ELENA GARCÍA - Academia.edu (original) (raw)

Papers by ELENA GARCÍA

Revista Española de Cardiología

Journal of Cardiovascular Development and Disease, 2022

Aims: Non-ischaemic dilated cardiomyopathy (NIDCM) is characterized by left ventricular (LV) cham... more Aims: Non-ischaemic dilated cardiomyopathy (NIDCM) is characterized by left ventricular (LV) chamber enlargement and systolic dysfunction in the absence of coronary artery disease. Left ventricular reverse remodelling (LVRR) is the ability of a dilated ventricle to restore its normal size, shape and function. We sought to determine the frequency, clinical predictors and prognostic implications of LVRR, in a cohort of heart failure (HF) patients with NIDCM. Methods: We conducted a multicentre observational, retrospective cohort study of patients with NIDCM, with prospective serial echocardiography evaluations. LVRR was defined as an increase of ≥15% in left ventricular ejection fraction (LVEF) or as a LVEF increase ≥ 10% plus reduction of LV end-systolic diameter index ≥ 20%. We used multivariable logistic regression analyses to identify the baseline clinical predictors of LVRR and evaluate the prognostic impact of LVRR. Results: LVRR was achieved in 42.5% of 527 patients with NIDCM ...

Cell & Bioscience, 2021

Background Iron deficiency (ID) is common in patients with heart failure (HF) and is associated w... more Background Iron deficiency (ID) is common in patients with heart failure (HF) and is associated with poor outcomes, yet its role in the pathophysiology of HF is not well-defined. We sought to determine the consequences of HF neurohormonal activation in iron homeostasis and mitochondrial function in cardiac cells. Methods HF was induced in C57BL/6 mice by using isoproterenol osmotic pumps and embryonic rat heart-derived H9c2 cells were subsequently challenged with Angiotensin II and/or Norepinephrine. The expression of several genes and proteins related to intracellular iron metabolism were assessed by Real time-PCR and immunoblotting, respectively. The intracellular iron levels were also determined. Mitochondrial function was analyzed by studying the mitochondrial membrane potential, the accumulation of radical oxygen species (ROS) and the adenosine triphosphate (ATP) production. Results Hearts from isoproterenol-stimulated mice showed a decreased in both mRNA and protein levels of ...

The Journal of Heart and Lung Transplantation, 2021

Journal of Clinical Medicine, 2021

Background: Iron deficiency is a common disorder in patients with heart failure and is related wi... more Background: Iron deficiency is a common disorder in patients with heart failure and is related with adverse outcomes and poor quality of life. Previous experimental studies have shown biological connections between iron homeostasis, mitochondrial metabolism, and myocardial function. However, the mechanisms involved in this crosstalk are yet to be unfolded. Methods: The present research attempts to investigate the intrinsic biological mechanisms between heart failure and iron deficiency and to identify potential prognostic biomarkers by determining the gene expression pattern in the blood of heart failure patients, using whole transcriptome and targeted TaqMan® low-density array analyses. Results: We performed a stepwise cross-sectional longitudinal study in a cohort of chronic heart failure patients with and without systemic iron deficiency. First, the full transcriptome was performed in a nested case-control exploratory cohort of 7 paired patients and underscored 1128 differentiall...

Revista Española de Cardiología (English Edition), 2021

European Journal of Internal Medicine, 2020

BACKGROUND Sympathetic activity (SA) is increased in patients with heart failure and reduced ejec... more BACKGROUND Sympathetic activity (SA) is increased in patients with heart failure and reduced ejection fraction (HFrEF) and is associated with poor outcomes. However, its clinical implications are less understood in HF with mid-range (HFmrEF) and preserved ejection fraction (HFpEF). We aimed to study SA across left ventricle ejection fraction (LVEF) groups and its association with clinical outcomes. METHODS AND RESULTS SA estimated by norepinephrine (NE) levels was determined in 742 consecutive outpatients with chronic HF: 348 (47%) with HFrEF, 116 (16%) HFmrEF, and 278 (37%) HFpEF. After a mean follow-up of 15 months, 17% died. Adjusted analyses showed that patients with HFpEF and HFmrEF had lower estimated marginal means of NE levels compared to HFrEF (278 and 116 pg/mL, respectively, vs. 348 pg/mL; p-value=0.005). Adjusted Cox regression analyses showed that high norepinephrine levels independently predicted all-cause mortality (ACM) in all 3 groups. The strongest associations between high NE levels and cardiovascular mortality (CVM) were observed in HFmrEF (HR: 4.7 [1.33-16.68]), while the weakest association was in HFpEF (HR: 2.62 [1.08-6.35]). CONCLUSIONS Adjusted analyses showed that HFpEF and HFmrEF were associated with lower SA compared to HFrEF. Nevertheless, increasing NE levels were independently associated with ACM and CVM in all three LVEF groups. The strongest association between high NE levels and CVM was present in HFmrEF patients, while the weakest was seen in HFpEF. These findings could explain why the response to neurohormonal therapies in patients with HFmrEF is similar to that of patients with HFrEF rather than with HFpEF.

American Journal of Transplantation, 2021

Journal of Clinical Medicine, 2020

The effects of iron deficiency (ID) have been widely studied in heart failure (HF) with reduced e... more The effects of iron deficiency (ID) have been widely studied in heart failure (HF) with reduced ejection fraction. On the other hand, studies in HF with preserved ejection fraction (HFpEF) are few and have included small numbers of participants. The aim of this study was to assess the role that ID plays in functional capacity and quality of life (QoL) in HFpEF while comparing several iron-related biomarkers to be used as potential predictors. ID was defined as ferritin <100 ng/mL or transferrin saturation <20%. Submaximal exercise capacity, measured by the 6-min walking test (6MWT), and QoL, assessed by the Minnesotta Living with Heart Failure Questionnaire (MLHFQ), were compared between iron deficient patients and patients with normal iron status. A total of 447 HFpEF patients were included in the present cross-sectional study, and ID prevalence was 73%. Patients with ID performed worse in the 6MWT compared to patients with normal iron status (ID 271 ± 94 m vs. non-ID 310 ± 1...

The Journal of Heart and Lung Transplantation, 2019

patient's warfarin dosage remained the same from discharge until month 12. The mean increase in w... more patient's warfarin dosage remained the same from discharge until month 12. The mean increase in warfarin dose was 8.8%, 21.0%, 25.1%, and 26.5% at months 1, 3, 6, and 12 respectively. The dose increases were statistically significantly different at months 6 (p=0.023) and 12 (p=0.049) versus the dose increase at month 1. The dose increase comparison between month 1 and 3 were not statistically different (p=0.076). The median warfarin dose at discharge was 4mg per day with an interquartile range of 2.57 mg to 6 mg per day. By month 12, the median daily dose was 4.3 mg per day with an interquartile range of 3.9 mg to 6.4 mg per day derived from weekly totals. Conclusion: MCS team members that manage warfarin dosing may expect gradual increases on average during the first year post discharge. This expectation may avert unwanted sub-therapeutic INRs in these MCS patients.

