Mar Domingo - Academia.edu (original) (raw)

Papers by Mar Domingo

BMC Neurology, Oct 2, 2013

Background: Silent brain infarcts are detected by neuroimaging in up to 20% of asymptomatic patie... more Background: Silent brain infarcts are detected by neuroimaging in up to 20% of asymptomatic patients based on population studies. They are five times more frequent than stroke in general population, and increase significantly both with advancing age and hypertension. Moreover, they are independently associated with the risk of future stroke and cognitive decline. Despite these numbers and the clinical consequences of silent brain infarcts, their prevalence in Mediterranean populations is not well known and their role as predictors of future cerebrovascular and cardiovascular events in hypertensive remains to be determined. ISSYS (Investigating Silent Strokes in Hypertensives: a magnetic resonance imaging study) is an observational crosssectional and longitudinal study aimed to: 1-determine the prevalence of silent cerebrovascular infarcts in a large cohort of 1000 hypertensives and to study their associated factors and 2-to study their relationship with the risk of future stroke and cognitive decline. Methods/Design: Cohort study in a randomly selected sample of 1000 participants, hypertensive aged 50 to 70 years old, with no history of previous stroke or dementia. On baseline all participants will undergo a brain MRI to determine the presence of brain infarcts and other cerebrovascular lesions (brain microbleeds, white matter changes and enlarged perivascular spaces) and will be also tested to determine other than brain organ damage (heart-left ventricular hypertrophy, kidney-urine albumin to creatinine ratio, vessels-pulse wave velocity, ankle brachial index), in order to establish the contribution of other subclinical conditions to the risk of further vascular events. Several sub-studies assessing the role of 24 hour ambulatory BP monitoring and plasma or genetic biomarkers will be performed. Follow-up will last for at least 3 years, to assess the rate of further stroke/transient ischemic attack, other cardiovascular events and cognitive decline, and their predictors.

European Heart Journal

Background Alcoholic Cardiomyopathy (ACM) remains a prevalent form of toxic-induced heart damage.... more Background Alcoholic Cardiomyopathy (ACM) remains a prevalent form of toxic-induced heart damage. Whether ACM prognosis depends on the persistence of alcohol consumption is a matter of debate. Purpose We sought to determine predictors of adverse events during long-term follow-up and left ventricular ejection fraction (LVEF) changes between abstainers and non-abstainers. Methods Consecutive patients admitted to a HF clinic from 2001 to 2020 with ACM were included. The primary endpoint was the composite of all-cause death or HF hospitalization. HF hospitalization was analyzed as a secondary outcome. Changes in LVEF at 1- and 3-years follow-up according to discontinuation of alcohol consumption was also analyzed. Multivariable Cox regression analyses were performed using the competing risk strategy for the secondary endpoint. Results A total of 122 patients were included with a mean age of 57.8±10.0 years and 95.1% (n=116) of males. The mean LVEF was 27.5% ± 10.6 and 11.5% (n=14) exhib...

ESC Heart Failure

AimsPrior studies have not fully characterized the haemodynamic effects of the angiotensin recept... more AimsPrior studies have not fully characterized the haemodynamic effects of the angiotensin receptor‐neprilysin inhibitor (ARNI) sacubitril/valsartan in heart failure with preserved ejection fraction and pulmonary hypertension (HFpEF–PH). The aim of the Treatment of PH With Angiotensin II Receptor Blocker and Neprilysin Inhibitor in HFpEF Patients With CardioMEMS Device (ARNIMEMS‐HFpEF) study is to assess pulmonary artery pressure (PAP) dynamics by means of implanted PAP monitors in patients with HFpEF–PH treated with sacubitril/valsartan.Methods and resultsThis single‐arm, investigator‐initiated, interventional study included 14 consecutive ambulatory symptomatic HFpEF–PH patients who underwent CardioMEMS implantation prior to enrolment [mean ejection fraction 60.4 ± 7.2%, baseline mean PAP (mPAP) 33.9 ± 7.6 mmHg]. Daily PAP values were examined during three periods: a 6 week period after CardioMEMS implantation and before sacubitril/valsartan treatment (pre‐ARNI), a 6 week period w...

Nutrients

Background: The Global Leadership Initiative on Malnutrition (GLIM) criteria were recently propos... more Background: The Global Leadership Initiative on Malnutrition (GLIM) criteria were recently proposed to build a global consensus on the diagnostic criteria for malnutrition. This study aimed to evaluate the GLIM criteria for its prognostic significance in outpatients with heart failure (HF), and to compare them to a previous validated method, such as the Mini Nutritional Assessment (MNA). Methods: This was a post hoc observational analysis of a prospectively recruited cohort, which included 151 subjects that attended an outpatient HF clinic. At baseline, all patients completed the nutritional screening MNA short form and the nutritional assessment MNA. In a post hoc analysis, we evaluated the GLIM criteria at baseline. The outcomes were based on data from a five-year follow-up. The primary endpoint was all-cause mortality. Secondary endpoints were cardiovascular (CV) mortality and recurrent HF-related hospitalizations. We also investigated whether the GLIM criteria had better prognos...

