Ricardo Vivancos Delgado - Academia.edu (original) (raw)
Papers by Ricardo Vivancos Delgado
European Heart Journal. Acute Cardiovascular Care, 2021
Funding Acknowledgements Type of funding sources: None. Background It is well defined the prognos... more Funding Acknowledgements Type of funding sources: None. Background It is well defined the prognosis value of the abnormalities in the circadian variation in hypertensive patients. In the phisiopathology of heart failure, neurohumoral mechanism plays an important role. Nevertheless, the circadian variation in nonhypertensive heart failure patients has not been well evaluated. Purpose Our aim was to evaluate 24-h blood pressure patterns and the prevalence of nocturnal hypertension in patients admitted with acute heart failure. Methods We studied 122 patients with a clinical diagnosis of AHF. We permormed a 24-h ambulatory blood pressure monitoring as well as an echocardiogram and anaytical test. Results 122 patients. Mean age: 63 ± 10. Males: 75%. Mean BMI: 30 ± 6 Kg/m2. Associated risk factors: 56,6% hypertension, 40 % dyslipidemia, 34,7% Diabetes, 29,3% obesity, 22,9% smoking. The etiology of HF: ischemic 41,2%;hypertensive 22,7%; dilated cardiomyopathy 20,9%;valvular 8,3%; others ...
Clinical Microbiology and Infection, 2021
Impact of the COVID-19 pandemic on the diagnosis, management and prognosis of infective endocarditis
EGA Revista de expresión gráfica arquitectónica, 2009
Granada1963, p. 44, al señalar que en la documentación consta el pago por las trazas de estas pie... more Granada1963, p. 44, al señalar que en la documentación consta el pago por las trazas de estas piezas en 1549.
Actas Del Tercer Congreso Nacional De Historia De La Construccion Sevilla 26 a 28 De Octubre De 2000 Vol 2 2000 Isbn 84 95365 56 1 Pags 1039 1048, 2000
Cirugía Cardiovascular, 2009
la cirugía endovascular se impone en el tratamiento de un número sustancial de casos de enfermeda... more la cirugía endovascular se impone en el tratamiento de un número sustancial de casos de enfermedad de aorta descendente. no obstante, la afectación del arco aórtico ha supuesto una frontera natural de este tratamiento hasta el reciente desarrollo de la llamada «cirugía híbrida», en la que, además de tratar el cayado con endoprótesis, se asocian derivaciones quirúrgicas de troncos supraaórticos. Potencialmente, este tipo de abordajes evitaría intervenciones más agresivas en una población cada vez más añosa, ofreciendo una alternativa a la circulación extracorpórea y la parada circulatoria. la presente revisión propone un abordaje sistemático de la enfermedad del cayado aórtico, dividiendo éste en «zonas de anclaje proximal». se describen las distintas estrategias y los resultados iniciales de esta aún joven modalidad terapéutica. Palabras clave: Endoprótesis. Procedimiento híbrido. Arco aórtico. tEVAr. Aneurisma. Hybrid surgery of the aortic arch: a systematic approach thoracic endovascular aneurysm repair (tEVAr) has evolved in the past years to be considered the first line treatment for most diseases of the descending thoracic aorta. When the aortic arch is involved, open surgery with circulatory arrest and antegrade cerebral perfusion is still considered the "gold standard". however alternative approaches to the treatment of the aortic arch have been developed in recent years, aiming at offering a relatively less aggressive option to an ever ageing patient population. in this review, a systematic approach to the socalled "hybrid" treatment of the aortic arch, dividing it according to "proximal landing zones" is presented. the different strategies and initial results are described for this still young treatment option.
Revista Española de Cardiología, 1997
... Manuel de Mora Martín, Pedro Aranda Lara*, Francisco Javier Aranda Lara*, Said Barakat, Javie... more ... Manuel de Mora Martín, Pedro Aranda Lara*, Francisco Javier Aranda Lara*, Said Barakat, Javier Zafra Sánchez, Álvaro Rubio Alcaide, Tomás Urda Valcárcel, Jesús Álvarez Rubiera, Ricardo ... 8. Redón J, Gómez-Sánchez MA, Baldo E, Casal MC, Fernández ML, Miralles A et al ...
