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1. Respiratory Syncytial Virus Risk Profile in Hospitalized Infants and Comparison with Influenza and COVID-19 Controls in Valladolid, Spain, 2010–2022

Author: Mariana Haeberer, Martin Mengel, Rong Fan, Marina Toquero-Asensio, Alejandro Martin-Toribio, Qing Liu, Yongzheng He, Sonal Uppal, Silvia Rojo-Rello, Marta Domínguez-Gil, Cristina Hernán-García, Virginia Fernández-Espinilla, Jessica E. Atwell, Javier Castrodeza Sanz, José M. Eiros, and Ivan Sanz-Muñoz
Subjects: Respiratory syncytial virus, Influenza, SARS-CoV-2, Hospitalization, Infants, Premature infants, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Introduction We aimed to describe the risk profile of RSV infections among children aged ≤ 24 months in Valladolid from January 2010 to August 2022 and to compare them with influenza and COVID-19 controls. Methods We conducted a retrospective cohort study of all laboratory-confirmed RSV, influenza, and COVID-19 infections. We analyzed risk factors for RSV hospitalization and severity (length-of-stay ≥ 8 days, intensive-care-unit admission, in-hospital death or readmission
Published: 2024
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2. RSV Risk Profile in Hospitalized Adults and Comparison with Influenza and COVID-19 Controls in Valladolid, Spain, 2010–2022

Author: Mariana Haeberer, Martin Mengel, Rong Fan, Marina Toquero-Asensio, Alejandro Martin-Toribio, Qing Liu, Yongzheng He, Sonal Uppal, Silvia Rojo-Rello, Marta Domínguez-Gil, Cristina Hernán-García, Virginia Fernández-Espinilla, Caihua Liang, Elizabeth Begier, Javier Castrodeza Sanz, José M. Eiros, and Ivan Sanz-Muñoz
Subjects: Respiratory syncytial virus, Influenza, SARS-CoV-2, Hospitalization, Adult patients, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Introduction We aimed to describe the risk profile of respiratory syncytial virus (RSV) infections among adults ≥ 60 years in Valladolid from January 2010 to August 2022, and to compare them with influenza and COVID-19 controls. Methods This was a retrospective cohort study of all laboratory-confirmed RSV infections identified in centralized microbiology database during a 12-year period. We analyzed risk factors for RSV hospitalization and severity (length of stay, intensive care unit admission, in-hospital death or readmission
Published: 2024
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3. Echocardiogram by apical-subcostal protocol in prone position during invasive mechanical ventilation in cardiovascular intensive care unit

Author: César Del Castillo, Fernando Verdugo, Franco Appiani, Francisca Yáñez, Camila Bontá, Carlos Torres-Herrera, Angela Garcia, Zorba Blázquez-Bermejo, Javier Castrodeza, Daniel Requena, Andreina Rodríguez, Arquimedes Silvio, Agustín Gatica, Arnulfo Begazo, and Mario Alfaro
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Aims To evaluate the feasibility of a transthoracic echocardiogram using an apical-subcostal protocol in invasive mechanical ventilation (IMV) and prone position. Methods Prospective study of adults who required a prone position during IMV. A pillow was placed only under the left hemithorax in the prone position to elevate and ease the apical and subcostal windows. A critical care cardiologist (prone group) acquired and evaluated the images using the apical-subcostal protocol. Besides, we used ambulatory echocardiograms performed as a comparative group (supine group). Results 86 patients were included, 43 in the prone and 43 in the supine. In the prone group, the indication to perform an echocardiogram was hemodynamic monitoring. All patients were ventilated with protective parameters, and the mean end-expiratory pressure was 10.6 cmH2O. The protocol was performed entirely in 42 of 43 patients in the prone group because one patient did not have any acoustic window. In the 43 patients in the prone group analyzed and compared to the supine group, global biventricular function was assessed in 97.7% (p = 1.0), severe heart valve disease in 88.4% (p = 0.055), ruled out of the presence of pulmonary hypertension in 76.7% (p = 0.80), pericardial effusion in 93% (p = 0.12), and volume status by inferior vena cava in 93% (p = 0.48). Comparing prone versus supine position, a statistical difference was found when evaluating the left ventricle apical 2-chamber view (65.1 versus 100%, p
Published: 2024
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4. Bleeding Risk of Anticoagulation Reversal Strategies Before Heart Transplantation: A Retrospective Comparative Cohort Study

Author: Antonio Prieto-Romero, Sara Ibañez-García, Xandra García-González, Javier Castrodeza, Beatriz Torroba-Sanz, Carlos Ortiz-Bautista, Cristina Pascual-Izquierdo, José María Barrio-Gutiérrez, Ángel González-Pinto, Ana Herranz-Alonso, and María Sanjurjo-Sáez
Subjects: idarucizumab, anticoagulation reversal, bleeding risk, heart transplantation, economic analysis, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Heart transplantation (HT) poses high bleeding risks, especially for patients on anticoagulation. This study evaluates the use of idarucizumab for dabigatran (DBG) reversal compared to vitamin K antagonist (VKA) strategies in HT. A retrospective analysis of HT patients from January 2018 to December 2022, excluding those requiring ECMO immediately before or after surgery, was conducted. Outcomes included transfusion needs, re-surgery due to bleeding, ICU stay lengths, and 30-day survival. A cost analysis compared the direct expenses of each strategy. Among 34 patients, 20 were on DBG and 14 on VKAs or not anticoagulated. Idarucizumab significantly reduced the number of patients requiring transfusion (p = 0.034) and ICU stay lengths (p = 0.014), with no significant impact on re-surgery rates (p = 0.259) or survival (p = 0.955). Despite higher initial costs, overall expenses for idarucizumab were comparable to VKA reversal due to reduced transfusion needs and shorter ICU stays. Idarucizumab offers a viable and potentially cost-neutral anticoagulation reversal option for HT patients on DBG, presenting an alternative to VKA strategies. However, due to the retrospective nature of the study and the small sample size, further prospective studies are needed to confirm these findings.
Published: 2024
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5. Analyzing Changes in Attitudes and Behaviors towards Seasonal Influenza Vaccination in Spain’s Adult Population over Three Seasons

Author: Camino Prada-García, Marina Toquero-Asensio, Virginia Fernández-Espinilla, Cristina Hernán-García, Iván Sanz-Muñoz, Jose M. Eiros, and Javier Castrodeza-Sanz
Subjects: vaccine hesitancy, healthcare communication, attitudes, behaviors, public health, Medicine
Abstract: Background/Objectives: The experience of the COVID-19 pandemic has turned the spotlight on the importance of public health measures and disease prevention. Despite this, the acceptance of influenza vaccination has remained low in most countries (and far from the 75% target set by the World Health Organization). The objective of this study has been to investigate how attitudes and behaviors regarding influenza vaccination in the Spanish adult population have changed over the last three years (from 2021 to 2024) in order to analyze trends in influenza vaccination. Methods: To this end, a cross-sectional study was conducted through 2206 telephone interviews, and the results were compared with those obtained in previous campaigns. Results: The findings indicate a significant decline in overall vaccination intent. Healthcare professionals remain the most influential factor in encouraging vaccination, yet there is a notable increase in the lack of vaccine recommendations, contributing to the decision not to vaccinate. This study also reveals low awareness of the influenza vaccine campaign, emphasizing the need for improved public health communication. Conclusions: To counteract these trends, this study recommends intensifying awareness campaigns, strengthening the role of healthcare providers in vaccine advocacy, and tailoring communication strategies. These efforts are crucial to enhancing vaccination coverage and protecting vulnerable populations against influenza.
Published: 2024
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6. Potential Effects on Elderly People From Nirsevimab Use in Infants