Scientific Reports, 2021

Evidence regarding any association of HDL-particle (HDL-P) derangements and HDL-cholesterol conte... more Evidence regarding any association of HDL-particle (HDL-P) derangements and HDL-cholesterol content with cardiovascular (CV) death in chronic heart failure (HF) is lacking. To investigate the prognostic value of HDL-P size (HDL-Sz) and the number of cholesterol molecules per HDL-P for CV death in HF patients. Outpatient chronic HF patients were enrolled. Baseline HDL-P number, subfractions and HDL-Sz were measured using 1H-NMR spectroscopy. The HDL-C/P ratio was calculated as HDL-cholesterol over HDL-P. Endpoint was CV death, with non-CV death as the competing event. 422 patients were included and followed-up during a median of 4.1 (0–8) years. CV death occurred in 120 (30.5%) patients. Mean HDL-Sz was higher in CV dead as compared with survivors (8.39 nm vs. 8.31 nm, p < 0.001). This change in size was due to a reduction in the percentage of small HDL-P (54.6% vs. 60% for CV-death vs. alive; p < 0.001). HDL-C/P ratio was higher in the CV-death group (51.0 vs. 48.3, p < 0.0...

European Heart Journal, 2021

Background N-terminal pro-brain natriuretic peptide (NT-proBNP) predicts mortality and the develo... more Background N-terminal pro-brain natriuretic peptide (NT-proBNP) predicts mortality and the development of heart failure (HF) in hypertrophic cardiomyopathy (HCM), however, evidence regarding soluble interleukin-1 receptor-like 1 (ST2) in this population is lacking. Purpose To assess the ST2 and NT-proBNP significance for risk stratification of patients with HCM during long-term follow-up. Methods We prospectively enrolled a cohort of consecutive patients with HCM admitted to an ambulatory HF Unit in a Tertiary University Hospital. All patients had clinical and echocardiographic evaluation and measurement of NT-proBNP and ST2 at inclusion. The primary endpoint was the composite of all-cause death or HF-related hospitalization. Results 103 patients were enrolled, 68% (n=70) males with a median (IQR) age of 60 (50–71) years. The median (IQR) of ST2 was 31.5 (IQR: 24.5 – 40.7) pg/mL. During a median follow-up of 2.5 years, 17 patients had the primary endpoint. Both, NT-proBNP and ST2 (b...

Revista Española de Cardiología (English Edition), 2020

Revista Española de Cardiología, 2020

Resumen Introduccion y objetivos La utilidad de la ecografia pulmonar (EP) en la insuficiencia ca... more Resumen Introduccion y objetivos La utilidad de la ecografia pulmonar (EP) en la insuficiencia cardiaca (IC) aguda esta bien definida, pero no asi en la IC cronica. Este estudio investigo el valor pronostico de la EP en pacientes estables con IC cronica. Metodos Se incluyo a pacientes ambulatorios consecutivos con visita programada en una unidad de IC. La EP se realizo in situ, con los datos clinicos enmascarados, y evaluo 8 areas toracicas. La suma de lineas B en todas las areas pulmonares y los cuartiles de dicha adicion se utilizaron para los analisis de regresion lineal y de Cox. Los objetivos principales fueron el compuesto de muerte por cualquier causa u hospitalizacion por IC y mortalidad por cualquier causa. Resultados Se incluyo a 577 individuos (edad, 69 ± 12 anos; el 72% varones). La media de lineas B fue de 5 ± 6. Durante un seguimiento de 31 ± 7 meses, en 157 pacientes se produjo el resultado compuesto y 111 fallecieron. Tener ≥ 8 lineas B (Q4) doblo el riesgo de padecer el evento compuesto (p Conclusiones La EP identifico a pacientes con IC cronica estable y alto riesgo de muerte u hospitalizacion por IC.

European Heart Journal, 2018

Chronic heart failure-pathophysiology and mechanisms 1189 for indexed LV mass, indexed LA volume,... more Chronic heart failure-pathophysiology and mechanisms 1189 for indexed LV mass, indexed LA volume, mean E/e' and systolic blood pressure (B=-0.87 and B=0.78, P<0.001). Conclusions: HFpEF is characterized by impaired LA reservoir and pump function and increased stiffness which contribute to exercise mediated rises in PCWP. These markers may be of diagnostic potential and may be useful measures in studies of novel interventions. P5656 Heart failure with preserved ejection fraction (HFpEF) infrequently evolves towards a HFpEF-declined phenotype

