97%) and the lowest in the group with moderate and severe mixed AS and AR (79%). During a median follow-up of 10 years, 210 (41%) patients underwent aortic valve replacement and 17 (3%) died. Patients with preserved LV systolic function (LVGLS ≤ -13.6%) had significantly better event-free survival compared to those with impaired LV systolic function (LVGLS > -13.6%). LVGLS was independently associated with increased risk of events (mainly aortic valve replacement): hazard ratio 1.09; P < 0.001.

Conclusion: Impaired LVGLS in BAV with preserved LVEF is not infrequent and was independently associated with increased risk of events (mainly aortic valve replacement events).
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http://dx.doi.org/10.1093/ehjci/jez252DOI Listing
July 2020

A genetic risk score predicts recurrent events after myocardial infarction in young adults.

Rev Esp Cardiol (Engl Ed) 2020 Aug 17;73(8):623-631. Epub 2019 Oct 17.

Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital La Zarzuela, Madrid, Spain.

Introduction And Objectives: To evaluate whether a genetic risk score (GRS) improves prediction of recurrent events in young nondiabetic patients presenting with an acute myocardial infarction (AMI) and identifies a more aggressive form of atherosclerosis.

Methods: We conducted a prospective study with consecutive nondiabetic patients aged <55 years presenting with AMI. We performed a genetic test, cardiac computed tomography, and analyzed several biomarkers. We studied the association of a GRS composed of 11 genetic variants and a primary composite endpoint (cardiovascular mortality, a recurrent event, and cardiac hospitalization).

Results: A total of 81 patients were studied and followed up for a median of 4.1 years. There were 24 recurrent cardiovascular events. Compared with the general population, study participants had a higher prevalence of 9 out of 11 risk alleles. The GRS was significantly associated with recurrent cardiovascular events, especially when baseline low-density lipoprotein cholesterol (LDL-C) levels were elevated. Compared with the low-risk GRS tertile, the multivariate-adjusted HR for recurrences was 10.2 (95%CI, 1.1-100.3; P=.04) for the intermediate-risk group and was 20.7 (2.4-181.0; P=.006) for the high-risk group when LDL-C was≥2.8mmol/L (≥ 110mg/dL). Inclusion of the GRS improved the C-statistic (ΔC-statistic=0.086), cNRI (continuous net reclassification improvement) (30%), and the IDI (integrated discrimination improvement) index (0.05). Cardiac computed tomography frequently detected coronary calcified atherosclerosis but had limited value for prediction of recurrences. No association was observed between metalloproteinases, GRS and recurrences.

Conclusions: A multilocus GRS may identify individuals at increased risk of long-term recurrences among young nondiabetic patients with AMI and improve clinical risk stratification models, particularly among patients with high baseline LDL-C levels.
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http://dx.doi.org/10.1016/j.rec.2019.08.006DOI Listing
August 2020

A Novel and Simple Percutaneous Technique to Treat a Complex Pseudoaneurysm of Post-Aortic Coarctation Patch Aortoplasty.

JACC Cardiovasc Interv 2019 09 28;12(18):e159-e160. Epub 2019 Aug 28.

Department of Cardiology, Ramón y Cajal University Hospital, Madrid, Spain.

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http://dx.doi.org/10.1016/j.jcin.2019.06.016DOI Listing
September 2019

Age-specific reference values for carotid arterial stiffness estimated by ultrasonic wall tracking.

J Hum Hypertens 2020 03 21;34(3):214-222. Epub 2019 Aug 21.

Wales Heart Research Institute, School of Medicine, Cardiff University, Cardiff, UK.

Interaction between arterial stiffness and hypertension plays an important role in the development of cardiovascular disease. Accordingly, assessment of arterial stiffness may provide a tool for estimating cardiovascular risk and monitoring therapy in hypertensive patients. Radiofrequency-based vascular ultrasound allows accurate noninvasive assessment of local mechanical properties of large arteries, but for its use in clinical practice, reference values according to age and sex are mandatory for each vascular site. To provide reference values for common carotid artery stiffness as assessed by an echo-tracking imaging system Hitachi-Aloka, we pooled measurements collected in 1847 healthy subjects aged 3-74 years (1008 males and 839 females) recruited in 14 European centers in the E-tracking International Collaboration (ETIC). Statistical models were developed to describe relationships of different stiffness indices with age and to calculate median values and Z-scores corresponding to ± 1 and ± 2 standard deviations. In our apparently healthy population, age accounted for 53% of variability in the elastic modulus (epsilon), 39% in arterial compliance, 47% in stiffness index (β), and 56% in local pulse wave velocity; on average, blood pressure accounted for a further 7.5% of variability. Dependence on age was not linear; changes in mean values increased at older ages, especially for epsilon and β. There was an interaction between age and gender for arterial compliance, which was higher in males. We present nomograms and a software that can be used for the automated calculation of Z-scores for local carotid stiffness in individual patients. These tools can be used to establish prognostic indicators or surrogate targets for treatment monitoring.
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http://dx.doi.org/10.1038/s41371-019-0228-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076029PMC
March 2020

Differential expression of circulating miRNAs as a novel tool to assess BAG3-associated familial dilated cardiomyopathy.