The Journal of Heart and Lung Transplantation, 2019

Purpose: Approximately 30% of patients undergoing heart transplantation (HTx) may have diabetes m... more Purpose: Approximately 30% of patients undergoing heart transplantation (HTx) may have diabetes mellitus type 2 (DM2). More importantly, DM2 may become more prevalent after HTx because of high corticosteroid use. Metformin-an oral anti-hypoglycemic drug for DM2-has also been demonstrated to have immunomodulatory effects. It has been reported that metformin may decrease acute and chronic rejection as well as the development of cardiac allograft vasculopathy (CAV). Therefore, we reviewed our HTx patients placed on metformin pre-HTx and post-HTx to assess potential outcomes and benefits. Methods: Between 2010 and 2017, we assessed 229 heart transplant patients with DM2. We divided these diabetic patients in those on metformin post-HTx (n=32) and those not on metformin (n=176). Metformin was continued for at least one-year post-transplant. Endpoints included 1-year survival, 1-year freedom from CAV (as defined by >30% stenosis via angiography), 1-year freedom from non-fatal major adverse cardiac events (NF-MACE: myocardial infarction, new congestive heart failure, percutaneous coronary intervention, implantable cardioverter defibrillator/pacemaker implant, stroke), and 1-year freedom from any-treated rejection (ATR), acute cellular rejection (ACR), and antibody-mediated rejection (AMR). Results: There was no significant difference in 1-year survival in DM2 patients on metformin and DM2 patients not on metformin. There was no significant difference in 1-year freedom from CAV, NF-MACE or rejection between the groups (see table). Conclusion: The use of metformin does not appear to demonstrate an immunomodulatory benefit. A larger cohort of patients are needed to confirm these findings. Endpoints DM2 on Metformin post-HTx (n=32) Control Group w/o Metformin Use (n=176) P-Value

European Heart Journal - Case Reports, 2018

Pulmonary artery aneurysms (PAAs) are rare and they are infrequently diagnosed due to the non-spe... more Pulmonary artery aneurysms (PAAs) are rare and they are infrequently diagnosed due to the non-specificity of their symptoms. However, their related complications, mainly described in patients with pulmonary hypertension (PH), are associated with significant morbidity and mortality.

Journal of cardiovascular electrophysiology, Jan 4, 2017

Risk stratification for ventricular arrhythmias in patients with ischemic cardiomyopathy needs to... more Risk stratification for ventricular arrhythmias in patients with ischemic cardiomyopathy needs to be improved. Coronary chronic total occlusions in an infarct-related artery (IRA-CTOs) have been associated with an increased arrhythmic risk. This study aimed to evaluate the association between IRA-CTOs and appropriate implantable cardioverter-defibrillator (ICD) therapies. Observational cohort study that included 342 patients with ischemic cardiomyopathy, an ICD implanted for primary or secondary prevention and a coronary angiography performed shortly before ICD implantation. The ICD was implanted for primary prevention in 163 patients (48%). IRA-CTO was found in 161 patients (47%). During a median follow-up of 33 months, 41% of patients experienced at least one appropriate ICD therapy. Patients with IRA-CTO had higher proportions of appropriate ICD therapies (57% vs 26%, p<0.001) and appropriate ICD shocks (40% vs 17%, p<0.001). At multivariate Cox regression, IRA-CTO was the ...

Revista Española de Cardiología (English Edition), 2020

Kidney International

Long-term adaptive immune memory has been reported among immunocompetent individuals up to eight ... more Long-term adaptive immune memory has been reported among immunocompetent individuals up to eight months following SARS-CoV-2 infection. However, limited data is available in convalescent patients with a solid organ transplant. To investigate this, we performed a thorough evaluation of adaptive immune memory at different compartments (serological, memory B cells and cytokine [IFN-γ, IL-2, IFN-γ/IL2 and IL-21] producing T cells) specific to SARS-CoV-2 by ELISA and FluoroSpot-based assays in 102 convalescent patients (53 with a solid organ transplants (38 kidney, 5 liver, 5 lung and 5 heart transplant) and 49 immunocompetent controls) with different clinical COVID-19 severity (severe, mild and asymptomatic) beyond six months after infection. While similar detectable memory responses at different immune compartments were detected between those with a solid organ transplant and immunocompetent individuals, these responses were predominantly driven by distinct COVID-19 clinical severities (97.6%, 80.5% and 42.1%, all significantly different, were seropositive; 84% vs 75% vs 35.7%, all significantly different, showed IgG-producing memory B cells and 82.5%, 86.9% and 31.6%, displayed IFN-γ producing T cells; in severe, mild and asymptomatic convalescent patients, respectively). Notably, patients with a solid organ transplant with longer time after transplantation did more likely show detectable long-lasting immune memory, regardless of COVID-19 severity. Thus, our study shows that patients with a solid organ transplant are capable of maintaining long-lasting peripheral immune memory after COVID-19 infection; mainly determined by the degree of infection severity.