European Heart Journal, 2018

Risk of sudden death in hypertrophic cardiomyopathy / Advanced nursing roles within cardiology 55... more Risk of sudden death in hypertrophic cardiomyopathy / Advanced nursing roles within cardiology 55 The International Classification of Diseases-Ninth Revision (ICD-9) codes were utilized to identify patients with diagnosis of HCM as well as those who underwent ICD implantation. Demographics, annual implantation rates, in-hospital mortality, complications and length of stay were analyzed. Results: From 2008 to 2014, an estimated total of 171,305 patients with diagnosis of HCM were admitted to the hospitals in U.S. Out of them, 5,805 patients underwent ICD implantation. About 38% of patients undergoing ICD implantation were electively admitted; and about 47.3% had a prior ventricular tachycardia, ventricular fibrillation or cardiac arrest. Overall, in-patient mortality was 0.03% while 11.1% patients had at least one complication. Most frequent complications were hemorrhagic (n=285, 4.9%), followed by cardiac (n=208, 3.6%) and pericardial complications (n=121, 2%). The mean length of stay was 5.3 days. The site of ICD implantations was more likely to be urban teaching hospitals (80%), with higher bed-size (78%) and located in southern US (33%). During our study period, there was no significant trend in in-hospital mortality and overall complications. However, rate of pericardial complications increased from 0.016 to 0.028 (p=0.001). Increased length of stay was a significant predictor of occurrence of any complication (OR: 1.173; 95% CI: 1.154-1.191). Interestingly, about 8.5% with all HCM patients during our study period had a prior ventricular tachycardia, ventricular fibrillation or cardiac arrest. However, only 17.6% of those patients received ICD implantation. Conclusion: From 2008-2014, about 3.4% patients with HCM underwent ICD implantation. About half of them did not have any reported prior ventricular tachycardia, ventricular fibrillation of cardiac arrest, suggestive of primary prevention. In-hospital mortality and complications through our study period did not show any significant trend. 403 An international validation study of the 2014 european society of cardiology sudden cardiac death risk prediction model in childhood hypertrophic cardiomyopathy

European Heart Journal, 2018

Patient and family journeys through cardiac illness / HDL cholesterol-A moving target 3 were foun... more Patient and family journeys through cardiac illness / HDL cholesterol-A moving target 3 were found comparing male and females or between adolescents with mild, moderate or severe CHD, However, 17y and 18y had a higher IP score (p=0.006), than younger participants (14y=25.00; 15y=25.61; 16y=31-02; 17y=26.87; and 18y=43.83). In univariate linear regression analyses demographic characteristics, empowerment, transition readiness, patient reported health and QOL were significant at p<0.1. Multivariate analyses showed that a higher level of IP score was only significantly associated with a lower QOL, experiencing more symptoms and higher treatment anxiety (Table 1). Multivariable linear regression Correlates with p≤0.05 B (SE) β Quality of life-0.16 (0.05)-0.25 Heart problems-0.14 (0.06)-0.20 Treatment anxiety-0.15 (0.04)-0.30 Conclusion: A more threatening view of their CHD was associated with experiencing symptoms, treatment anxiety and lower QOL. By intervening on treatment anxiety and increase awareness about symptoms this might lead to a less threating view of their disease, which may have implications on QoL. However, further longitudinal research is needed.

European Heart Journal, 2018

Background: Systemic light chain (AL) amyloidosis is considered a rare disease, but knowledge of ... more Background: Systemic light chain (AL) amyloidosis is considered a rare disease, but knowledge of its exact incidence and prevalence is based on old data involving limited populations. Purpose: To determine the incidence and prevalence of AL amyloidosis in the general population. Patients and methods: The national reference center for AL amyloidosis is located in the University Hospital of Limoges, in Limoges (France), the administrative center of the Limousin region (738,110 inhabitants in 2014). A comprehensive and exhaustive database of AL amyloidosis patients diagnosed in this region has been computerized since January 2007. All patients living in the Limousin region and with a first diagnosis of systemic AL amyloidosis between January 1, 2012, and December 31, 2016, were retrospectively included to determine the disease incidence. All departments and laboratories of pathology were contacted in the region, and any possible missing cases diagnosed during the same period were collected. Prevalence was determined as all living patients with AL amyloidosis during 2016 regardless of the diagnosis date. Cardiac involvement was defined according to current definition (ie, mean wall thickness >12 mm in the absence of other causes of left ventricular hypertrophy). Renal involvement was defined as proteinuria >0.5 g/L (predominantly albumin) in the absence of other etiology. Results: Over the 5-year period, 46 new patients in the Limousin region had a confirmed diagnosis of AL amyloidosis (70% men; median age, 72.5 years), corresponding to a crude yearly incidence of 12.5 (95% CI, 5.6-19.4) cases per million inhabitants. The calculated prevalence of AL amyloidosis was 58 (95% CI, 43-73) cases per million inhabitants. Cardiac and renal involvement was found in 70% and 72% of cases, respectively. Mayo Clinic stages I, II, IIIA (NT-proBNP ≤8500 ng/L), and IIIB (NT-proBNP >8500 ng/L) based on cardiac biomarkers were found in 21%, 29%, 29%, and 21% of patients respectively. The underlying disease was multiple myeloma in 19 patients (41%), including smoldering myeloma in 14 patients, MGUS (monoclonal gammopathy of undetermined significance) in 22 patients (48%), IgM in 2 patients, Waldenström disease in 1 patient, low-grade lymphoma in 3 patients, plasmocytoma in 1 patient, and unknown in 1 patient. In this 5 year-period, 16 patients (35%) died. Conclusion: This is the first report of contemporary incidence and prevalence of systemic AL amyloidosis in France. Incidence was slightly higher than the incidence (adjusted to sex and age) previously reported by Kyle & colleagues (Blood,

