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Papers by Vicente Climent

Thrombosis Research, 2010

Hypertrophic cardiomyopathy (HCM) is characterised by inappropriate hypertrophy, small-vessel cor... more Hypertrophic cardiomyopathy (HCM) is characterised by inappropriate hypertrophy, small-vessel coronary artery disease, myocyte disarray and increased interstitial fibrosis. Microvascular dysfunction is a common finding in HCM and its extent has been proposed as an important prognostic marker. Plasma von Willebrand factor (vWf) is an established marker of endothelial damage or dysfunction; however it has scarcely been studied in HCM. We hypothesised that vWf could be raised in patients with HCM and be related to different variables associated with severity of HCM. Methods: We included 124 HCM patients, 93 males, aged 48 ± 15 years, 59 healthy control subjects with similar age and sex and 20 patients with ischemic heart disease but clinical stability for the last 6 months. A complete history and clinical examination was performed, including 12-lead electrocardiogram, echocardiography, 24 hours ECG-Holter monitoring, and symptom limited treadmill exercise test. Risk factors for sudden death were evaluated. A blinded cardiac MRI was performed with late enhanced study with Gadolinium. Plasma vWf levels were assayed by commercial ELISA. Results: Patients showed higher levels of vWf (140.0 ± 65.0 UI/ml vs 105.0 ± 51.0 UI/ml, p b 0.001) even after adjusting for ABO blood group. vWf levels were found raised in patients with severe functional class (168.4 ± 65.9 UI/mL vs 132.4 ± 60.7 UI/mL, p = 0.020), atrial fibrillation (175.8 ± 69.4 UI/mL vs 133.0 ± 59.0 UI/mL, p = 0.005), hypertension (161.4 ± 60.8 vs 128.9 ± 60.5, p = 0.010) obstruction (153.9 ± 67.9 vs 128.2 ± 57.4 UI/mL, p = 0.046) and non sustained ventricular tachycardia (159.3 ± 59.1 vs 133.0 ± 63.0, p = 0.049). vWf correlated with age (r:0.26; p = 0.006) and obstruction (r:0.22; p = 0.021). Conclusions: We show, for the first time, patients with HCM present significantly raised levels of vWf. These are associated with different conditions related to the severity of the disease.

European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology, 2006

N-terminal pro-brain natriuretic peptide (NT-proBNP) is useful in the diagnosis of heart failure ... more N-terminal pro-brain natriuretic peptide (NT-proBNP) is useful in the diagnosis of heart failure (HF). LV two-dimensional cavity area from end-diastole (LVEDA) and end-systole (LVESA), and LV fractional area change (LVFAC) reflect changes in LV morphology and function without using geometric assumptions. In a multicenter study, we correlated LVEDA, LVESA and LVFAC with NT-proBNP, comparing patients with dilated and ischemic cardiomyopathy. We studied 106 HF patients. In the dilated group, NT-proBNP correlated with LVEDAI (r=0.6), LVESAI (r=0.7) and LVFAC (r=-0.6), all significant at p<0.001. In patients with ischemic cardiomyopathy we found LVESAI (r=0.3, p<0.05) and LVFAC (r=-0.4, p<0.01). After adjustment for age and BMI, LVFAC and LVESAI were associated in a multiple linear regression analysis with peptide levels (adjusted r(2)=0.5, p<0.001). In this study we found a good correlation of NT-proBNP with LV cavity areas and LVFAC. Multiple regression analysis showed that...

Haemostasis, 2000

Objective: We evaluated the changes in fibrinolytic activation markers before starting anticoagul... more Objective: We evaluated the changes in fibrinolytic activation markers before starting anticoagulation, at 1 and 6 months following the introduction of anticoagulant therapy. Design and Methods: Tissue plasminogen activator (t-PA), its endothelial inhibitor (PAI-1), plasmin:antiplasmin complexes (PAPc), modified antithrombin III (ATM), D dimer (D-D) and fibrinogen (FIB) were measured in 36 patients with chronic atrial fibrillation. Fifteen of them had

Revista Espanola De Cardiologia, 2004

Introduction. N-terminal pro-brain natriuretic peptide (NT-proBNP) is useful in the diagnosis of ... more Introduction. N-terminal pro-brain natriuretic peptide (NT-proBNP) is useful in the diagnosis of heart failure. We compared NT-proBNP levels in patients with and without a diagnosis of arterial hypertension.

International Journal of Cardiology, 2006

We have read with great interest a retrospective cohort study recently published by Blich and Gro... more We have read with great interest a retrospective cohort study recently published by Blich and Gross. In our opinion, this article renews the controversy of the best antithrombotic therapy in patients with AF. The use of anticoagulant treatment to prevent the occurrence of stroke in patients with AF is supported by several randomized controlled clinical trials. Aspirin is also effective in preventing stroke in AF, but both direct and indirect comparisons with oral anticoagulation suggest less effectiveness. However, very probably these patients are quite different than those seen in the clinical practice. The role of antiplatelet therapy is not completely established, and the selection between aspirin or warfarin in advanced age remains an unfinished task.

Revista Espanola De Cardiologia, 2003

Introducción y objetivos. El factor de necrosis tumoral alfa es una citocina inflamatoria que se ... more Introducción y objetivos. El factor de necrosis tumoral alfa es una citocina inflamatoria que se eleva en la insuficiencia cardíaca, con valor pronóstico en casos graves, aunque menos establecido en casos moderados. Pretendemos conocer su valor pronóstico en los casos de un hospital secundario.

Revista Espanola De Cardiologia, 2008

Current Medicinal Chemistry, 2007

Growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis is not only involved in the regulat... more Growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis is not only involved in the regulation of somatic growth but also has important physiological functions in adults. Several studies have shown that GH deficiency in adults is associated with abnormalities in body composition, metabolic derangements, and suboptimal physical performance. Furthermore, GH/IGF-I axis plays an important role in the maintenance of heart structure and function. Until recently, GH therapy was only used to treat short stature children, with or without established GH deficiency, and it remains common practice to discontinue GH replacement therapy when final height is achieved. Acromegaly, entity characterized by GH hypersecretion, is associated with an increased risk of premature death. Cardiac complications are known to be major determinants of the shortened life expectancy. Treatment of acromegaly accounts for a substantial decrease in morbidity and mortality. Surgery, radiation therapy and bromocriptine have only been able to reduce GH levels to normal levels in 10-30% of patients. The synthesis of somatostatin analogs has provided a new approach to acromegaly treatment. These drugs reduce GH and IGF-I levels in 80% of cases and normalize them in 40-60% of cases. Finally, GH/IGF-I system improves left ventricular systolic function and has also indirect effects on the cardiovascular system, mainly as a consequence of the peripheral vasodilatation. These effects are important in the understanding of the potential role of GH on improving ventricular systolic dysfunction and point to the use of GH as a potential therapy for chronic heart failure. The aim of the present review is to provide an update overview describing the role of GH on acromegaly, adult GH deficiency and heart failure, as well as the influence of GH-based therapy on heart structure and function.