Revista Española de Cardiología, 1997
Journal of Biological Chemistry, 2007
La carne bovina es un alimento importante para la nutrición del ser humano y el buen funcionamien... more La carne bovina es un alimento importante para la nutrición del ser humano y el buen funcionamiento del organismo. La Zona Metropolitana del Valle de México es el principal centro de comercialización y consumo de este alimento en el país. El objetivo del presente trabajo fue realizar una caracterización del consumidor de carne bovina en la Zona Metropolitana del Valle para conocer el tipo de productos que demandan asociando variables como su nivel de ingresos, nivel de consumo, los servicios integrados de estos productos, entre otros. La metodología empleada en el trabajo es el algoritmo CHAID (Chi-squared Automatic Interaction Detection), el cual permite segmentar las variables cuantitativas y categóricas de carácter económico y social, además de realizar pruebas de asociación de variables mediante la distribución X 2. La información se obtuvo mediante el levantamiento de una encuesta semiestructurada, aplicada a 440 individuos. Los resultados muestran que las variables ingreso y consumo son características correlacionadas de forma positiva con los tipos de cortes de carne y la frescura del producto (carne caliente); y se detecto una débil correlación también positiva con el tipo de expendio donde se adquiere y el tipo de empaque del producto. La única variable que no tuvo ninguna relación significativa con el consumo e ingreso fue la cantidad de cortes que adquieren, esto quiere decir que no es relevante. Al final se concluye que los consumidores con ingresos medios y bajos demandan cortes populares (bistec, molida y retazo).
Revista Española de Cardiología, 1998
Acinetobacter es una bacteria gramnegativa de adquisición fundamentalmente hospitalaria, ubicuida... more Acinetobacter es una bacteria gramnegativa de adquisición fundamentalmente hospitalaria, ubicuidad que le confiere múltiples resistencias a antibióticos 1. La endocarditis por Acinetobacter es excepcional, con tan sólo 20 casos descritos hasta 1992 2. Presentamos un caso de endocarditis por Acinetobacter sobre un tubo valvulado aórtico, con tórpida evolución, que provocó dehiscencia del injerto y requirió cirugía de emergencia.
Revista Portuguesa De Pneumologia, 2004
Revista espanola de cardiologia, 2011
The development of a noninvasive diagnostic test follows a typical timeline: description, enthusi... more The development of a noninvasive diagnostic test follows a typical timeline: description, enthusiasm, clinical assessment and application, and epidemiological study. However, for techniques such as echocardiography that are widely available, have no harmful effects and are inexpensive, clinical applications may become widespread before they have been evaluated. Real progress is being made with the use of new methodologies, such as myocardial deformation echocardiography and three-dimensional echocardiography. Three-dimensional transesophageal echocardiography has returned echocardiography to its place at the center of modern cardiac diagnosis after it had been displaced in recent years by cardiac multislice CT and cardiac magnetic resonance. However, the new radiological techniques that have helped to reduce radiation exposure to patients and that have improved image acquisition could restore CT to the heart of general cardiac diagnosis. At the moment, it is not possible to displace...