Revista Española de Cardiología

Revista Española de Cardiología

Introduccio´n y objetivos: Se presentan las características clínicas y los resultados de los tras... more Introduccio´n y objetivos: Se presentan las características clínicas y los resultados de los trasplantes cardiacos realizados en Españ a con la actualizació n correspondiente a 2019. Me´todos: Se describen las características clínicas y los resultados de los trasplantes cardiacos realizados en 2019, así como las tendencias de estos en el periodo 2010-2018. Resultados: En 2019 se realizaron 300 trasplantes (8.794 desde 1984; 2.745 entre 2010 y 2019). Respecto a añ os previos, los cambios má s llamativos son el descenso hasta el 38% de los trasplantes realizados en có digo urgente, y la consolidació n en el cambio de asistencia circulatoria pretrasplante, con la prá ctica desaparició n del baló n de contrapulsació n (0,7%), la estabilizació n del uso del oxigenador extracorpó reo de membrana (9,6%) y el aumento de los dispositivos de asistencia ventricular (29%). La supervivencia en el trienio 2016-2018 es similar a la del trienio 2013-2015 (p = 0,34), y ambas mejores que la del trienio 2010-2012 (p = 0,002 y p = 0,01 respectivamente). Conclusiones: Se mantienen estables tanto la actividad del trasplante cardiaco en Españ a como los resultados en supervivencia en los ú ltimos 2 trienios. Hay una tendencia a realizar menos trasplantes urgentes, la mayoría con dispositivos de asistencia ventricular.

Revista Española de Cardiología

Journal of Cardiovascular Development and Disease, 2022

Aims: Non-ischaemic dilated cardiomyopathy (NIDCM) is characterized by left ventricular (LV) cham... more Aims: Non-ischaemic dilated cardiomyopathy (NIDCM) is characterized by left ventricular (LV) chamber enlargement and systolic dysfunction in the absence of coronary artery disease. Left ventricular reverse remodelling (LVRR) is the ability of a dilated ventricle to restore its normal size, shape and function. We sought to determine the frequency, clinical predictors and prognostic implications of LVRR, in a cohort of heart failure (HF) patients with NIDCM. Methods: We conducted a multicentre observational, retrospective cohort study of patients with NIDCM, with prospective serial echocardiography evaluations. LVRR was defined as an increase of ≥15% in left ventricular ejection fraction (LVEF) or as a LVEF increase ≥ 10% plus reduction of LV end-systolic diameter index ≥ 20%. We used multivariable logistic regression analyses to identify the baseline clinical predictors of LVRR and evaluate the prognostic impact of LVRR. Results: LVRR was achieved in 42.5% of 527 patients with NIDCM ...

Cell & Bioscience, 2021

Background Iron deficiency (ID) is common in patients with heart failure (HF) and is associated w... more Background Iron deficiency (ID) is common in patients with heart failure (HF) and is associated with poor outcomes, yet its role in the pathophysiology of HF is not well-defined. We sought to determine the consequences of HF neurohormonal activation in iron homeostasis and mitochondrial function in cardiac cells. Methods HF was induced in C57BL/6 mice by using isoproterenol osmotic pumps and embryonic rat heart-derived H9c2 cells were subsequently challenged with Angiotensin II and/or Norepinephrine. The expression of several genes and proteins related to intracellular iron metabolism were assessed by Real time-PCR and immunoblotting, respectively. The intracellular iron levels were also determined. Mitochondrial function was analyzed by studying the mitochondrial membrane potential, the accumulation of radical oxygen species (ROS) and the adenosine triphosphate (ATP) production. Results Hearts from isoproterenol-stimulated mice showed a decreased in both mRNA and protein levels of ...