International Journal of Cardiology, 2016

Introduction: Since reported evidence is both scarce and controversial, the objective of this stu... more Introduction: Since reported evidence is both scarce and controversial, the objective of this study is to determine the risk factors involved in the prognosis of older patients with heart failure (HF) receiving home healthcare from primary care professionals. Methods: Retrospective cohort community study carried out in 52 primary healthcare centres in Barcelona (Spain). A follow-up was performed between January 2009 and December 2012 with 7461 HF patients aged >64 years. Information was obtained from

Revista Espanola De Cardiologia, Jul 1, 2012

Conclusiones: En una població n ambulatoria atendida en atenció n primaria, el mejor punto de cor... more Conclusiones: En una població n ambulatoria atendida en atenció n primaria, el mejor punto de corte de fracció n N-terminal del pé ptido natriuré tico tipo B para descartar insuficiencia cardiaca fue 280 pg/ml. La determinació n de fracció n N-terminal del pé ptido natriuré tico tipo B mejora los procesos diagnó sticos y podría ser coste-efectiva.

Revista Española de Cardiología

Frontiers in Cardiovascular Medicine

ObjectivesHeart failure (HF) management has significantly improved over the past two decades, lea... more ObjectivesHeart failure (HF) management has significantly improved over the past two decades, leading to better survival. This study aimed to assess changes in predicted mortality risk after 12 months of management in a multidisciplinary HF clinic.Materials and MethodsOut of 1,032 consecutive HF outpatients admitted from March-2012 to November-2018, 357 completed the 12-months follow-up and had N-terminal pro-B-type natriuretic peptide (NTproBNP), high sensitivity troponin T (hs-TnT), and interleukin-1 receptor-like-1 (known as ST2) measurements available both at baseline and follow-up. Three contemporary risk scores were used: MAGGIC-HF, Seattle HF Model (SHFM), and the Barcelona Bio-HF (BCN Bio-HF) calculator, which incorporates the three above mentioned biomarkers. The predicted risk of all-cause death at 1 and 3 years was calculated at baseline and re-evaluated after 12 months.ResultsA significant decline in predicted 1-and 3-year mortality risk was observed at 12 months: MAGGIC...

Additional file 8: Figure S4. Survival and event-free survival curves related to the presence of ... more Additional file 8: Figure S4. Survival and event-free survival curves related to the presence of diabetes mellitus and to etiology (ischemic vs. non-ischemic). Panel B: Event-free survival curves (composite end-point of all-cause death or HF hospitalizations). Diabetic patients from ischemic etiology (dark purple) showed the worse prognosis, while non-diabetic from non-ischemic etiology (blue) showed the best. Remarkably diabetic patients from non-ischemic etiology (soft orange) showed slightly worse prognosis than non-diabetic patients from ischemic etiology (green).

Journal of Circulating Biomarkers, 2020

Introduction: The association of pulmonary congestion assessed by lung ultrasound (LUS) and bioma... more Introduction: The association of pulmonary congestion assessed by lung ultrasound (LUS) and biomarkers—other than N-terminal pro-brain natriuretic peptide (NT-proBNP)—is uncertain. Methods: We investigated the relationship between total B-line count by LUS and several biomarkers in outpatients with suspicion of heart failure (HF). Primary care patients with suspected new-onset nonacute HF were evaluated both with a 12-scan LUS protocol (8 anterolateral areas plus 4 lower posterior thoracic areas) and 11 inflammatory and cardiovascular biomarkers. A cardiologist blinded to LUS and biomarkers except NT-proBNP confirmed HF diagnosis. After log-transformation of biomarkers’ concentrations, unadjusted and adjusted correlations were performed. Results: A total of 170 patients were included (age 76 ± 10 years, 67.6% women). HF diagnosis was confirmed in 38 (22.4%) patients. After adjustment by age, sex, body mass index, and renal function, total B-line sum significantly correlated with NT-...