Journal of the American Society of Echocardiography
BACKGROUND Left ventricular wall thickness (LVWT) measurement is key in the diagnostic and progno... more BACKGROUND Left ventricular wall thickness (LVWT) measurement is key in the diagnostic and prognostic assessment of hypertrophic cardiomyopathy (HCM). Recent investigations have highlighted discrepancies in LVWT by cardiac magnetic resonance (CMR) and standard echocardiography (S-Echo) in this condition. The aim of this study was to elucidate the role of contrast-enhanced echocardiography (C-Echo) to optimize LVWT measurement in patients with HCM. METHODS Fifty patients with HCM were prospectively enrolled, undergoing S-Echo, C-Echo, and CMR. Blinded LVWT measurements were performed according to a 16-segment left ventricular model using all three imaging techniques. Agreement between both echocardiographic modalities and CMR (as the reference technique) at the segmental level was tested using Bland-Altman analyses. Reproducibility on segmental measurements by S-Echo and C-Echo was also investigated. RESULTS Patients' mean age was 47 ± 21 years, and 35 (70%) were men. Maximal mean LVWT by S-Echo (20.1 ± 3.8 mm) was greater than the values derived using C-Echo (17.6 ± 4.0 mm, P < .01) and CMR (17.7 ± 4.5 mm, P < .01), with no statistically significant difference between the latter two. Segmental Bland-Altman models demonstrated globally smaller bias and narrower 95% limits of agreement for C-Echo compared with S-Echo. Across all left ventricular segments, LVWT by C-Echo was 2.4 mm lower (range, 1.0-2.5 mm) than that derived by S-Echo, which accounted for a 25% intertechnique difference. Regarding maximal LVWT, the mean absolute difference between C-Echo and S-Echo was 3.0 ± 1.9 mm (range, 0.0-7.9 mm), which represented a 15% intertechnique change. Data analyses demonstrated globally less intra- and interobserver variability in segmental LVWT derived from C-Echo compared with S-Echo. CONCLUSIONS C-Echo rendered LVWT measurements closer to those derived by the reference technique (CMR) and improved reproducibility compared with S-Echo. C-Echo represents a suitable tool for LVWT measurement in patients with HCM as an alternative to CMR whenever this is not available or possible.
Revista Espa de Cardiologia
The Von Reyn criteria determine only a small number of definitive diagnoses of infectious endocar... more The Von Reyn criteria determine only a small number of definitive diagnoses of infectious endocarditis, while it is mainly diagnosed by histopathological confirmation in surgery or autopsy. This necessitates carrying out a new diagnostic scheme with accurate sensitivity and specificity based on rigorous clinical support. This scheme is provided by the Duke University criteria, which enhance the role of conventional and transesophageal echocardiography, in the diagnosis of infectious endocarditis. Echocardiography is the only accurate procedure for a non invasive diagnosis of vegetation, the main lesion in this pathology. Often, tissue destruction causes regurgitation, which is responsible for hemodynamic impairment or allows the spread of the infectious process to perivalvular tissue and can form an abscess. These complications and many others, which are difficult to treat, require an early diagnosis of this disease. Sensitivity of transesophageal technique to detect vegetations and complications is higher than that observed in conventional echocardiography, above all in patients with prosthetic valves. If the transesophageal study is negative, the existence of an infectious endocarditis is quite unlikely. Nevertheless, we need to consider clinical features, as the specificity of this technique is moderate.
Revista Espa de Cardiologia
The occurrence of iatrogenic aortic dissection after aortic valve replacement is uncommon, usuall... more The occurrence of iatrogenic aortic dissection after aortic valve replacement is uncommon, usually late, and exceptionally asymptomatic. We present here a case of dissecting aneurysm suspected by excessive mediastinal dilatation observed in the routine annual roentgenogram exam of a patient who has had an aortic valve prosthesis for thirteen years. The confirmation with other diagnostic methods and its successful surgical treatment are also described.
Revista Espa de Cardiologia
This study aims to investigate what is the best initial therapy for patients with obstructive pro... more This study aims to investigate what is the best initial therapy for patients with obstructive prosthetic valve thrombosis. Data from 47 patients diagnosed with prosthetic valve thrombosis in two tertiary hospitals during an 8-years period were analyzed. The involved prostheses were in mitral position in 34 cases (2 biological valves), in aortic position in 12, and in double mitral and aortic position in one. The thrombosis was not obstructive in 12 patients. In the remaining 35 patients, the prosthetic obstruction was treated by heparin (n = 2), thrombolysis (n = 19), or direct surgery (n = 14). There was no mortality in the thrombolytic group, although 6 patients needed surgery before discharge because of an abnormal prosthetic residual gradient (n = 5) or a persisting abnormal disc valve motion (n = 1). Five out of 14 patients of direct surgery died, 2 before the planned operation could be performed. Thus, mortality rate, in an intention to treat analysis, was very favourable to t...
European Heart Journal. Acute Cardiovascular Care, 2021
Funding Acknowledgements Type of funding sources: None. Background It is well defined the prognos... more Funding Acknowledgements Type of funding sources: None. Background It is well defined the prognosis value of the abnormalities in the circadian variation in hypertensive patients. In the phisiopathology of heart failure, neurohumoral mechanism plays an important role. Nevertheless, the circadian variation in nonhypertensive heart failure patients has not been well evaluated. Purpose Our aim was to evaluate 24-h blood pressure patterns and the prevalence of nocturnal hypertension in patients admitted with acute heart failure. Methods We studied 122 patients with a clinical diagnosis of AHF. We permormed a 24-h ambulatory blood pressure monitoring as well as an echocardiogram and anaytical test. Results 122 patients. Mean age: 63 ± 10. Males: 75%. Mean BMI: 30 ± 6 Kg/m2. Associated risk factors: 56,6% hypertension, 40 % dyslipidemia, 34,7% Diabetes, 29,3% obesity, 22,9% smoking. The etiology of HF: ischemic 41,2%;hypertensive 22,7%; dilated cardiomyopathy 20,9%;valvular 8,3%; others ...
Clinical Microbiology and Infection, 2021
Impact of the COVID-19 pandemic on the diagnosis, management and prognosis of infective endocarditis
EGA Revista de expresión gráfica arquitectónica, 2009
Granada1963, p. 44, al señalar que en la documentación consta el pago por las trazas de estas pie... more Granada1963, p. 44, al señalar que en la documentación consta el pago por las trazas de estas piezas en 1549.
Actas Del Tercer Congreso Nacional De Historia De La Construccion Sevilla 26 a 28 De Octubre De 2000 Vol 2 2000 Isbn 84 95365 56 1 Pags 1039 1048, 2000
Cirugía Cardiovascular, 2009
la cirugía endovascular se impone en el tratamiento de un número sustancial de casos de enfermeda... more la cirugía endovascular se impone en el tratamiento de un número sustancial de casos de enfermedad de aorta descendente. no obstante, la afectación del arco aórtico ha supuesto una frontera natural de este tratamiento hasta el reciente desarrollo de la llamada «cirugía híbrida», en la que, además de tratar el cayado con endoprótesis, se asocian derivaciones quirúrgicas de troncos supraaórticos. Potencialmente, este tipo de abordajes evitaría intervenciones más agresivas en una población cada vez más añosa, ofreciendo una alternativa a la circulación extracorpórea y la parada circulatoria. la presente revisión propone un abordaje sistemático de la enfermedad del cayado aórtico, dividiendo éste en «zonas de anclaje proximal». se describen las distintas estrategias y los resultados iniciales de esta aún joven modalidad terapéutica. Palabras clave: Endoprótesis. Procedimiento híbrido. Arco aórtico. tEVAr. Aneurisma. Hybrid surgery of the aortic arch: a systematic approach thoracic endovascular aneurysm repair (tEVAr) has evolved in the past years to be considered the first line treatment for most diseases of the descending thoracic aorta. When the aortic arch is involved, open surgery with circulatory arrest and antegrade cerebral perfusion is still considered the "gold standard". however alternative approaches to the treatment of the aortic arch have been developed in recent years, aiming at offering a relatively less aggressive option to an ever ageing patient population. in this review, a systematic approach to the socalled "hybrid" treatment of the aortic arch, dividing it according to "proximal landing zones" is presented. the different strategies and initial results are described for this still young treatment option.
Revista Española de Cardiología, 1997
... Manuel de Mora Martín, Pedro Aranda Lara*, Francisco Javier Aranda Lara*, Said Barakat, Javie... more ... Manuel de Mora Martín, Pedro Aranda Lara*, Francisco Javier Aranda Lara*, Said Barakat, Javier Zafra Sánchez, Álvaro Rubio Alcaide, Tomás Urda Valcárcel, Jesús Álvarez Rubiera, Ricardo ... 8. Redón J, Gómez-Sánchez MA, Baldo E, Casal MC, Fernández ML, Miralles A et al ...