Author: Iván Sanz-Muñoz, Javier Castrodeza-Sanz, and José M. Eiros
Subjects: Virus respiratorio sincitial, Nirsevimab, Adultos de edad avanzada, Vacunas, Diseases of the respiratory system, RC705-779
Abstract: Nirsevimab therapy has the potential to revolutionize infant respiratory syncytial virus (RSV) prophylaxis. But other populations suffering RSV, such the elderly or those over 60, may also be protected by using this novel antibody in the infant group. It is true that some studies link the use of nirsevimab to a reduction in the virus's ability to spread by lowering the viral load in infants as a result of the drug's long half-life. However, this protective effect may not be very significant because RSV transmission in the elderly typically comes from other elderly people or from school-aged children. Furthermore, RSV may be transmitted at any time of the year and not just during the period of nirsevimab protection due to its existence in human reservoirs. The reasons made here show that, even though nirsevimab treatment in infants may protect the elderly, this benefit would be limited and testimonial. Therefore, immunizing the elderly with currently licensed and developing vaccines should be a priority. Resumen: El uso de nirsevimab puede suponer una revolución en la prevención del virus respiratorio sincitial (VRS) en lactantes. Sin embargo, el uso de este nuevo anticuerpo en dicho grupo de edad podría proteger también a otros grupos que conviven con ellos, como por ejemplo las personas de edad avanzada o grupo de personas mayores de 60 años. Si bien es cierto que algunos estudios sugieren una disminución en la propagación del virus con el uso de nirsevimab, al reducir la carga viral en lactantes como consecuencia de la prolongada vida media del fármaco, este efecto protector podría ser de escasa relevancia, ya que la transmisión del VRS en personas de edad avanzada sucede en la mayor parte de los casos desde personas de la misma edad o desde niños en edad escolar. Adicionalmente, la presencia de VRS en reservorios humanos puede permitir que el VRS se transmita en cualquier época del año, no limitándose únicamente al periodo de protección de nirsevimab. Los argumentos aquí expuestos demuestran que, si bien el uso de nirsevimab en lactantes podría tener un efecto protector en las personas de edad avanzada, este solo sería testimonial y limitado. En consecuencia, debe priorizarse la inmunización de los pacientes de edad avanzada con las vacunas actualmente autorizadas y en desarrollo.
Published: 2024
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7. Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO‐D registry

Author: David Dobarro, Víctor Donoso‐Trenado, Eduard Solé‐González, Carlos Moliner‐Abós, José Manuel Garcia‐Pinilla, Silvia Lopez‐Fernandez, Sonia Ruiz‐Bustillo, Carles Diez‐Lopez, Javier Castrodeza, Ana B. Méndez‐Fernández, David Vaqueriza‐Cubillo, Marta Cobo‐Marcos, Javier Tobar, Igor Sagasti‐Aboitiz, Miguel Rodriguez, Vanessa Escolar, Ana Abecia, Pau Codina, Inés Gómez‐Otero, Francisco Pastor, Raquel Marzoa‐Rivas, Eva González‐Babarro, Javier deJuan‐Baguda, María Melendo‐Viu, Fernando deFrutos, and José Gonzalez‐Costello
Subjects: Inotropes, Levosimendan, Palliative care, Advanced heart failure, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Aim Patients with advanced heart failure (AHF) who are not candidates to advanced therapies have poor prognosis. Some trials have shown that intermittent levosimendan can reduce HF hospitalizations in AHF in the short term. In this real‐life registry, we describe the patterns of use, safety and factors related to the response to intermittent levosimendan infusions in AHF patients not candidates to advanced therapies. Methods and results Multicentre retrospective study of patients diagnosed with advanced heart failure, not HT or LVAD candidates. Patients needed to be on the optimal medical therapy according to their treating physician. Patients with de novo heart failure or who underwent any procedure that could improve prognosis were not included in the registry. Four hundred three patients were included; 77.9% needed at least one admission the year before levosimendan was first administered because of heart failure. Death rate at 1 year was 26.8% and median survival was 24.7 [95% CI: 20.4–26.9] months, and 43.7% of patients fulfilled the criteria for being considered a responder lo levosimendan (no death, heart failure admission or unplanned HF visit at 1 year after first levosimendan administration). Compared with the year before there was a significant reduction in HF admissions (38.7% vs. 77.9%; P 12 g/dL (+1.5), amiodarone use (−1.5) HF visit 1 year before levosimendan (−1.5) and heart rate >70 b.p.m. (−2). Patients with a score less than −1 had a very low probability of response (21.5% free of death or HF event at 1 year) meanwhile those with a score over 1.5 had the better chance of response (68.4% free of death or HF event at 1 year). LEVO‐D score performed well in the ROC analysis. Conclusion In this large real‐life series of AHF patients treated with levosimendan as destination therapy, we show a significant decrease of heart failure events during the year after the first administration. The simple LEVO‐D Score could be of help when deciding about futile therapy in this population.
Published: 2023
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8. Long-term influenza antibodies profiles in previously vaccinated and non-vaccinated adults

Author: Iván Sanz-Muñoz, Conrado Lajara, Javier Sánchez-Martínez, Camino Prada-García, Silvia Rojo-Rello, Marta Domínguez-Gil, Virginia Fernández-Espinilla, Cristina Hernán-García, José M. Eiros-Bachiller, Asunción Caminero-Pérez, Yolanda Marcos-López, Luis Teso-Fernández, José Ignacio Echarren, Javier Castrodeza-Sanz, and José M. Eiros
Subjects: influenza, vaccine, vaccination, adults, workers, Immunologic diseases. Allergy, RC581-607, Therapeutics. Pharmacology, RM1-950
Abstract: The aim of this work is to describe the dynamics of influenza antibodies after vaccination in adults. We conducted a case-cohort serological study in the automobile manufacturing plants of the Renault España S.A. group in Valladolid and Palencia (Spain), including 550 workers (66.9%) previously vaccinated against influenza (group V), and 272 (33.1%) never vaccinated (group NV). A pre-vaccination serum sample was collected, another after 30–40 days and another after 6 months. The dynamics of antibodies were analyzed. A lower seroprotection of NV before vaccination was observed, but an antibody response between 2 and 4 times higher than in V was assessed. After 6 months, antibodies declined in both groups until equalize. Antibodies titers decrease with age, and no differences were found among underlying pathologies. Adults never vaccinated against influenza had lower seroprotection than those previously vaccinated, but influenza vaccination produces a more intense serological response in them, acquiring significantly higher antibody titers than those previously vaccinated. The antibodies, although in lower titers, persist and equalize among both groups at least 6 months after vaccination, which allows the individual to be protected during the entire circulation of the influenza virus in the same season.
Published: 2023
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9. Possible Mpox Protection from Smallpox Vaccine–Generated Antibodies among Older Adults

Author: Iván Sanz-Muñoz, Laura Sánchez-dePrada, Javier Sánchez-Martínez, Silvia Rojo-Rello, Marta Domínguez-Gil, Cristina Hernán-García, Virginia Fernández-Espinilla, Raúl Ortiz de Lejarazu-Leonardo, Javier Castrodeza-Sanz, and José María Eiros
Subjects: mpox, monkeypox, smallpox, vaccinia, vaccine, immunosenescence, Medicine, Infectious and parasitic diseases, RC109-216
Abstract: Smallpox vaccination may confer cross-protection to mpox. We evaluated vaccinia virus antibodies in 162 persons ≥50 years of age in Spain; 68.5% had detectable antibodies. Highest coverage (78%) was among persons 71–80 years of age. Low antibody levels in 31.5% of this population indicates that addressing their vaccination should be a priority.
Published: 2023
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10. Evolution of antibody profiles against SARS-CoV-2 in experienced and naïve vaccinated elderly people

Author: Iván Sanz-Muñoz, Rosa López-Mongil, Javier Sánchez-Martínez, Laura Sánchez-de Prada, Marta Domínguez-Gil González, Diana Pérez-SanJose, Silvia Rojo-Rello, Cristina Hernán-García, Virginia Fernández-Espinilla, Raúl Ortiz de Lejarazu-Leonardo, Javier Castrodeza-Sanz, and José María Eiros
Subjects: COVID-19, SARS – CoV – 2, nursing homes, elderly, third dose (booster), booster, Immunologic diseases. Allergy, RC581-607
Abstract: IntroductionThe third dose of the COVID-19 vaccine is especially necessary in people over 65 years of age due to their lower immune response.MethodsWe designed a multicentre, prospective observational study including 98 people ≤65 years old who lived in two nursing homes in Valladolid, Spain. One of the groups had previous experience with SARS-CoV-2 (n=68;69.4%) and the other was naïve (n=30;30.6%). We evaluated the response to the three doses of the Comirnaty vaccine and the dynamics of antibodies during 5 consecutive serum samplings: 2 after the first two doses of vaccination, one three months after the first dose, another at 6 months and the last one month after the third dose. IgG antibodies against SARS-CoV-2 S1, RBD and N antigens were analysed.ResultsBoth groups increased the level of Abs against S1 and RBD, but the experienced group showed a 130-fold higher humoral response due to hybrid immunisation (infection+vaccination). The response to vaccination with Comirnaty against COVID-19 was higher in those ≤65 years with previous experience than those who were naïve. However, the amount of antibodies against S1 and RBD equalised at 6 months. After the third dose, both groups raised the amount of antibodies to a similar level. The reinfections suggested by the analysis of antibodies against N were frequent in both groups.DiscussionThe third dose showed a clear benefit for elderly people, with the reinforcement of the antibody levels after the decline suffered after six months of the first two doses.
Published: 2023
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11. The Impact of the COVID-19 Pandemic on Influenza Vaccination Attitudes and Actions in Spain’s Adult Population

Author: Camino Prada-García, Marina Toquero-Asensio, Virginia Fernández-Espinilla, Cristina Hernán-García, Iván Sanz-Muñoz, María Dolores Calvo-Nieves, Jose M. Eiros, and Javier Castrodeza-Sanz
Subjects: influenza vaccine, COVID-19, attitudes, Spain, Medicine
Abstract: Seasonal influenza is an acute respiratory infection caused by the influenza virus which constitutes a significant public health issue associated with high morbidity and mortality. The aim of this study was to investigate changes in attitudes, perceptions, and practices regarding influenza vaccination in the Spanish adult population during the COVID-19 pandemic, as well as their vaccination intentions, with special attention paid to those over 65 years old and in high-risk groups. To this end, a cross-sectional study was conducted through 2219 telephone interviews, and the results were compared with results obtained a year earlier. Regarding the reasons for deciding to get vaccinated in the 2022/23 season, a significant increase was observed in vaccine confidence (36.7% vs. 42.8%), social responsibility (32.5% vs. 43.8%), and in awareness of the importance of vaccination due to COVID-19 (21.7% vs. 25.4%). Advanced age (OR 2.8, 95% CI 2.0–3.9), belonging to high-risk groups (OR 2.7, 95% CI 2.0–3.7), and prior vaccination (OR 25.3, 95% CI 19.5–32.7) emerged as significant predictors for the intent to receive the influenza vaccine in the 2022/23 season. Continuously observing shifts in perceptions and behaviors related to influenza immunization is crucial to pinpoint factors that may influence the willingness to receive the vaccine and, in this way, design public health strategies that achieve a greater acceptance of it.
Published: 2023
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12. Adjuvants for COVID-19 Vaccines

Author: Javier Castrodeza-Sanz, Iván Sanz-Muñoz, and Jose M. Eiros
Subjects: vaccines, adjuvants, COVID-19, immune response, Medicine
Abstract: In recent decades, the improvement of traditional vaccines has meant that we have moved from inactivated whole virus vaccines, which provoke a moderate immune response but notable adverse effects, to much more processed vaccines such as protein subunit vaccines, which despite being less immunogenic have better tolerability profiles. This reduction in immunogenicity is detrimental to the prevention of people at risk. For this reason, adjuvants are a good solution to improve the immunogenicity of this type of vaccine, with much better tolerability profiles and a low prevalence of side effects. During the COVID-19 pandemic, vaccination focused on mRNA-type and viral vector vaccines. However, during the years 2022 and 2023, the first protein-based vaccines began to be approved. Adjuvanted vaccines are capable of inducing potent responses, not only humoral but also cellular, in populations whose immune systems are weak or do not respond properly, such as the elderly. Therefore, this type of vaccine should complete the portfolio of existing vaccines, and could help to complete vaccination against COVID-19 worldwide now and over the coming years. In this review we analyze the advantages and disadvantages of adjuvants, as well as their use in current and future vaccines against COVID-19.
Published: 2023
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13. Do Vaccines Need a Gender Perspective? Influenza Says Yes!

Author: Laura Sánchez-de Prada, Raúl Ortiz de Lejarazu-Leonardo, Javier Castrodeza-Sanz, Eduardo Tamayo-Gómez, José María Eiros-Bouza, and Iván Sanz-Muñoz
Subjects: influenza, sex differences, influenza vaccine, sexual dimorphism, elderly, Immunologic diseases. Allergy, RC581-607
Abstract: BackgroundSex differences in immune responses are well known. However, the humoral response in males and females in the case of influenza vaccination is yet to be characterized since studies have shown uneven results.MethodsA retrospective study was conducted in 2,243 individuals (46.9% males) divided by age (15–64 and ≥65 years old). A serological analysis was performed by hemagglutination inhibition assay (HI) just before and 28 days after annual vaccination against seasonal influenza viruses in people vaccinated during the 2006–2018 seasons. A comparison of the humoral responses against influenza A and B viruses contained in the vaccine, between male and female individuals in young adults and elderly was conducted.ResultsSignificative higher humoral response against classical influenza A (H1N1), A(H1N1)pdm09 subtype and B/Victoria lineage in terms of seroconversion rate were found in elderly women. No significant differences were found in the case of A(H3N2) subtype.ConclusionsElderly women seem to display a greater humoral response against classical A(H1N1), pandemic A(H1N1)pmd09 and B/Victoria lineage than elderly men. Sex dimorphism does not affect young adults.
Published: 2021
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14. Rationale and Protocol of the Multimodality Evaluation of Antibody-Mediated Injury in Heart Transplantation (LEONE-HT) Observational Cross-Sectional Study

Author: Jorge Nuche, Javier de la Cruz Bertolo, Irene Marco Clement, Violeta Sánchez Sánchez, Fernando Sarnago Cebada, Esther Mancebo, Ana Belén Enguita, Marina Alonso-Riaño, Gema Ruiz-Hurtado, Juan Carlos López-Azor, Francisco José Hernández-Pérez, Javier Castrodeza, Javier Sánchez González, Fernando Arribas Ynsaurriaga, María Dolores García-Cosío Carmena, and Juan F. Delgado
Subjects: heart transplant, anti-HLA antibodies, rejection, Biology (General), QH301-705.5
Abstract: Introduction: Heart transplant (HT) survival has barely improved in the last decades, which is unsatisfactory for many HT recipients. The development of anti-human leukocyte antigen (anti-HLA) antibodies in HT patients is associated with a cardiac allograft dysfunction. The mechanisms leading to this damage are unclear. The Multimodality Evaluation Of Antibody-Mediated Injury In Heart Transplantation (LEONE-HT) study aimed to thoroughly describe the damage inflicted on the myocardium by anti-HLA antibodies. Methods and analysis: The LEONE-HT study is a cohort study with a cross-sectional approach in which HT patients with positive anti-HLA antibodies are compared with coetaneous HT patients with negative anti-HLA antibodies. All patients will undergo a state-of-the-art multimodal assessment, including imaging techniques, coronary anatomy and physiology evaluations and histological and immunological analyses. The individual and combined primary outcomes of structural graft injuries and longitudinal secondary outcomes are to be compared between the exposed and non-exposed groups with univariate and multivariable descriptive analyses. Ethics and dissemination: The LEONE-HT study is carried out in accordance with the principles set out in the Declaration of Helsinki and the International Conference on Harmonization guidelines for good clinical practice and following national laws and regulations. The study design, objectives and participant centers have been communicated to clinicaltrials.gov (NCT05184426). The LEONE-HT study counts on the support of patient associations to disseminate the objectives and results of the research. This study was funded by the Spanish Ministry of Science and Innovation and the Spanish Society of Cardiology.
Published: 2022
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15. Respiratory Syncytial Virus Risk Profile in Hospitalized Infants and Comparison with Influenza and COVID-19 Controls in Valladolid, Spain, 2010–2022

Author: Haeberer, Mariana, Mengel, Martin, Fan, Rong, Toquero-Asensio, Marina, Martin-Toribio, Alejandro, Liu, Qing, He, Yongzheng, Uppal, Sonal, Rojo-Rello, Silvia, Domínguez-Gil, Marta, Hernán-García, Cristina, Fernández-Espinilla, Virginia, Atwell, Jessica E., Sanz, Javier Castrodeza, Eiros, José M., and Sanz-Muñoz, Ivan
Published: 2024
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16. Should Advanced Friedreich’s Ataxia Be a Contraindication for Heart Transplantation? A Case Report of a Successful Procedure in a 58-Year-Old Patient

Author: María Jesús Valero, Jose L. Muñoz-Blanco, Alejandro Garrido Sanchez, Gregorio Cuerpo, Javier Castrodeza, Paula Navas, Iago Sousa, Adolfo Villa, Francisco Fernández-Avilés, and Manuel Martínez-Sellés
Subjects: Friedreich’s ataxia, heart transplantation, ethics, prognosis, neuromuscular disease, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: The information on heart transplantation (HT) in patients with Friedreich’s Ataxia (FA) is scarce, and the few published case reports are limited to young patients with mild neurological manifestations. We present the case of a 58-year-old patient with advanced FA (Scale for the Assessment and Rating of Ataxia [SARA] score 30/40), wheelchair-bound for the last 16 years and had urinary incontinence, dysarthria, and neurosensorial deafness. The patient was admitted for a refractory arrhythmic storm and had previous hypertrophic cardiomyopathy that evolved to dilated cardiomyopathy with severely reduced left ventricular ejection fraction and recurrent ventricular arrhythmias. A multidisciplinary team discussed the HT option. The patient was aware of the risks and benefits and considered worthy of the intervention, so he was listed for HT. After a successful surgical intervention, the patient had a long postoperative stay in ICU. He required a high dose of vasopressors, underwent hemofiltration for one month, suffered critical illness myopathy, had several respiratory infections and delayed tracheal extubation. Two and a half months after HT and almost five months at the hospital, the patient was successfully discharged. FA patients with severe heart conditions should be carefully evaluated by a multidisciplinary team to decide the candidacy for HT.
Published: 2022
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17. Social Distancing, Lockdown and the Wide Use of Mask; A Magic Solution or a Double-Edged Sword for Respiratory Viruses Epidemiology?

Author: Ivan Sanz-Muñoz, Sonia Tamames-Gómez, Javier Castrodeza-Sanz, José María Eiros-Bouza, and Raul Ortiz de Lejarazu-Leonardo
Subjects: influenza, respiratory syncytial virus, COVID-19, epidemic, pandemic, respiratory virus, Medicine
Abstract: The use of non-pharmaceutical interventions (NPIs), such as social distancing, lockdowns and the massive use of masks, have not only largely prevented the spread of SARS-CoV-2, but also of other respiratory viruses such as influenza or respiratory syncytial virus (RSV). This decrease has been so high that, in most countries, the influenza and RSV epidemic has not occurred. Far from being a beneficial fact, this can be problematic, since the absence of circulation of certain pathogens can lead to a decrease in herd immunity against them. This can promote the rise of more serious, longer-lasting epidemics that start sooner. To alleviate the collateral effects that may occur due to the decrease in circulation of viruses such as influenza, it is necessary to increase the production of influenza vaccines, carry out mass vaccination campaigns and focus on vaccinating the main drivers of this virus, children.
Published: 2021
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18. Adjuvanted Influenza Vaccines Elicits Higher Antibody Responses against the A(H3N2) Subtype than Non-Adjuvanted Vaccines

Author: Laura Sánchez de Prada, Iván Sanz Muñoz, Javier Castrodeza Sanz, Raúl Ortiz de Lejarazu Leonardo, and José María Eiros Bouza
Subjects: influenza A, Vaccines, adjuvanted Vaccines, Medicine
Abstract: Background: vaccination is the best approach to prevent influenza infections so far. Serological studies on the effect of different vaccine types are important to address vaccination campaigns and protect our population. In our study, we compared the serological response against influenza A subtypes using the non-adjuvanted influenza vaccine (NAIV) in adults and the elderly and the adjuvanted influenza vaccine (AIV) in the elderly. Methods: We performed a retrospective analysis by hemagglutination inhibition assay (HI) of serum samples right before and 28 days after seasonal influenza vaccination during the 1996–2017 seasons. Conclusions: The AIV presents better performance against the A(H3N2) subtype in the elderly whereas the NAIV induces a better response against A(H1N1)pdm09 in the same group.
Published: 2020
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19. Measuring the Burden of Hospitalization in Patients with Parkinson´s Disease in Spain.

Author: Ruth Gil-Prieto, Raquel Pascual-Garcia, Jesus San-Roman-Montero, Pablo Martinez-Martin, Javier Castrodeza-Sanz, and Angel Gil-de-Miguel
Subjects: Medicine, Science
Abstract: INTRODUCTION:This epidemiological survey estimates the hospitalization burden related to Parkinson´s Disease in Spain. METHODS:This observational retrospective survey was performed by reviewing data from the National Surveillance System for Hospital Data, which includes more than 98% of Spanish hospitals. All hospitalizations of patients with Parkinson´s disease that were reported from 1997-2012 were analyzed. Codes were selected using the 9th International Classification of Diseases: ICD-9-CM: 332.0. RESULTS:A total of 438,513 hospital discharges of patients with Parkinson´s Disease were reported during the study period. The annual hospitalization rate was 64.2 cases per 100,000. The average length of hospital stay was 10 days. The trend for the annual hospitalization rate differed significantly depending on whether Parkinson´s disease was the main cause of hospitalization (n = 23,086, 1.14% annual increase) or was not the main cause of hospitalization (n = 415,427, 15.37% annual increase). The overall case-fatality rate among hospitalized patients was 10%. The case fatality rate among patient´s hospitalized with Parkinson´s disease as the main cause of hospitalization was 2.5%. The hospitalization rate and case-fatality rate significantly increased with age. The primary causes of hospitalization when Parkinson´s disease was not coded as the main cause of hospitalization were as follows: respiratory system diseases (24%), circulatory system diseases (19%), injuries and poisoning, including fractures (12%), diseases of the digestive system (10%) and neoplasms (5%). The annual average cost for National Health Care System was € 120 M, with a mean hospitalization cost of €4,378. CONCLUSIONS:Parkinson´s disease poses a significant health threat in Spain, particularly in the elderly. While hospitalizations due to Parkinson´s Disease are relatively stable over time, the number of patients presenting with Parkinson´s disease as an important comorbidity has increased dramatically. Medical staff must be specifically trained to treat the particular needs of hospitalized patients suffering from Parkinson´s disease as an important comorbidity.
Published: 2016
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20. Perfil de ingresos y urgencias pediátricas en período epidémico de rotavirus en Valladolid: Utilidad de un modelo predictivo Profile of paediatric admissions and emergencies during an epidemic period of rotavirus in Valladolid [Spain]: Utility of a predictive model

Author: Francisco Javier Luquero, Cristina Hernán García, José María Eiros Bouza, Javier Castrodeza Sanz, Elisabeth Sánchez-Padilla, Fernando Simón Soria, and Raúl Ortiz de Lejarazu Leonardo
Subjects: Rotavirus, Modelo predictivo, Ingresos, Urgencias, Carga de enfermedad, Predictive model, Admissions, Emergencies, Disease burden, Public aspects of medicine, RA1-1270
Abstract: Introducción: Este estudio pretende determinar las semanas de alta circulación de rotavirus en valladolid, y comparar las características de los ingresos y urgencias en período epidémico con respecto al período no epidémico. Métodos: Se utilizaron las declaraciones al sistema de información microbiológica, el conjunto mínimo básico de datos y el registro de urgencias. Se calcularon los casos esperados para 2006 a partir de un modelo elaborado previamente. Si los casos observados superaban el umbral superior del 95% de los esperados, la semana se consideró epidémica. Se compararon las características de los ingresos y urgencias en ambos períodos. Resultados: En 2006 se diagnosticaron un 42% menos de los casos esperados. La media de ingresos diarios fue superior en período epidémico (diferencia=1,49; p=0,01), y también fue mayor la duración media del ingreso. Conclusión: La actividad del servicio de pediatría se incrementó en período epidémico, por lo que es oportuna la implantación de actividades de vigilancia, programas de prevención y control frente a rotavirus en el ámbito hospitalario.Introduction: The aim of this study was to determine the weeks of high rotavirus circulation in Valladolid (Spain) and to compare the characteristics of hospitalizations and emergencies in epidemic and nonepidemic periods. Methods: The information sources consisted of the weekly notifications to the Microbiological Information System, the Minimum Data Set, and the Emergency Registry. Expected cases for 2006 were calculated using a previously developed model. Weeks with observed cases over the upper limit of the 95% confidence interval for expected cases were considered epidemic periods. Hospitalization and emergencies in epidemic and nonepidemic periods were compared. Results: The number of cases in 2006 was 42% less than the expected number. The mean number of daily admissions was higher in epidemic periods (d=1.49; p=0.01) and the length of admissions was longer. Conclusion: The activity of the paediatric service increased during the epidemic period. Consequently, implementation of surveillance activities and prevention and control programs for rotavirus in hospitals would seem advisable.
Published: 2009

21. Factores determinantes de la estancia inadecuada en un hospital de tercer nivel Factors determining inappropriate days of stay in a third-level hospital

Author: Francisco Javier Luquero Alcalde, Sara Santos Sanz, Alberto Pérez Rubio, Sonia Tamames Gómez, M. Belén Cantón Álvarez, and Javier Castrodeza Sanz
Subjects: Hospitalización, Adecuación, Factores epidemiológicos, Hospitalization, Appropriateness, Epidemiological factors, Public aspects of medicine, RA1-1270
Abstract: Introducción: Identificar los factores asociados a un mayor riesgo de estancias inadecuadas. Material y método: Se calcularon las tasas crudas y ajustadas de inadecuación mediante regresión binomial negativa, obteniéndose los riesgos relativos para distintas variables. La recogida de datos se realizó mediante el Appropriateness Evaluation Protocol. Resultados: El 34,17% (intervalo de confianza del 95%, 33,28-35,08) de las estancias fueron inadecuadas. Las mujeres, los mayores de 65 años, los ingresos programados y las estancias en servicios médicos tuvieron más riesgo de inadecuación. La ausencia en la historia clínica de un seguimiento continuado del paciente incrementa el riesgo de inadecuación un 36%. Conclusiones: La ausencia de un registro continuado de la evolución clínica del paciente es un factor que incrementa el riesgo de estancias inadecuadas. La utilización de la binomial negativa es una alternativa válida y sencilla para el análisis de este tipo de fenómenos.Background: To identify the factors associated with a higher risk of inappropriate days of stay. Material and method: Crude and adjusted inappropriateness rates were calculated using negative binomial regression to obtain information about the relative risk of each variable. The Appropriateness Evaluation Protocol (AEP) was applied to collect information about patients' hospital stays. Results: A total of 34.17% (95%CI, 33.28-35.08) of the stays were inappropriate. Women, age older than 65 years, elective admission, and stays in medical services showed the highest inappropriateness risk. Lack of correct patient follow-up in the medical record increased the risk of inappropriateness to 36%. Conclusions: Lack of continual registration of the patient's clinical course increased the risk of inappropriate days of stay in the hospital. The use of the negative binomial is a valid and simple option for analysis of this type of phenomenon.
Published: 2008

22. Promotion of influenza vaccination in hospital workers

Author: del Rio García, Isaías, Pérez, Natán Redondo, de Castro, Mercedes Fernández, Santiago, Fernando Rescalvo, Sanz, Jose Javier Castrodeza, and Pérez-Rubio, Alberto
Published: 2022
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23. Asistencia ventricular de larga duración en España (2007-2020). I informe del registro REGALAD

Author: Manuel Gómez-Bueno, Enrique Pérez de la Sota, Alberto Forteza Gil, Daniel Ortiz-Berbel, Javier Castrodeza, María Dolores García-Cosío Carmena, Eduardo Barge-Caballero, Diego Rangel Sousa, Beatriz Díaz Molina, Rebeca Manrique Antón, Luis Almenar-Bonet, Aitor Uribarri González, Alfredo Barrio-Rodríguez, María Ángeles Castel Lavilla, Laura López-López, David Dobarro Pérez, Francisco Pastor Pérez, Virginia Burgos-Palacios, Jesús Álvarez-García, José Manuel Garrido-Jiménez, Óscar González-Fernández, Pau Codina, Amador López-Granados, Andrés Grau-Sepulveda, and José González-Costello
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023
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24. Vigilancia de la COVID-19 tras la pandemia. ¿Cómo lo hacemos?

Author: Iván Sanz-Muñoz, Javier Castrodeza Sanz, and José María Eiros
Subjects: General Medicine
Published: 2022
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25. Surveillance of COVID-19 after the pandemic. How do we do it?

Author: Iván, Sanz-Muñoz, Javier, Castrodeza Sanz, and José María, Eiros
Subjects: SARS-CoV-2, COVID-19, Humans, Public Health, General Medicine, Pandemics
Published: 2022
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26. Sacubitril/valsartan use in combination with inotropic support. An option for patients with acute heart failure

Author: Carlos Ortiz-Bautista, Eduardo Zataraín, Manuel Martínez-Sellés, Francisco Fernández-Avilés, Javier Castrodeza, and Cristian Herrera
Subjects: Inotrope, medicine.medical_specialty, Medicamento, business.industry, Enfermedad cardiovascular, medicine.disease, Heart failure, Internal medicine, medicine, Cardiology, Valsartán, Cardiology and Cardiovascular Medicine, business, Sacubitril, Valsartan, Insuficiencia cardiaca
Abstract: Sin financiación No data JCR (2021) 0.130 SJR (2021) Q4, 317/356 Cardiology and Cardiovascular Medicine No data IDR 2021 UEM
Published: 2022
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27. Comparison of 1-Year Outcome in Patients With Severe Aorta Stenosis Treated Conservatively or by Aortic Valve Replacement or by Percutaneous Transcatheter Aortic Valve Implantation (Data from a Multicenter Spanish Registry)

Author: Saldivar, Hugo González, Rodriguez-Pascual, Carlos, Parajes-Vazquez, Teresa, Montero-Magan, Marina, De la Morena, Gonzalo, Flores-Blanco, Pedro J., Fernández-Golfín, Covadonga, Lozano, Cristina, Rincón, Luis Miguel, Amorós, Carmen, Borras, Xavier, Alonso, Mario Baquero, Camacho, Eva García, Pérez, Andrés Sánchez, Dolz, Luis Martínez, Climent, Herminio Morillas, Sánchez, Jorge Sanz, Vallverdú, María Ferré, Solé, Albert Ariza, Guzmán-Martínez, Gabriela, González-Fernández, Óscar, Gómez-Doblas, Juan José, Jiménez, Antonio Arribas, Garcia Sánchez, Maria Jesús, Sánchez Fernandez, Pedro Luis, Fuentes, María Eugenia, Millán, María Victoria, Gay, Laura Galian, Ortiz, Martin Ruiz, Avanzas, Pablo, Pascual, Isaac, Morís, César, Abu-Assi, Emad, Vera, Tomás Ripoll, Pérez, Yolanda Gómez, Diaz-Castro, Oscar, Borreguero, Jesús Jimenez, Pozo, Eduardo, Antuña, Paula, Viliani, Dafne, Mogollón Jiménez, María Victoria, Gómez, Gonzalo Marcos, García, Marcelino Cortés, Orejas, Miguel Orejas, Quiles, Juan, Gunturiz, Clara, Castrodeza, Javier, Tobar, Javier, López, Javier, Garcia Gonzalez, Martin Jesús, Labrador, Eva Bernal, Ayerbe, Jorge López, Barros, Sonia María, Ruiz, Antoni Carol, Botas, Javier, García, Alberto Núñez, Girgas, Esther Sanz, Ruiz, Alfredo Bardají, Caro Martinez, Cesar S., Aguera, Alicia Gómez, Sierra, Teresa Pareja, Yarcuri, Fiorella Quinte, Rodriguez, Irene Mateo, Martínez, Maria del Pilar Zuazola, Pérez, Teresa, Arrarte Esteban, Vicente Ignacio, Garri, Francisco Sogorb, Ramirez-Marrero, Miguel A., Campaña, Sonia Ibars, Marchan, Ferrán Padilla, Rodríguez-Capitán, Jorge, Andion, Ramón, de Isla, Leopoldo Pérez, Casado, Patricia Mahía, Carrera, José Plaza, de la Villa Redondo, Bernardo García, Valencia-Serrano, Félix M., Bustos, Daniel Bravo, Lacambra-Blasco, Isaac, Isasti, Guillermo, Paves, Alicia Bautista, Pereyra, Eduardo, Pueo, Eva, Santos, Luis Cornide, Martín, Ana Garrido, Lozano, Clara Bonanad, Diaz, Javier Lopez, Calvo, Javier Castrodeza, Ruiz, Javier Tobar, Martínez-Sellés, Manuel, González-Saldivar, Hugo, de la Morena, Gonzalo, Ripoll-Vera, Tomás, Díaz-Castro, Oscar, and Osinalde, Eduardo P.
Published: 2016
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28. Promotion of influenza vaccination in hospital workers

Author: Isaías del Rio García, Natán Redondo Pérez, Mercedes Fernández de Castro, Fernando Rescalvo Santiago, Jose Javier Castrodeza Sanz, and Alberto Pérez-Rubio
Subjects: General Medicine
Published: 2022
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29. Continuous-flow left ventricular assist device: Current knowledge, complications, and future directions

Author: Javier, Castrodeza, Carlos, Ortiz-Bautista, and Francisco, Fernández-Avilés
Subjects: Heart Failure, Heart Transplantation, Humans, Heart-Assist Devices, General Medicine, Cardiology and Cardiovascular Medicine
Abstract: Long-term continuous-flow left ventricular assist devices have become a real alternative to heart transplantation in patients with advanced heart failure, achieving a promising 2-year event-free survival rate with new-generation devices. Currently, this technology has spread throughout the world, and any cardiologist or cardiac surgeon should be familiar with its fundamentals and its possible complications as well as the advances made in recent years. The aim of this review is to describe current knowledge, management of complications, and future directions of this novel heart-failure therapy.
Published: 2022
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30. Registro Español de Trasplante Cardiaco. XXXII Informe Oficial de la Asociación de Insuficiencia Cardiaca de la Sociedad Española de Cardiología

Author: Ana Pórtoles-Ocampo, José María Arizón del Prado, Laura Morán-Fernández, Manuel Martínez-Sellés, Luis García-Guereta Silva, Juan Carlos López-Azor, Álvarez González-Rocafort, Raquel López-Viella, Leticia Jimeno-San Martín, Javier Castrodeza, Miguel Llano-Cardenal, María Ángeles Castel, Gregorio Rábago-Juan-Aracil, Ferrán Gran-Ipiña, Francisco José Hernández-Pérez, Juan Delgado-Jiménez, José J. Cuenca-Castillo, Mónica Cebrián, Eduardo Zatarain, Gonzalo Barge-Caballero, Teresa Blasco-Peiró, M. Farrero, Isabel Zegrí, José González-Costello, Carlos Ortiz, María del Val Groba-Marco, Francisco González-Vílchez, Antonio García-Quintana, Pedro Caravaca, Francisco Nistal-Herrera, Víctor Donoso, Mercedes Rivas-Lasarte, María Dolores García-Cosío, Javier Tobar-Ruiz, Luis de la Fuente-Galán, Oscar Gonzalez-Fernandez, Nuria Gil-Villanueva, Rebeca Manrique-Antón, Laura López, Beatriz Díaz-Molina, Nicolás Manito, Luz Polo-López, José Luis Lambert-Rodríguez, Zorba Blázquez, Carlos Labrandero de Lera, Luis Almenar-Bonet, Carles Díez, Iago Sousa, Luis Martínez, Manuel Gómez-Bueno, José María Herrera-Noreña, María Lasala-Alastuey, Antonio Grande-Trillo, Vicens Brossa-Loidi, Iris P. Garrido-Bravo, Mario Galván-Ruiz, Paola Dolader, Inés Ponz de Antonio, Marta de Antonio, Paula Navas, Cristina Mitroi, Ignacio Sánchez-Lázaro, Amador López-Granados, Francisco J. Pastor-Pérez, Javier Segovia-Cubero, María Jesús Valero-Masa, Cristina Fidalgo-Muñiz, David Couto-Mallón, Domingo A. Pascual-Figal, María J. Paniagua-Martín, María G. Crespo-Leiro, Eduardo Barge-Caballero, José A. Vázquez de Prada, Diego Rangel-Sousa, Sol Martínez, José Manuel Sobrino-Márquez, Manuela Camino-López, Josep Roca, Elena García-Romero, Félix Pérez-Villa, Jorge García-Carreño, Sonia Mirabet-Pérez, Manuel Cobo-Belaustegui, and Miriam Juárez
Subjects: business.industry, Medicine, Cardiology and Cardiovascular Medicine, business, Humanities
Abstract: Resumen Introduccion y objetivos Se presentan las caracteristicas clinicas y los resultados de los trasplantes cardiacos realizados en Espana con la actualizacion correspondiente a 2019. Metodos Se describen las caracteristicas clinicas y los resultados de los trasplantes cardiacos realizados en 2019, asi como las tendencias de estos en el periodo 2010-2018. Resultados En 2019 se realizaron 300 trasplantes (8.794 desde 1984; 2.745 entre 2010 y 2019). Respecto a anos previos, los cambios mas llamativos son el descenso hasta el 38% de los trasplantes realizados en codigo urgente, y la consolidacion en el cambio de asistencia circulatoria pretrasplante, con la practica desaparicion del balon de contrapulsacion (0,7%), la estabilizacion del uso del oxigenador extracorporeo de membrana (9,6%) y el aumento de los dispositivos de asistencia ventricular (29%). La supervivencia en el trienio 2016-2018 es similar a la del trienio 2013-2015 (p = 0,34), y ambas mejores que la del trienio 2010-2012 (p = 0,002 y p = 0,01 respectivamente). Conclusiones Se mantienen estables tanto la actividad del trasplante cardiaco en Espana como los resultados en supervivencia en los ultimos 2 trienios. Hay una tendencia a realizar menos trasplantes urgentes, la mayoria con dispositivos de asistencia ventricular.
Published: 2021
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31. Attitudes, Perceptions and Practices of Influenza Vaccination in the Adult Population: Results of a Cross-Sectional Survey in Spain

Author: Camino Prada-García, Virginia Fernández-Espinilla, Cristina Hernán-García, Iván Sanz-Muñoz, José Martínez-Olmos, Jose M. Eiros, and Javier Castrodeza-Sanz
Subjects: Adult, Health Knowledge, Attitudes, Practice, vaccination coverage, SARS-CoV-2, Health, Toxicology and Mutagenesis, Vaccination, Public Health, Environmental and Occupational Health, COVID-19, elderly, influenza vaccine, survey, Spain, Cross-Sectional Studies, Influenza Vaccines, Surveys and Questionnaires, Influenza, Human, Humans, RNA, Viral, Female, Pandemics, Aged
Abstract: In Spain, the 2021/22 influenza season overlapped with the sixth wave of the 2019 coronavirus disease pandemic (COVID-19). Influenza is a major public health problem associated with high morbidity and mortality. The objectives of this study were to determine the knowledge, perceptions and practices of influenza vaccination in the Spanish population, coinciding with the COVID-19 pandemic, with special attention paid to people over 65 years of age. A cross-sectional study was carried out by conducting 2211 telephone interviews. It was observed that 81.6% of people ≥ 65 years were vaccinated annually or with some frequency compared to 35.5% of those under 65 years (p < 0.001). Fifty percent of Spaniards showed an intention to be vaccinated in the 2021/22 campaign, during the SARS-CoV2 pandemic. In the case of people ≥ 65 years old, this figure was 83% compared to 42% of those under 65 years old (p < 0.001). Significant predictors of intention to be vaccinated were age of 65 years or older (OR 1.8, 95% CI 1.3–2.5), female sex (OR 1.9, 95% CI 1.5–2.4), belonging to risk groups (OR 2.2, 95% CI 1.6–3.1) and having been previously vaccinated (OR 29.7, 95% CI 22.5–39.2). The main reasons for deciding to be vaccinated were the need to be protected against the virus and to be vaccinated annually. On the other hand, lack of recommendation and considering the influenza vaccine as not necessary were the main reasons for not getting vaccinated. In addition, health personnel stood out as the main source of information (32.9%) compared to traditional media (26.9%) and public administration (12.3%). This study aimed to assess and analyse the factors influencing willingness to receive influenza vaccines in the COVID-19 era among Spanish adults, as well as the main information channels and strategies to encourage vaccination.
Published: 2022
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32. Impact of COVID-19 on Adherence to Treatment in Patients with HIV

Author: Pablo Carbonero-Lechuga, Javier Castrodeza-Sanz, Iván Sanz-Muñoz, Pilar Marqués-Sánchez, Jose M. Eiros, Carlos Dueñas-Gutiérrez, and Camino Prada-García
Subjects: Health Information Management, HIV, adherence, COVID-19, antiretroviral treatments, SMAQ, Leadership and Management, Health Policy, Health Informatics
Abstract: In patients with human immunodeficiency virus (HIV), adherence to treatment is affected by the adverse effects of treatment, the presence of additional comorbidities, the complexity of dosage, and family and community support. However, one recent circumstance that was likely to have influenced therapeutic adherence was the COVID-19 pandemic and the applied containment measures. An observational retrospective study of a sample of patients with HIV was conducted to establish the relationship between sociodemographic, clinical, and pharmacological variables and therapeutic adherence before and after the pandemic. Adherence was measured using the validated simplified medication adherence questionnaire (SMAQ) and medication possession rate. A statistical analysis was performed to determine the mean, standard deviation, and median of the quantitative variables and the frequencies of the qualitative variables, and the relationship between the dependent and independent variables was analysed using the chi-squared test and Student’s t-test. No statistically significant differences were found between treatment adherence measured before and 22 months after the start of the pandemic. Sex, occupation, treatment regimen, viral load levels, and COVID-19 disease status did not influence adherence during either period. However, the age of patients with HIV had an impact on adherence during both periods (p = 0.008 and p = 0.002, respectively), with the age group under 45 years being less adherent. In addition, experiencing adverse drug reactions (ADRs) was shown to have an impact on adherence before the pandemic (p = 0.006) but not afterwards. The COVID-19 pandemic was not shown to have an impact on the degree of adherence to antiretroviral treatment in patients with HIV. Instead, adherence was influenced by patient age and ADR occurrence; therefore, measures must be taken in this regard. The SMAQ demonstrated sensitivity in assessing adherence.
Published: 2023
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33. Heart valve disease in Hurler-Scheie syndrome

Author: María del Carmen García del Rey, Javier Castrodeza, Ángel Pinto, Maria Ángeles Espinosa Castro, Cecilia Muñoz Delgado, and Francisco Fernández-Avilés
Subjects: Mucopolysaccharidosis I, Heart Valve Diseases, Humans, General Medicine, Cardiology and Cardiovascular Medicine
Published: 2022

34. Exercise right heart catheterization predicts outcome in asymptomatic degenerative aortic stenosis

Author: J. Alberto San Román, Luis H. Varela-Falcón, Carlos Veras, David Dobarro, Luis R. Goncalves-Ramírez, Lucía Vera, Gretel Varvaro, María José Coya, Carlos Gómez Alonso, Javier Castrodeza-Calvo, Carmen Martín, Javier Lopez, and Javier Tobar
Subjects: Cardiac Catheterization, medicine.medical_specialty, medicine.medical_treatment, 030204 cardiovascular system & hematology, Asymptomatic, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, Internal medicine, medicine.artery, medicine, Humans, Prospective Studies, Pulmonary wedge pressure, Cardiac catheterization, Heart Valve Prosthesis Implantation, Ejection fraction, business.industry, valvular heart disease, Hemodynamics, Stroke Volume, Aortic Valve Stenosis, General Medicine, medicine.disease, Pulmonary hypertension, Pulmonary artery, Exercise Test, Cardiology, medicine.symptom, business
Abstract: Introduction and objectives Degenerative aortic stenosis (DAS) is the most frequent valvular heart disease. It remains unclear how to identify asymptomatic DAS patients with normal left ventricular ejection fraction who have a high probability of event occurrence and would thus benefit from early intervention. Here, we describe a protocol for exercise hemodynamics in true asymptomatic patients with moderate or severe DAS and assess the prognostic value of the data obtained in this population. Methods This study involved a prospective single-centre registry of consecutive asymptomatic patients with moderate or severe DAS. Patients underwent cardiopulmonary exercise testing to confirm symptom absence during exercise and then right heart catheterization (RHC) at rest and during exercise. Events were defined as death, surgical aortic valve replacement, or transcatheter aortic valve implantation according to clinical guidelines. Results Thirty-three patients underwent baseline and exercise RHC. The mean aortic valve area was 1.08 cm2 and the aortic gradient was 39 mmHg. The mean pulmonary artery pressure was 21 mmHg with a pulmonary artery occlusion pressure of 14 mmHg and cardiac output of 5.6 L/min. The mean pulmonary artery pressure at peak exercise was 34 mmHg. After a mean follow-up of 27 months, 8 patients experienced an event (24%). There were no differences in baseline variables, aortic valve area, or cardiopulmonary exercise testing parameters between the event and event-free groups. Patients with an event did not have higher pulmonary or filling pressures after peak exercise but had lower pulmonary artery oxygen saturation on effort (median, 48% vs 57%, P = .03). Conclusions Exercise RHC is feasible and safe in this population. Peak pulmonary artery oxygen saturation might identify patients with increased risk of serious adverse events.
Published: 2020
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35. El cateterismo cardiaco derecho de esfuerzo predice eventos en los pacientes con estenosis aórtica degenerativa asintomática

Author: J. Alberto San Román, David Dobarro, Luis H. Varela-Falcón, María José Coya, Luis R. Goncalves-Ramírez, Javier Castrodeza-Calvo, Carlos Gómez Alonso, Gretel Varvaro, Carlos Veras, Carmen Martín, Lucía Vera, Javier Tobar, and Javier Lopez
Subjects: Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, medicine, 030204 cardiovascular system & hematology, Cardiology and Cardiovascular Medicine, business
Abstract: Resumen Introduccion y objetivos La estenosis aortica degenerativa es la valvulopatia mas frecuente. Aun no esta claro como identificar a los pacientes asintomaticos con fraccion de eyeccion del ventriculo izquierdo normal y alta probabilidad de eventos que por ello pudieran beneficiarse de una intervencion valvular precoz. En este estudio se describe un protocolo de hemodinamica de esfuerzo para los pacientes asintomaticos con estenosis aortica moderada o grave para evaluar su valor pronostico para esta poblacion. Metodos Estudio prospectivo unicentrico de una poblacion de pacientes con estenosis aortica moderada o grave asintomaticos. Los pacientes realizaron una ergoespirometria para confirmar la ausencia de sintomas en esfuerzo. