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Papers by RAFAEL SANCHEZ
Revista Española de Cardiologia, 2003
Functional Assessment of Patients With Hypertrophic Cardiomyopathy by Maximal Oxygen Consumption ... more Functional Assessment of Patients With Hypertrophic Cardiomyopathy by Maximal Oxygen Consumption Introduction and objectives. Differences between anatomical severity and clinical manifestations are frequent in patients with hypertrophic cardiomyopathy. Our objective was to assess functional capacity in a consecutive group of patients with hypertrophic cardiomyopathy measuring exercise aerobic parameters, as well as clinical and echocardiographic variables. Patients and method. We studied 98 consecutive patients with hypertrophic cardiomyopathy. All patients underwent both echocardiographic and cardiopulmonary exercise testing. The control group consisted of 22 untrained persons. We studied exercise capacity by analyzing maximal oxygen consumption and aerobic functional capacity, among other variables. Results. Patients with hypertrophic cardiomyopathy attained significantly lower maximal oxygen consumption values than controls (24.1 ± 5.9 vs 36.4 ± 5.9 ml/kg/min; p = 0.0001). Maximal aerobic capacity was significantly different among patients with NYHA functional capacity class I, II or III (78.9 ± 13.5%; 71.9 ± 14.7%; 63.9 ± 15.7%; p = 0.009). However, considerable overlap was found between groups in maximal aerobic capacity. Functional impairment was greater in patients with left ventricular thickness > 20 mm, ejection fraction < 50%, left atrial dimension > 45 mm and pseudonormal or restrictive transmitral flow pattern. Conclusions. Patients with hypertrophic cardiomyopathy show significant functional impairment, which is difficult to detect from their clinical manifestations. Optimal assessment requires cardiopulmonary exercise testing.
Revista Espanola De Medicina Nuclear, 2011
Study objectives: Respiratory complications are frequent after lung transplantation (LTx), and ma... more Study objectives: Respiratory complications are frequent after lung transplantation (LTx), and many of these complications have the potential to cause hemoptysis. However, surprisingly, only a few isolated cases of hemoptysis have been reported in LTx recipients. Here, we describe a series of patients who underwent LTx at our center who developed hemoptysis during their postoperative course. Setting: A tertiary care university hospital. Results: Of 197 LTx recipients, hemoptysis developed in 15 over a 16-year period. The pulmonary circulation as well as the systemic circulation were involved in the mechanism of hemoptysis. Six patients had moderate or minimal hemoptysis, while nine patients had life-threatening hemoptysis, which occurred during the first year after LTx in all cases. Active necrotizing ischemic airway injury was present in five of the nine patients with life-threatening hemoptysis. Eight of those nine patients died as a result of hemoptysis. Overall, hemoptysis was the cause of death in 4.5% of patients who underwent LTx at our institution. Conclusion: In our series of transplant patients, hemoptysis was not rare and was associated with a high rate of mortality.
Revista Española de Cardiologia, 2003
Functional Assessment of Patients With Hypertrophic Cardiomyopathy by Maximal Oxygen Consumption ... more Functional Assessment of Patients With Hypertrophic Cardiomyopathy by Maximal Oxygen Consumption Introduction and objectives. Differences between anatomical severity and clinical manifestations are frequent in patients with hypertrophic cardiomyopathy. Our objective was to assess functional capacity in a consecutive group of patients with hypertrophic cardiomyopathy measuring exercise aerobic parameters, as well as clinical and echocardiographic variables. Patients and method. We studied 98 consecutive patients with hypertrophic cardiomyopathy. All patients underwent both echocardiographic and cardiopulmonary exercise testing. The control group consisted of 22 untrained persons. We studied exercise capacity by analyzing maximal oxygen consumption and aerobic functional capacity, among other variables. Results. Patients with hypertrophic cardiomyopathy attained significantly lower maximal oxygen consumption values than controls (24.1 ± 5.9 vs 36.4 ± 5.9 ml/kg/min; p = 0.0001). Maximal aerobic capacity was significantly different among patients with NYHA functional capacity class I, II or III (78.9 ± 13.5%; 71.9 ± 14.7%; 63.9 ± 15.7%; p = 0.009). However, considerable overlap was found between groups in maximal aerobic capacity. Functional impairment was greater in patients with left ventricular thickness > 20 mm, ejection fraction < 50%, left atrial dimension > 45 mm and pseudonormal or restrictive transmitral flow pattern. Conclusions. Patients with hypertrophic cardiomyopathy show significant functional impairment, which is difficult to detect from their clinical manifestations. Optimal assessment requires cardiopulmonary exercise testing.
Revista Espanola De Medicina Nuclear, 2011
Study objectives: Respiratory complications are frequent after lung transplantation (LTx), and ma... more Study objectives: Respiratory complications are frequent after lung transplantation (LTx), and many of these complications have the potential to cause hemoptysis. However, surprisingly, only a few isolated cases of hemoptysis have been reported in LTx recipients. Here, we describe a series of patients who underwent LTx at our center who developed hemoptysis during their postoperative course. Setting: A tertiary care university hospital. Results: Of 197 LTx recipients, hemoptysis developed in 15 over a 16-year period. The pulmonary circulation as well as the systemic circulation were involved in the mechanism of hemoptysis. Six patients had moderate or minimal hemoptysis, while nine patients had life-threatening hemoptysis, which occurred during the first year after LTx in all cases. Active necrotizing ischemic airway injury was present in five of the nine patients with life-threatening hemoptysis. Eight of those nine patients died as a result of hemoptysis. Overall, hemoptysis was the cause of death in 4.5% of patients who underwent LTx at our institution. Conclusion: In our series of transplant patients, hemoptysis was not rare and was associated with a high rate of mortality.