Revista Española de Cardiología, 1997
Journal of Biological Chemistry, 2007
La carne bovina es un alimento importante para la nutrición del ser humano y el buen funcionamien... more La carne bovina es un alimento importante para la nutrición del ser humano y el buen funcionamiento del organismo. La Zona Metropolitana del Valle de México es el principal centro de comercialización y consumo de este alimento en el país. El objetivo del presente trabajo fue realizar una caracterización del consumidor de carne bovina en la Zona Metropolitana del Valle para conocer el tipo de productos que demandan asociando variables como su nivel de ingresos, nivel de consumo, los servicios integrados de estos productos, entre otros. La metodología empleada en el trabajo es el algoritmo CHAID (Chi-squared Automatic Interaction Detection), el cual permite segmentar las variables cuantitativas y categóricas de carácter económico y social, además de realizar pruebas de asociación de variables mediante la distribución X 2. La información se obtuvo mediante el levantamiento de una encuesta semiestructurada, aplicada a 440 individuos. Los resultados muestran que las variables ingreso y consumo son características correlacionadas de forma positiva con los tipos de cortes de carne y la frescura del producto (carne caliente); y se detecto una débil correlación también positiva con el tipo de expendio donde se adquiere y el tipo de empaque del producto. La única variable que no tuvo ninguna relación significativa con el consumo e ingreso fue la cantidad de cortes que adquieren, esto quiere decir que no es relevante. Al final se concluye que los consumidores con ingresos medios y bajos demandan cortes populares (bistec, molida y retazo).
Revista Española de Cardiología, 1998
Acinetobacter es una bacteria gramnegativa de adquisición fundamentalmente hospitalaria, ubicuida... more Acinetobacter es una bacteria gramnegativa de adquisición fundamentalmente hospitalaria, ubicuidad que le confiere múltiples resistencias a antibióticos 1. La endocarditis por Acinetobacter es excepcional, con tan sólo 20 casos descritos hasta 1992 2. Presentamos un caso de endocarditis por Acinetobacter sobre un tubo valvulado aórtico, con tórpida evolución, que provocó dehiscencia del injerto y requirió cirugía de emergencia.
Revista Portuguesa De Pneumologia, 2004
Revista espanola de cardiologia, 2011
The development of a noninvasive diagnostic test follows a typical timeline: description, enthusi... more The development of a noninvasive diagnostic test follows a typical timeline: description, enthusiasm, clinical assessment and application, and epidemiological study. However, for techniques such as echocardiography that are widely available, have no harmful effects and are inexpensive, clinical applications may become widespread before they have been evaluated. Real progress is being made with the use of new methodologies, such as myocardial deformation echocardiography and three-dimensional echocardiography. Three-dimensional transesophageal echocardiography has returned echocardiography to its place at the center of modern cardiac diagnosis after it had been displaced in recent years by cardiac multislice CT and cardiac magnetic resonance. However, the new radiological techniques that have helped to reduce radiation exposure to patients and that have improved image acquisition could restore CT to the heart of general cardiac diagnosis. At the moment, it is not possible to displace...