BMC Neurology, Oct 2, 2013

Background: Silent brain infarcts are detected by neuroimaging in up to 20% of asymptomatic patie... more Background: Silent brain infarcts are detected by neuroimaging in up to 20% of asymptomatic patients based on population studies. They are five times more frequent than stroke in general population, and increase significantly both with advancing age and hypertension. Moreover, they are independently associated with the risk of future stroke and cognitive decline. Despite these numbers and the clinical consequences of silent brain infarcts, their prevalence in Mediterranean populations is not well known and their role as predictors of future cerebrovascular and cardiovascular events in hypertensive remains to be determined. ISSYS (Investigating Silent Strokes in Hypertensives: a magnetic resonance imaging study) is an observational crosssectional and longitudinal study aimed to: 1-determine the prevalence of silent cerebrovascular infarcts in a large cohort of 1000 hypertensives and to study their associated factors and 2-to study their relationship with the risk of future stroke and cognitive decline. Methods/Design: Cohort study in a randomly selected sample of 1000 participants, hypertensive aged 50 to 70 years old, with no history of previous stroke or dementia. On baseline all participants will undergo a brain MRI to determine the presence of brain infarcts and other cerebrovascular lesions (brain microbleeds, white matter changes and enlarged perivascular spaces) and will be also tested to determine other than brain organ damage (heart-left ventricular hypertrophy, kidney-urine albumin to creatinine ratio, vessels-pulse wave velocity, ankle brachial index), in order to establish the contribution of other subclinical conditions to the risk of further vascular events. Several sub-studies assessing the role of 24 hour ambulatory BP monitoring and plasma or genetic biomarkers will be performed. Follow-up will last for at least 3 years, to assess the rate of further stroke/transient ischemic attack, other cardiovascular events and cognitive decline, and their predictors.

European Heart Journal

Background Alcoholic Cardiomyopathy (ACM) remains a prevalent form of toxic-induced heart damage.... more Background Alcoholic Cardiomyopathy (ACM) remains a prevalent form of toxic-induced heart damage. Whether ACM prognosis depends on the persistence of alcohol consumption is a matter of debate. Purpose We sought to determine predictors of adverse events during long-term follow-up and left ventricular ejection fraction (LVEF) changes between abstainers and non-abstainers. Methods Consecutive patients admitted to a HF clinic from 2001 to 2020 with ACM were included. The primary endpoint was the composite of all-cause death or HF hospitalization. HF hospitalization was analyzed as a secondary outcome. Changes in LVEF at 1- and 3-years follow-up according to discontinuation of alcohol consumption was also analyzed. Multivariable Cox regression analyses were performed using the competing risk strategy for the secondary endpoint. Results A total of 122 patients were included with a mean age of 57.8±10.0 years and 95.1% (n=116) of males. The mean LVEF was 27.5% ± 10.6 and 11.5% (n=14) exhib...

ESC Heart Failure

AimsPrior studies have not fully characterized the haemodynamic effects of the angiotensin recept... more AimsPrior studies have not fully characterized the haemodynamic effects of the angiotensin receptor‐neprilysin inhibitor (ARNI) sacubitril/valsartan in heart failure with preserved ejection fraction and pulmonary hypertension (HFpEF–PH). The aim of the Treatment of PH With Angiotensin II Receptor Blocker and Neprilysin Inhibitor in HFpEF Patients With CardioMEMS Device (ARNIMEMS‐HFpEF) study is to assess pulmonary artery pressure (PAP) dynamics by means of implanted PAP monitors in patients with HFpEF–PH treated with sacubitril/valsartan.Methods and resultsThis single‐arm, investigator‐initiated, interventional study included 14 consecutive ambulatory symptomatic HFpEF–PH patients who underwent CardioMEMS implantation prior to enrolment [mean ejection fraction 60.4 ± 7.2%, baseline mean PAP (mPAP) 33.9 ± 7.6 mmHg]. Daily PAP values were examined during three periods: a 6 week period after CardioMEMS implantation and before sacubitril/valsartan treatment (pre‐ARNI), a 6 week period w...

Nutrients

Background: The Global Leadership Initiative on Malnutrition (GLIM) criteria were recently propos... more Background: The Global Leadership Initiative on Malnutrition (GLIM) criteria were recently proposed to build a global consensus on the diagnostic criteria for malnutrition. This study aimed to evaluate the GLIM criteria for its prognostic significance in outpatients with heart failure (HF), and to compare them to a previous validated method, such as the Mini Nutritional Assessment (MNA). Methods: This was a post hoc observational analysis of a prospectively recruited cohort, which included 151 subjects that attended an outpatient HF clinic. At baseline, all patients completed the nutritional screening MNA short form and the nutritional assessment MNA. In a post hoc analysis, we evaluated the GLIM criteria at baseline. The outcomes were based on data from a five-year follow-up. The primary endpoint was all-cause mortality. Secondary endpoints were cardiovascular (CV) mortality and recurrent HF-related hospitalizations. We also investigated whether the GLIM criteria had better prognos...

Scientific Reports, 2021

Evidence regarding any association of HDL-particle (HDL-P) derangements and HDL-cholesterol conte... more Evidence regarding any association of HDL-particle (HDL-P) derangements and HDL-cholesterol content with cardiovascular (CV) death in chronic heart failure (HF) is lacking. To investigate the prognostic value of HDL-P size (HDL-Sz) and the number of cholesterol molecules per HDL-P for CV death in HF patients. Outpatient chronic HF patients were enrolled. Baseline HDL-P number, subfractions and HDL-Sz were measured using 1H-NMR spectroscopy. The HDL-C/P ratio was calculated as HDL-cholesterol over HDL-P. Endpoint was CV death, with non-CV death as the competing event. 422 patients were included and followed-up during a median of 4.1 (0–8) years. CV death occurred in 120 (30.5%) patients. Mean HDL-Sz was higher in CV dead as compared with survivors (8.39 nm vs. 8.31 nm, p < 0.001). This change in size was due to a reduction in the percentage of small HDL-P (54.6% vs. 60% for CV-death vs. alive; p < 0.001). HDL-C/P ratio was higher in the CV-death group (51.0 vs. 48.3, p < 0.0...

European Heart Journal, 2021

Background N-terminal pro-brain natriuretic peptide (NT-proBNP) predicts mortality and the develo... more Background N-terminal pro-brain natriuretic peptide (NT-proBNP) predicts mortality and the development of heart failure (HF) in hypertrophic cardiomyopathy (HCM), however, evidence regarding soluble interleukin-1 receptor-like 1 (ST2) in this population is lacking. Purpose To assess the ST2 and NT-proBNP significance for risk stratification of patients with HCM during long-term follow-up. Methods We prospectively enrolled a cohort of consecutive patients with HCM admitted to an ambulatory HF Unit in a Tertiary University Hospital. All patients had clinical and echocardiographic evaluation and measurement of NT-proBNP and ST2 at inclusion. The primary endpoint was the composite of all-cause death or HF-related hospitalization. Results 103 patients were enrolled, 68% (n=70) males with a median (IQR) age of 60 (50–71) years. The median (IQR) of ST2 was 31.5 (IQR: 24.5 – 40.7) pg/mL. During a median follow-up of 2.5 years, 17 patients had the primary endpoint. Both, NT-proBNP and ST2 (b...

Revista Española de Cardiología (English Edition), 2020

Revista Española de Cardiología, 2020

Resumen Introduccion y objetivos La utilidad de la ecografia pulmonar (EP) en la insuficiencia ca... more Resumen Introduccion y objetivos La utilidad de la ecografia pulmonar (EP) en la insuficiencia cardiaca (IC) aguda esta bien definida, pero no asi en la IC cronica. Este estudio investigo el valor pronostico de la EP en pacientes estables con IC cronica. Metodos Se incluyo a pacientes ambulatorios consecutivos con visita programada en una unidad de IC. La EP se realizo in situ, con los datos clinicos enmascarados, y evaluo 8 areas toracicas. La suma de lineas B en todas las areas pulmonares y los cuartiles de dicha adicion se utilizaron para los analisis de regresion lineal y de Cox. Los objetivos principales fueron el compuesto de muerte por cualquier causa u hospitalizacion por IC y mortalidad por cualquier causa. Resultados Se incluyo a 577 individuos (edad, 69 ± 12 anos; el 72% varones). La media de lineas B fue de 5 ± 6. Durante un seguimiento de 31 ± 7 meses, en 157 pacientes se produjo el resultado compuesto y 111 fallecieron. Tener ≥ 8 lineas B (Q4) doblo el riesgo de padecer el evento compuesto (p Conclusiones La EP identifico a pacientes con IC cronica estable y alto riesgo de muerte u hospitalizacion por IC.

European Heart Journal, 2018

Chronic heart failure-pathophysiology and mechanisms 1189 for indexed LV mass, indexed LA volume,... more Chronic heart failure-pathophysiology and mechanisms 1189 for indexed LV mass, indexed LA volume, mean E/e' and systolic blood pressure (B=-0.87 and B=0.78, P<0.001). Conclusions: HFpEF is characterized by impaired LA reservoir and pump function and increased stiffness which contribute to exercise mediated rises in PCWP. These markers may be of diagnostic potential and may be useful measures in studies of novel interventions. P5656 Heart failure with preserved ejection fraction (HFpEF) infrequently evolves towards a HFpEF-declined phenotype