The Journal of Heart and Lung Transplantation, 2021

Journal of Clinical Medicine, 2021

Background: Iron deficiency is a common disorder in patients with heart failure and is related wi... more Background: Iron deficiency is a common disorder in patients with heart failure and is related with adverse outcomes and poor quality of life. Previous experimental studies have shown biological connections between iron homeostasis, mitochondrial metabolism, and myocardial function. However, the mechanisms involved in this crosstalk are yet to be unfolded. Methods: The present research attempts to investigate the intrinsic biological mechanisms between heart failure and iron deficiency and to identify potential prognostic biomarkers by determining the gene expression pattern in the blood of heart failure patients, using whole transcriptome and targeted TaqMan® low-density array analyses. Results: We performed a stepwise cross-sectional longitudinal study in a cohort of chronic heart failure patients with and without systemic iron deficiency. First, the full transcriptome was performed in a nested case-control exploratory cohort of 7 paired patients and underscored 1128 differentiall...

Revista Española de Cardiología (English Edition), 2021

European Journal of Internal Medicine, 2020

BACKGROUND Sympathetic activity (SA) is increased in patients with heart failure and reduced ejec... more BACKGROUND Sympathetic activity (SA) is increased in patients with heart failure and reduced ejection fraction (HFrEF) and is associated with poor outcomes. However, its clinical implications are less understood in HF with mid-range (HFmrEF) and preserved ejection fraction (HFpEF). We aimed to study SA across left ventricle ejection fraction (LVEF) groups and its association with clinical outcomes. METHODS AND RESULTS SA estimated by norepinephrine (NE) levels was determined in 742 consecutive outpatients with chronic HF: 348 (47%) with HFrEF, 116 (16%) HFmrEF, and 278 (37%) HFpEF. After a mean follow-up of 15 months, 17% died. Adjusted analyses showed that patients with HFpEF and HFmrEF had lower estimated marginal means of NE levels compared to HFrEF (278 and 116 pg/mL, respectively, vs. 348 pg/mL; p-value=0.005). Adjusted Cox regression analyses showed that high norepinephrine levels independently predicted all-cause mortality (ACM) in all 3 groups. The strongest associations between high NE levels and cardiovascular mortality (CVM) were observed in HFmrEF (HR: 4.7 [1.33-16.68]), while the weakest association was in HFpEF (HR: 2.62 [1.08-6.35]). CONCLUSIONS Adjusted analyses showed that HFpEF and HFmrEF were associated with lower SA compared to HFrEF. Nevertheless, increasing NE levels were independently associated with ACM and CVM in all three LVEF groups. The strongest association between high NE levels and CVM was present in HFmrEF patients, while the weakest was seen in HFpEF. These findings could explain why the response to neurohormonal therapies in patients with HFmrEF is similar to that of patients with HFrEF rather than with HFpEF.

American Journal of Transplantation, 2021

Journal of Clinical Medicine, 2020

The effects of iron deficiency (ID) have been widely studied in heart failure (HF) with reduced e... more The effects of iron deficiency (ID) have been widely studied in heart failure (HF) with reduced ejection fraction. On the other hand, studies in HF with preserved ejection fraction (HFpEF) are few and have included small numbers of participants. The aim of this study was to assess the role that ID plays in functional capacity and quality of life (QoL) in HFpEF while comparing several iron-related biomarkers to be used as potential predictors. ID was defined as ferritin <100 ng/mL or transferrin saturation <20%. Submaximal exercise capacity, measured by the 6-min walking test (6MWT), and QoL, assessed by the Minnesotta Living with Heart Failure Questionnaire (MLHFQ), were compared between iron deficient patients and patients with normal iron status. A total of 447 HFpEF patients were included in the present cross-sectional study, and ID prevalence was 73%. Patients with ID performed worse in the 6MWT compared to patients with normal iron status (ID 271 ± 94 m vs. non-ID 310 ± 1...

The Journal of Heart and Lung Transplantation, 2019

patient's warfarin dosage remained the same from discharge until month 12. The mean increase in w... more patient's warfarin dosage remained the same from discharge until month 12. The mean increase in warfarin dose was 8.8%, 21.0%, 25.1%, and 26.5% at months 1, 3, 6, and 12 respectively. The dose increases were statistically significantly different at months 6 (p=0.023) and 12 (p=0.049) versus the dose increase at month 1. The dose increase comparison between month 1 and 3 were not statistically different (p=0.076). The median warfarin dose at discharge was 4mg per day with an interquartile range of 2.57 mg to 6 mg per day. By month 12, the median daily dose was 4.3 mg per day with an interquartile range of 3.9 mg to 6.4 mg per day derived from weekly totals. Conclusion: MCS team members that manage warfarin dosing may expect gradual increases on average during the first year post discharge. This expectation may avert unwanted sub-therapeutic INRs in these MCS patients.

The Journal of Heart and Lung Transplantation, 2019

Purpose: Approximately 30% of patients undergoing heart transplantation (HTx) may have diabetes m... more Purpose: Approximately 30% of patients undergoing heart transplantation (HTx) may have diabetes mellitus type 2 (DM2). More importantly, DM2 may become more prevalent after HTx because of high corticosteroid use. Metformin-an oral anti-hypoglycemic drug for DM2-has also been demonstrated to have immunomodulatory effects. It has been reported that metformin may decrease acute and chronic rejection as well as the development of cardiac allograft vasculopathy (CAV). Therefore, we reviewed our HTx patients placed on metformin pre-HTx and post-HTx to assess potential outcomes and benefits. Methods: Between 2010 and 2017, we assessed 229 heart transplant patients with DM2. We divided these diabetic patients in those on metformin post-HTx (n=32) and those not on metformin (n=176). Metformin was continued for at least one-year post-transplant. Endpoints included 1-year survival, 1-year freedom from CAV (as defined by >30% stenosis via angiography), 1-year freedom from non-fatal major adverse cardiac events (NF-MACE: myocardial infarction, new congestive heart failure, percutaneous coronary intervention, implantable cardioverter defibrillator/pacemaker implant, stroke), and 1-year freedom from any-treated rejection (ATR), acute cellular rejection (ACR), and antibody-mediated rejection (AMR). Results: There was no significant difference in 1-year survival in DM2 patients on metformin and DM2 patients not on metformin. There was no significant difference in 1-year freedom from CAV, NF-MACE or rejection between the groups (see table). Conclusion: The use of metformin does not appear to demonstrate an immunomodulatory benefit. A larger cohort of patients are needed to confirm these findings. Endpoints DM2 on Metformin post-HTx (n=32) Control Group w/o Metformin Use (n=176) P-Value

European Heart Journal - Case Reports, 2018

Pulmonary artery aneurysms (PAAs) are rare and they are infrequently diagnosed due to the non-spe... more Pulmonary artery aneurysms (PAAs) are rare and they are infrequently diagnosed due to the non-specificity of their symptoms. However, their related complications, mainly described in patients with pulmonary hypertension (PH), are associated with significant morbidity and mortality.

Journal of cardiovascular electrophysiology, Jan 4, 2017

Risk stratification for ventricular arrhythmias in patients with ischemic cardiomyopathy needs to... more Risk stratification for ventricular arrhythmias in patients with ischemic cardiomyopathy needs to be improved. Coronary chronic total occlusions in an infarct-related artery (IRA-CTOs) have been associated with an increased arrhythmic risk. This study aimed to evaluate the association between IRA-CTOs and appropriate implantable cardioverter-defibrillator (ICD) therapies. Observational cohort study that included 342 patients with ischemic cardiomyopathy, an ICD implanted for primary or secondary prevention and a coronary angiography performed shortly before ICD implantation. The ICD was implanted for primary prevention in 163 patients (48%). IRA-CTO was found in 161 patients (47%). During a median follow-up of 33 months, 41% of patients experienced at least one appropriate ICD therapy. Patients with IRA-CTO had higher proportions of appropriate ICD therapies (57% vs 26%, p<0.001) and appropriate ICD shocks (40% vs 17%, p<0.001). At multivariate Cox regression, IRA-CTO was the ...

Revista Española de Cardiología (English Edition), 2020

Kidney International

Long-term adaptive immune memory has been reported among immunocompetent individuals up to eight ... more Long-term adaptive immune memory has been reported among immunocompetent individuals up to eight months following SARS-CoV-2 infection. However, limited data is available in convalescent patients with a solid organ transplant. To investigate this, we performed a thorough evaluation of adaptive immune memory at different compartments (serological, memory B cells and cytokine [IFN-γ, IL-2, IFN-γ/IL2 and IL-21] producing T cells) specific to SARS-CoV-2 by ELISA and FluoroSpot-based assays in 102 convalescent patients (53 with a solid organ transplants (38 kidney, 5 liver, 5 lung and 5 heart transplant) and 49 immunocompetent controls) with different clinical COVID-19 severity (severe, mild and asymptomatic) beyond six months after infection. While similar detectable memory responses at different immune compartments were detected between those with a solid organ transplant and immunocompetent individuals, these responses were predominantly driven by distinct COVID-19 clinical severities (97.6%, 80.5% and 42.1%, all significantly different, were seropositive; 84% vs 75% vs 35.7%, all significantly different, showed IgG-producing memory B cells and 82.5%, 86.9% and 31.6%, displayed IFN-γ producing T cells; in severe, mild and asymptomatic convalescent patients, respectively). Notably, patients with a solid organ transplant with longer time after transplantation did more likely show detectable long-lasting immune memory, regardless of COVID-19 severity. Thus, our study shows that patients with a solid organ transplant are capable of maintaining long-lasting peripheral immune memory after COVID-19 infection; mainly determined by the degree of infection severity.

Revista Española de Cardiología

Revista Española de Cardiología

Introduccio´n y objetivos: Se presentan las características clínicas y los resultados de los tras... more Introduccio´n y objetivos: Se presentan las características clínicas y los resultados de los trasplantes cardiacos realizados en Españ a con la actualizació n correspondiente a 2019. Me´todos: Se describen las características clínicas y los resultados de los trasplantes cardiacos realizados en 2019, así como las tendencias de estos en el periodo 2010-2018. Resultados: En 2019 se realizaron 300 trasplantes (8.794 desde 1984; 2.745 entre 2010 y 2019). Respecto a añ os previos, los cambios má s llamativos son el descenso hasta el 38% de los trasplantes realizados en có digo urgente, y la consolidació n en el cambio de asistencia circulatoria pretrasplante, con la prá ctica desaparició n del baló n de contrapulsació n (0,7%), la estabilizació n del uso del oxigenador extracorpó reo de membrana (9,6%) y el aumento de los dispositivos de asistencia ventricular (29%). La supervivencia en el trienio 2016-2018 es similar a la del trienio 2013-2015 (p = 0,34), y ambas mejores que la del trienio 2010-2012 (p = 0,002 y p = 0,01 respectivamente). Conclusiones: Se mantienen estables tanto la actividad del trasplante cardiaco en Españ a como los resultados en supervivencia en los ú ltimos 2 trienios. Hay una tendencia a realizar menos trasplantes urgentes, la mayoría con dispositivos de asistencia ventricular.