Journal of the American Society of Echocardiography
BACKGROUND Left ventricular wall thickness (LVWT) measurement is key in the diagnostic and progno... more BACKGROUND Left ventricular wall thickness (LVWT) measurement is key in the diagnostic and prognostic assessment of hypertrophic cardiomyopathy (HCM). Recent investigations have highlighted discrepancies in LVWT by cardiac magnetic resonance (CMR) and standard echocardiography (S-Echo) in this condition. The aim of this study was to elucidate the role of contrast-enhanced echocardiography (C-Echo) to optimize LVWT measurement in patients with HCM. METHODS Fifty patients with HCM were prospectively enrolled, undergoing S-Echo, C-Echo, and CMR. Blinded LVWT measurements were performed according to a 16-segment left ventricular model using all three imaging techniques. Agreement between both echocardiographic modalities and CMR (as the reference technique) at the segmental level was tested using Bland-Altman analyses. Reproducibility on segmental measurements by S-Echo and C-Echo was also investigated. RESULTS Patients' mean age was 47 ± 21 years, and 35 (70%) were men. Maximal mean LVWT by S-Echo (20.1 ± 3.8 mm) was greater than the values derived using C-Echo (17.6 ± 4.0 mm, P < .01) and CMR (17.7 ± 4.5 mm, P < .01), with no statistically significant difference between the latter two. Segmental Bland-Altman models demonstrated globally smaller bias and narrower 95% limits of agreement for C-Echo compared with S-Echo. Across all left ventricular segments, LVWT by C-Echo was 2.4 mm lower (range, 1.0-2.5 mm) than that derived by S-Echo, which accounted for a 25% intertechnique difference. Regarding maximal LVWT, the mean absolute difference between C-Echo and S-Echo was 3.0 ± 1.9 mm (range, 0.0-7.9 mm), which represented a 15% intertechnique change. Data analyses demonstrated globally less intra- and interobserver variability in segmental LVWT derived from C-Echo compared with S-Echo. CONCLUSIONS C-Echo rendered LVWT measurements closer to those derived by the reference technique (CMR) and improved reproducibility compared with S-Echo. C-Echo represents a suitable tool for LVWT measurement in patients with HCM as an alternative to CMR whenever this is not available or possible.
Revista Espa de Cardiologia
The Von Reyn criteria determine only a small number of definitive diagnoses of infectious endocar... more The Von Reyn criteria determine only a small number of definitive diagnoses of infectious endocarditis, while it is mainly diagnosed by histopathological confirmation in surgery or autopsy. This necessitates carrying out a new diagnostic scheme with accurate sensitivity and specificity based on rigorous clinical support. This scheme is provided by the Duke University criteria, which enhance the role of conventional and transesophageal echocardiography, in the diagnosis of infectious endocarditis. Echocardiography is the only accurate procedure for a non invasive diagnosis of vegetation, the main lesion in this pathology. Often, tissue destruction causes regurgitation, which is responsible for hemodynamic impairment or allows the spread of the infectious process to perivalvular tissue and can form an abscess. These complications and many others, which are difficult to treat, require an early diagnosis of this disease. Sensitivity of transesophageal technique to detect vegetations and complications is higher than that observed in conventional echocardiography, above all in patients with prosthetic valves. If the transesophageal study is negative, the existence of an infectious endocarditis is quite unlikely. Nevertheless, we need to consider clinical features, as the specificity of this technique is moderate.
Revista Espa de Cardiologia
The occurrence of iatrogenic aortic dissection after aortic valve replacement is uncommon, usuall... more The occurrence of iatrogenic aortic dissection after aortic valve replacement is uncommon, usually late, and exceptionally asymptomatic. We present here a case of dissecting aneurysm suspected by excessive mediastinal dilatation observed in the routine annual roentgenogram exam of a patient who has had an aortic valve prosthesis for thirteen years. The confirmation with other diagnostic methods and its successful surgical treatment are also described.
Revista Espa de Cardiologia
This study aims to investigate what is the best initial therapy for patients with obstructive pro... more This study aims to investigate what is the best initial therapy for patients with obstructive prosthetic valve thrombosis. Data from 47 patients diagnosed with prosthetic valve thrombosis in two tertiary hospitals during an 8-years period were analyzed. The involved prostheses were in mitral position in 34 cases (2 biological valves), in aortic position in 12, and in double mitral and aortic position in one. The thrombosis was not obstructive in 12 patients. In the remaining 35 patients, the prosthetic obstruction was treated by heparin (n = 2), thrombolysis (n = 19), or direct surgery (n = 14). There was no mortality in the thrombolytic group, although 6 patients needed surgery before discharge because of an abnormal prosthetic residual gradient (n = 5) or a persisting abnormal disc valve motion (n = 1). Five out of 14 patients of direct surgery died, 2 before the planned operation could be performed. Thus, mortality rate, in an intention to treat analysis, was very favourable to t...