European Heart Journal, 2018

Risk of sudden death in hypertrophic cardiomyopathy / Advanced nursing roles within cardiology 55... more Risk of sudden death in hypertrophic cardiomyopathy / Advanced nursing roles within cardiology 55 The International Classification of Diseases-Ninth Revision (ICD-9) codes were utilized to identify patients with diagnosis of HCM as well as those who underwent ICD implantation. Demographics, annual implantation rates, in-hospital mortality, complications and length of stay were analyzed. Results: From 2008 to 2014, an estimated total of 171,305 patients with diagnosis of HCM were admitted to the hospitals in U.S. Out of them, 5,805 patients underwent ICD implantation. About 38% of patients undergoing ICD implantation were electively admitted; and about 47.3% had a prior ventricular tachycardia, ventricular fibrillation or cardiac arrest. Overall, in-patient mortality was 0.03% while 11.1% patients had at least one complication. Most frequent complications were hemorrhagic (n=285, 4.9%), followed by cardiac (n=208, 3.6%) and pericardial complications (n=121, 2%). The mean length of stay was 5.3 days. The site of ICD implantations was more likely to be urban teaching hospitals (80%), with higher bed-size (78%) and located in southern US (33%). During our study period, there was no significant trend in in-hospital mortality and overall complications. However, rate of pericardial complications increased from 0.016 to 0.028 (p=0.001). Increased length of stay was a significant predictor of occurrence of any complication (OR: 1.173; 95% CI: 1.154-1.191). Interestingly, about 8.5% with all HCM patients during our study period had a prior ventricular tachycardia, ventricular fibrillation or cardiac arrest. However, only 17.6% of those patients received ICD implantation. Conclusion: From 2008-2014, about 3.4% patients with HCM underwent ICD implantation. About half of them did not have any reported prior ventricular tachycardia, ventricular fibrillation of cardiac arrest, suggestive of primary prevention. In-hospital mortality and complications through our study period did not show any significant trend. 403 An international validation study of the 2014 european society of cardiology sudden cardiac death risk prediction model in childhood hypertrophic cardiomyopathy

European Heart Journal, 2018

Patient and family journeys through cardiac illness / HDL cholesterol-A moving target 3 were foun... more Patient and family journeys through cardiac illness / HDL cholesterol-A moving target 3 were found comparing male and females or between adolescents with mild, moderate or severe CHD, However, 17y and 18y had a higher IP score (p=0.006), than younger participants (14y=25.00; 15y=25.61; 16y=31-02; 17y=26.87; and 18y=43.83). In univariate linear regression analyses demographic characteristics, empowerment, transition readiness, patient reported health and QOL were significant at p<0.1. Multivariate analyses showed that a higher level of IP score was only significantly associated with a lower QOL, experiencing more symptoms and higher treatment anxiety (Table 1). Multivariable linear regression Correlates with p≤0.05 B (SE) β Quality of life-0.16 (0.05)-0.25 Heart problems-0.14 (0.06)-0.20 Treatment anxiety-0.15 (0.04)-0.30 Conclusion: A more threatening view of their CHD was associated with experiencing symptoms, treatment anxiety and lower QOL. By intervening on treatment anxiety and increase awareness about symptoms this might lead to a less threating view of their disease, which may have implications on QoL. However, further longitudinal research is needed.

European Heart Journal, 2018

Background: Systemic light chain (AL) amyloidosis is considered a rare disease, but knowledge of ... more Background: Systemic light chain (AL) amyloidosis is considered a rare disease, but knowledge of its exact incidence and prevalence is based on old data involving limited populations. Purpose: To determine the incidence and prevalence of AL amyloidosis in the general population. Patients and methods: The national reference center for AL amyloidosis is located in the University Hospital of Limoges, in Limoges (France), the administrative center of the Limousin region (738,110 inhabitants in 2014). A comprehensive and exhaustive database of AL amyloidosis patients diagnosed in this region has been computerized since January 2007. All patients living in the Limousin region and with a first diagnosis of systemic AL amyloidosis between January 1, 2012, and December 31, 2016, were retrospectively included to determine the disease incidence. All departments and laboratories of pathology were contacted in the region, and any possible missing cases diagnosed during the same period were collected. Prevalence was determined as all living patients with AL amyloidosis during 2016 regardless of the diagnosis date. Cardiac involvement was defined according to current definition (ie, mean wall thickness >12 mm in the absence of other causes of left ventricular hypertrophy). Renal involvement was defined as proteinuria >0.5 g/L (predominantly albumin) in the absence of other etiology. Results: Over the 5-year period, 46 new patients in the Limousin region had a confirmed diagnosis of AL amyloidosis (70% men; median age, 72.5 years), corresponding to a crude yearly incidence of 12.5 (95% CI, 5.6-19.4) cases per million inhabitants. The calculated prevalence of AL amyloidosis was 58 (95% CI, 43-73) cases per million inhabitants. Cardiac and renal involvement was found in 70% and 72% of cases, respectively. Mayo Clinic stages I, II, IIIA (NT-proBNP ≤8500 ng/L), and IIIB (NT-proBNP >8500 ng/L) based on cardiac biomarkers were found in 21%, 29%, 29%, and 21% of patients respectively. The underlying disease was multiple myeloma in 19 patients (41%), including smoldering myeloma in 14 patients, MGUS (monoclonal gammopathy of undetermined significance) in 22 patients (48%), IgM in 2 patients, Waldenström disease in 1 patient, low-grade lymphoma in 3 patients, plasmocytoma in 1 patient, and unknown in 1 patient. In this 5 year-period, 16 patients (35%) died. Conclusion: This is the first report of contemporary incidence and prevalence of systemic AL amyloidosis in France. Incidence was slightly higher than the incidence (adjusted to sex and age) previously reported by Kyle & colleagues (Blood,

