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A sol-gel (Pb0.76Ca0.24)TiO3 solution was deposited onto Pt/MgO(100) substrates. Previous thermal treatment of the substrate and the high rate of crystallization heating promote an important preferred orientation along the polar axis, and therefore selfpolarization , very convenient for the use of IR pyroelectric detectors. By depositing circular electrodes, 7.10-3 cm2 of area, an array of small capacitors are developed which are characterized as detectors in standard conditions: radiation from a black-body at 500 K, modulated between 1-20 Hz, a lock-in amplifier and an electronic circuit to sense and treat the electrical response. Three main factors affecting the detector performances are analyzed: a) Figures of merit of the pyroelectric material; b) assembly of the whole parts of detector (substrate, electrodes, leads, frame, etc) and c) electronic circuitry to sense and amplify signals. Thermal isolation is concluding as the most important fact to improve responsivity.Se han obtenido depósitos multicapa de titanato de plomo modificado con calcio, (Pb0.76Ca0.24)TiO3, mediante un método de sol-gel, sobre substratos de Pt/MgO(100). El tratamiento térmico del substrato y la cristalización de las multicapas mediante tasas de calentamiento rápidas causan el desarrollo de una importante orientación preferente según el eje polar, perpendicular al mismo, lo que supone una autopolarización muy rentable para su empleo en detectores piroeléctricos de radiación infrarroja. Mediante una configuración de electrodos discretos se fabrican minicondensadores de 7.10-3 cm2 de área con los que se caracteriza ópticamente el detector para condiciones estándar: cuerpo negro a 500 K, modulación mecánica de la radiación entre 1-20 Hz, una electrónica de acondicionamiento de la señal de respuesta y un amplificador sintonizado para medir la respuesta en voltaje. Se analiza el efecto de los tres factores que intervienen en la fabricación del detector: a) características del material piroeléctrico (figuras de mérito del material), b) ensamblado de las partes del detector (substrato, electrodos, conexiones, etc.) y c) diseño del circuito electrónico de medida (etapa de preamplificación, de filtrado y de amplificación), resaltando la necesidad del aislamiento térmico.

Introduction and Objectives: This article presents the annual activity report of the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) for the year 2022., Methods: All Spanish centers with catheterization laboratories were invited to participate. Data were collected online and were analyzed by an external company in collaboration with the members of the board of the ACI-SEC., Results: A total of 111 centers participated. The number of diagnostic studies increased by 4.8% compared with 2021, while that of percutaneous coronary interventions (PCI) remained stable. PCIs on the left main coronary artery increased by 22%. The radial approach continued to be preferred for PCI (94.9%). There was an upsurge in the use of drug-eluting balloons, as well as in intracoronary imaging techniques, which were used in 14.7% of PCIs. The use of pressure wires also increased (6.3% vs 2021) as did plaque modification techniques. Primary PCI continued to grow and was the most frequent treatment (97%) in ST-segment elevation myocardial infarction. Most noncoronary procedures maintained their upward trend, particularly percutaneous aortic valve implantation, atrial appendage closure, mitral/tricuspid edge-to-edge therapy, renal denervation, and percutaneous treatment of pulmonary arterial disease., Conclusions: The Spanish cardiac catheterization and coronary intervention registry for 2022 reveals a rise in the complexity of coronary disease, along with a notable growth in procedures for valvular and nonvalvular structural heart disease., (Copyright © 2023 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: There is current controversy regarding the benefits of percutaneous recanalization (PCI) of chronic total coronary occlusions (CTO). Our aim was to determine acute and follow-up outcomes in our setting., Methods: Two-year prospective registry of consecutive patients undergoing PCI of CTO in 24 centers., Results: A total of 1000 PCIs of CTO were performed in 952 patients. Most were symptomatic (81.5%), with chronic ischemic heart disease (59.2%). Previous recanalization attempts had been made in 15%. The mean SYNTAX score was 19.5 ± 10.6 and J-score was > 2 in 17.3%. A retrograde procedure was performed in 92 patients (9.2%). The success rate was 74.9% and was higher in patients without previous attempts (82.2% vs 75.2%; P = .001), those with a J-score ≤ 2 (80.5% vs 69.5%; P = .002), and in intravascular ultrasound-guided PCI (89.9% vs 76.2%, P = .001), which was an independent predictor of success. In contrast, severe calcification, length > 20mm, and blunt proximal cap were independent predictors of failed recanalization. The rate of procedural complications was 7.1%, including perforation (3%), myocardial infarction (1.3%), and death (0.5%). At 1-year of follow-up, 88.2% of successfully revascularized patients showed clinical improvement (vs 34.8%, P < .001), which was associated with lower mortality. At 1-year of follow-up, the mortality rate was 1.5%., Conclusions: Compared with other national registries, patients in the Iberian registry undergoing PCI of a CTO showed similar complexity, success rate, and complications. Successful recanalization was strongly associated with functional improvement, which was related to lower mortality., (Copyright © 2018. Published by Elsevier España, S.L.U.)

Introduction and Objectives: Hereditary pulmonary veno-occlusive disease (PVOD) has been associated with biallelic mutations in EIF2AK4 with the recent discovery of a founder mutation in Iberian Romani patients with familial PVOD. The aims of this study were phenotypical characterization and survival analysis of Iberian Romani patients with familial PVOD carrying the founder p.Pro1115Leu mutation in EIF2AK4, according to their tolerance to pulmonary vasodilators (PVD). Familial genetic screening was conducted, as well as assessment of sociocultural determinants with a potential influence on disease course., Methods: Observational study of Romani patients with familial PVOD included in the Spanish Registry of Pulmonary Arterial Hypertension. Genetic screening of EIF2AK4 was performed in index cases and relatives between November 2011 and July 2016 and histological pulmonary examination was carried out in patients who received a lung transplant or died. The patients were divided into 2 groups depending on their tolerance to PVD, with comparison of baseline characteristics and survival free of death or lung transplant., Results: Eighteen Romani patients were included: 9 index cases and 9 relatives. The biallelic founder mutation in EIF2AK4 was found in all affected cases and 2 unaffected relatives. Family screening showed 34.2% of healthy heterozygotes, high consanguinity, young age at childbirth, and frequent multiparity. Prognosis was bleak, with significant differences depending on tolerance to PVD., Conclusions: We describe 2 phenotypes of hereditary PVOD depending on tolerance to PVD, with prognostic impact and familial distribution. Consanguinity may have a negative impact on the transmission of PVOD, with familial genetic screening showing high effectiveness., (Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: Pulmonary arterial hypertension (PAH) is characterized by increased pulmonary vascular resistance, right ventricular dysfunction and death. Despite scientific advances, is still associated with high morbidity and mortality. The aim is to describe the clinical approach and determine the prognostic factors of patients with PAH treated in a national reference center over 30 years., Methods: Three hundred and seventy nine consecutive patients with PAH (January 1984 to December 2014) were studied. Were divided into 3 periods of time: before 2004, 2004-2009 and 2010-2014. Prognostic factors (multivariate analysis) were analyzed for clinical deterioration., Results: Median age was 44 years (68.6% women), functional class III-IV: 72%. An increase was observed in more complex etiologies in the last period of time: Pulmonary venooclusive disease and portopulmonary hypertension. Upfront combination therapy significantly increased (5% before 2004 vs 27% after 2010; P < .05). Multivariate analysis showed prognostic significance in age, sex, etiology and combined clinical variables as they are independent predictors of clinical deterioration (P < .05). Survival free from death or transplantation for the 1st, 3rd and 5th year was 92.2%, 80.6% and 68.5% respectively. The median survival was 9 years (95% confidence interval, 7.532-11.959) CONCLUSIONS: The PAH is a heterogeneous and complex disease, the median survival free from death or transplantation in our series is 9 years after diagnosis. The structure of a multidisciplinary unit PAH must adapt quickly to changes that occur over time incorporating new diagnostic and therapeutic techniques., (Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Non-induced hypothermia is caused by anesthetic techniques, surgical procedures, and the environmental temperature in operating rooms, which affect the body's physiologic thermoregulation mechanisms. Postoperative hypothermia occurs in 93% of surgical patients and is accompanied by shivering in 65% of cases. Non-induced hypothermia affects the patient's postoperative recovery, as it alters metabolic response and reduces the patient's comfort during this period. Within the protocol for controlling postoperative hypothermia, the main objective of the nurses' aide consists of detecting and recording postoperative hypothermia, as well as of correcting the deficit by means of active warming of the body's external surface. These activities not only aid the patient's recovery and reduce complications, but also lower healthcare costs and increase postoperative comfort.

Introduction and Objectives: Experimental and clinical studies suggest that necrotic myocardium may have the capacity to regenerate. We have started a clinical study to demonstrate that the intracoronary implantation of stem cells is feasible and safe. The results in our first 5 patients are presented here., Patients and Method: We included patients with anterior acute myocardial infarction and isolated stenosis of the left anterior descending artery that was successfully repaired by primary or facilitated angioplasty. Patients received an intracoronary infusion of bone marrow-derived cells 10-15 days after the infarction. The follow-up protocol included low-dose dobutamine echocardiography, magnetic resonance studies and ECG Holter monitoring., Results: The procedure was carried out with no complications. No patient had a cardiac event during the first 6 months. One patient had a transient ischemic attack without sequelae. No arrhythmias were found. Left ventricular end-diastolic volume remained the same at 6 months (159+/-25 ml, 157+/-16 ml), left ventricular end-systolic volume decreased (77+/-22 ml, 65+/-16 ml), and the ejection fraction increased (53+/-7%, 58+/-8%) although no statistically significant differences were found. In the 3 patients in whom dobutamine echocardiography ruled out viability, we found a significant reduction in both volumes., Conclusions: Intracoronary bone marrow-derived cell transplantation after an acute myocardial infarction seems to be safe and feasible, and might lead to favorable remodeling.

The formation of atrial hematomas with a mass effect in patients who have undergone cardiac surgery originates a clinical and hemodynamic syndrome that is difficult to assess. Hypotension with high right atrial pressure and equalization of pulmonary wedge pressure is not always present due to the irregular distribution of the hematoma in cardiac chambers. Transesophageal echocardiography is a useful diagnostic procedure for atrial hematomas, differentiating them from other similar clinical and hemodynamic situations like left ventricular or prosthetic valve dysfunction. We present five clinical cases of patients who underwent cardiac surgery and presented atrial hematoma, right atrial in four and left atrial in one. All were diagnosed by transesophageal echocardiography. In one case magnetic resonance imaging was used.

Introduction and objectives. Troponin T (TnT) is a very specific marker of myocardial damage. Our objective was to describe TnT behavior after dobutamine stress echocardiography (EDOB) and evaluate its usefulness for improving the diagnostic power of EDOB.Methods. Blood levels of TnT were measured at baseline and 3, 6, 12, and 24 h after EDOB in 63 patients (mean age: 69 9; 38 males). Coronary angiography was performed on 36 patients.Results. EDOB was positive in 29 patients and there was an increase over baseline values in 15 of them (51%); EDOB was negative in 34 patients and there was only a rise in TnT in 7 (20%; p < 0.01). The TnT increment was higher in patients with a positive response to EDOB (0.033 0.02 vs. 0.026 0.01; p < 0.01). The ischemia score index was higher in patients in which a significant increase in TnT values was later detected (0.41 0.31 vs. 0.38 0.20; p < 0.01). Coronariography was performed in 36 patients. EDOB was positive in 22 of the 29 patients with coronary artery disease (76%) and TnT was raised in 14 of them (48%; p < 0.05).Conclusion. The rise in TnT levels during EDOB suggests that this test may produce myocardial damage associated with the appearance of contractility disorders during dobutamine infusion.