Biosci Rep 2019 03 15;39(3). Epub 2019 Mar 15.

Univ Puerta del Mar, School of Medicine, Cadiz, Spain

A new familial dilated cardiomyopathy (FDCM) was found related to mutations in gene. MicroRNAs (miRNAs) represent new targets of FDCM, although no studies have assessed clinical association between Bcl2-associated athanogene 3 (BAG3)-related DCM and miRNAs. Here, we studied whether a clinical association between BAG3-related FDCM and circulating miRNAs may have diagnostic and prognostic value in a small cohort of familial related individuals carrying a BAG3 mutation (BAG3+) and/or diagnosed of dilated cardiomyopathy (DCM) (DCM+). The analysis of 1759 circulating miRNAs showed significant differences between BAG3+ and BAG3- individuals for miRNAs mir-3191-3p, 6769b-3p, 1249-ep, 154-5p, 6855-5p, and 182-5p, while comparisons between BAG3+/DCM+ versus BAG3+/DCM- were restricted to miRNAs mir-154-5p, 6885-5p, and 182-5p, showing significant correlation with systolic and diastolic blood pressure, A wave, left atrium length, and left atrium area. Additionally, when stratified by gender and age, miRNAs were statistically correlated with critical parameters, including left ventricle ejection fraction (LVEF) and ventricular diameter, in women and young men. Likewise, 56% of BAG3+/DCM+, significantly co-expressed mir-154-5p and mir-182-5p, and a slight 4% did not express such combination, suggesting that co-expression of mir-154-5p and mir-182-5p may potentially show diagnostic value. Further studies will require long-term follow-up, and validation in larger populations.
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http://dx.doi.org/10.1042/BSR20180934DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6418398PMC
March 2019

Cardiac Troponin T Concentrations, Reversible Myocardial Ischemia, and Indices of Left Ventricular Remodeling in Patients with Suspected Stable Angina Pectoris: a DOPPLER-CIP Substudy.

Clin Chem 2018 09 29;64(9):1370-1379. Epub 2018 Jun 29.

Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Oslo, Norway;

Background: Cardiac troponin T concentrations measured with high-sensitivity assays (hs-cTnT) provide important prognostic information for patients with stable coronary artery disease (CAD). However, whether hs-cTnT concentrations mainly reflect left ventricular (LV) remodeling or recurrent myocardial ischemia in this population is not known.

Methods: We measured hs-cTnT concentrations in 619 subjects with suspected stable CAD in a prospectively designed multicenter study. We identified associations with indices of LV remodeling, as assessed by cardiac MRI and echocardiography, and evidence of myocardial ischemia diagnosed by single positron emission computed tomography.

Results: Median hs-cTnT concentration was 7.8 ng/L (interquartile range, 4.8-11.6 ng/L), and 111 patients (18%) had hs-cTnT concentrations above the upper reference limit (>14 ng/L). Patients with hs-cTnT >14 ng/L had increased LV mass (144 ± 40 g vs 116 ± 34 g; < 0.001) and volume (179 ± 80 mL vs 158 ± 44 mL; = 0.006), lower LV ejection fraction (LVEF) (59 ± 14 vs 62 ± 11; = 0.006) and global longitudinal strain (14.1 ± 3.4% vs 16.9 ± 3.2%; < 0.001), and more reversible perfusion defects ( = 0.001) and reversible wall motion abnormalities ( = 0.008). Age ( = 0.009), estimated glomerular filtration rate ( = 0.01), LV mass ( = 0.003), LVEF ( = 0.03), and evidence of reversible myocardial ischemia ( = 0.004 for perfusion defects and = 0.02 for LV wall motion) were all associated with increasing hs-cTnT concentrations in multivariate analysis. We found analogous results when using the revised US upper reference limit of 19 ng/L.

Conclusions: hs-cTnT concentrations reflect both LV mass and reversible myocardial ischemia in patients with suspected stable CAD.
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http://dx.doi.org/10.1373/clinchem.2018.288894DOI Listing
September 2018

The need for a new tricuspid regurgitation grading scheme.

Eur Heart J Cardiovasc Imaging 2017 12;18(12):1342-1343

CiberCV University Hospital Ramón y Cajal, Carretera de Colmenar Km 9.100, Madrid 28034, Spain.

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http://dx.doi.org/10.1093/ehjci/jex139DOI Listing
December 2017

Clinical Trial Principles and Endpoint Definitions for Paravalvular Leaks in Surgical Prosthesis.

Eur Heart J 2018 04;39(15):1224-1245

Imperial College London, London, United Kingdom.

The VARC (Valve Academic Research Consortium) for transcatheter aortic valve replacement set the standard for selecting appropriate clinical endpoints reflecting safety and effectiveness of transcatheter devices, and defining single and composite clinical endpoints for clinical trials. No such standardization exists for circumferentially sutured surgical valve paravalvular leak (PVL) closure. This document seeks to provide core principles, appropriate clinical endpoints, and endpoint definitions to be used in clinical trials of PVL closure devices. The PVL Academic Research Consortium met to review evidence and make recommendations for assessment of disease severity, data collection, and updated endpoint definitions. A 5-class grading scheme to evaluate PVL was developed in concordance with VARC recommendations. Unresolved issues in the field are outlined. The current PVL Academic Research Consortium provides recommendations for assessment of disease severity, data collection, and endpoint definitions. Future research in the field is warranted.
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http://dx.doi.org/10.1093/eurheartj/ehx211DOI Listing
April 2018

Clinical Trial Principles and Endpoint Definitions for Paravalvular Leaks in Surgical Prosthesis: An Expert Statement.

J Am Coll Cardiol 2017 Apr;69(16):2067-2087

Imperial College London, London, United Kingdom.

The VARC (Valve Academic Research Consortium) for transcatheter aortic valve replacement set the standard for selecting appropriate clinical endpoints reflecting safety and effectiveness of transcatheter devices, and defining single and composite clinical endpoints for clinical trials. No such standardization exists for circumferentially sutured surgical valve paravalvular leak (PVL) closure. This document seeks to provide core principles, appropriate clinical endpoints, and endpoint definitions to be used in clinical trials of PVL closure devices. The PVL Academic Research Consortium met to review evidence and make recommendations for assessment of disease severity, data collection, and updated endpoint definitions. A 5-class grading scheme to evaluate PVL was developed in concordance with VARC recommendations. Unresolved issues in the field are outlined. The current PVL Academic Research Consortium provides recommendations for assessment of disease severity, data collection, and endpoint definitions. Future research in the field is warranted.
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http://dx.doi.org/10.1016/j.jacc.2017.02.038DOI Listing
April 2017

Frequency, Mechanism and Severity of Mitral Regurgitation: Are There any Differences Between Primary and Secondary Mitral Regurgitation?

J Heart Valve Dis 2016 11;25(6):724-729

University Alcala de Henares, Hospital Ramon y Cajal, Carretera de Colmenar Km 9.100, Madrid, Spain.

Background And Aim Of The Study: Although mitral regurgitation (MR) is a well-recognized prognosis factor, its true prevalence is probably underestimated and its etiology and mechanisms have not been sufficiently explored. The study aim was to evaluate the burden of MR, focusing attention on its frequency, severity, etiology, mechanism, and other associated conditions.

Methods: Between February and June 2015, a total of 39,855 consecutive echocardiographic studies was performed at nine tertiary hospitals, and were prospectively included in the study. MR severity was graded into four groups, ranging from none or trace to severe MR, in accordance with the recommendations of the European Association of Cardiovascular Imaging. Patients with moderate to severe MR were selected for the analysis.

Results: MR was detected in 22.6% of cases. MR severity was mild in 82.5% of patients (n = 7,376), moderate in 11.7% (n = 1,048), and severe in 5.8% (n = 521). Concomitant valvular heart disease was present in 3,544 patients (39.7%), with tricuspid regurgitation the most frequently encountered (21.6%). Among moderate and severe MR, primary MR was more frequent than secondary MR (58.8% versus 23.5%), with degenerative valve disease being the most common cause of primary MR (49.2%). A third group composed of mixed forms of MR was described in 17.8% of cases.

Conclusions: MR is a common finding on echocardiography, and is frequently associated with other valvular heart disease. Most MRs are of degenerative origin. The primary and secondary forms of MR differ significantly in their clinical presentation with regard to gender, age, and ventricular function. There appears to be a gap for a 'mixed' group, though further studies are needed to confirm this suggestion.
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November 2016

Three-Dimensional Echocardiography and Right Ventricular Function: The Beauty and the Beast?

Circ Cardiovasc Imaging 2017 02;10(2)

From the Cardiology Department, Ramón y Cajal University Hospital, Madrid, Spain.

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http://dx.doi.org/10.1161/CIRCIMAGING.117.006099DOI Listing
February 2017

Specific risk of atrial fibrillation and stroke in oncology patients.

Authors:
José L Zamorano

Eur Heart J 2016 09;37(36):2747-2748

University Alcala, Hospital Ramon y Cajal, Madrid, Spain

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http://dx.doi.org/10.1093/eurheartj/ehw385DOI Listing
September 2016
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