International Journal of Cardiology, 2016

Introduction: Since reported evidence is both scarce and controversial, the objective of this stu... more Introduction: Since reported evidence is both scarce and controversial, the objective of this study is to determine the risk factors involved in the prognosis of older patients with heart failure (HF) receiving home healthcare from primary care professionals. Methods: Retrospective cohort community study carried out in 52 primary healthcare centres in Barcelona (Spain). A follow-up was performed between January 2009 and December 2012 with 7461 HF patients aged >64 years. Information was obtained from

Revista Espanola De Cardiologia, Jul 1, 2012

Conclusiones: En una població n ambulatoria atendida en atenció n primaria, el mejor punto de cor... more Conclusiones: En una població n ambulatoria atendida en atenció n primaria, el mejor punto de corte de fracció n N-terminal del pé ptido natriuré tico tipo B para descartar insuficiencia cardiaca fue 280 pg/ml. La determinació n de fracció n N-terminal del pé ptido natriuré tico tipo B mejora los procesos diagnó sticos y podría ser coste-efectiva.

Revista Española de Cardiología

Frontiers in Cardiovascular Medicine

ObjectivesHeart failure (HF) management has significantly improved over the past two decades, lea... more ObjectivesHeart failure (HF) management has significantly improved over the past two decades, leading to better survival. This study aimed to assess changes in predicted mortality risk after 12 months of management in a multidisciplinary HF clinic.Materials and MethodsOut of 1,032 consecutive HF outpatients admitted from March-2012 to November-2018, 357 completed the 12-months follow-up and had N-terminal pro-B-type natriuretic peptide (NTproBNP), high sensitivity troponin T (hs-TnT), and interleukin-1 receptor-like-1 (known as ST2) measurements available both at baseline and follow-up. Three contemporary risk scores were used: MAGGIC-HF, Seattle HF Model (SHFM), and the Barcelona Bio-HF (BCN Bio-HF) calculator, which incorporates the three above mentioned biomarkers. The predicted risk of all-cause death at 1 and 3 years was calculated at baseline and re-evaluated after 12 months.ResultsA significant decline in predicted 1-and 3-year mortality risk was observed at 12 months: MAGGIC...

Additional file 8: Figure S4. Survival and event-free survival curves related to the presence of ... more Additional file 8: Figure S4. Survival and event-free survival curves related to the presence of diabetes mellitus and to etiology (ischemic vs. non-ischemic). Panel B: Event-free survival curves (composite end-point of all-cause death or HF hospitalizations). Diabetic patients from ischemic etiology (dark purple) showed the worse prognosis, while non-diabetic from non-ischemic etiology (blue) showed the best. Remarkably diabetic patients from non-ischemic etiology (soft orange) showed slightly worse prognosis than non-diabetic patients from ischemic etiology (green).

Journal of Circulating Biomarkers, 2020

Introduction: The association of pulmonary congestion assessed by lung ultrasound (LUS) and bioma... more Introduction: The association of pulmonary congestion assessed by lung ultrasound (LUS) and biomarkers—other than N-terminal pro-brain natriuretic peptide (NT-proBNP)—is uncertain. Methods: We investigated the relationship between total B-line count by LUS and several biomarkers in outpatients with suspicion of heart failure (HF). Primary care patients with suspected new-onset nonacute HF were evaluated both with a 12-scan LUS protocol (8 anterolateral areas plus 4 lower posterior thoracic areas) and 11 inflammatory and cardiovascular biomarkers. A cardiologist blinded to LUS and biomarkers except NT-proBNP confirmed HF diagnosis. After log-transformation of biomarkers’ concentrations, unadjusted and adjusted correlations were performed. Results: A total of 170 patients were included (age 76 ± 10 years, 67.6% women). HF diagnosis was confirmed in 38 (22.4%) patients. After adjustment by age, sex, body mass index, and renal function, total B-line sum significantly correlated with NT-...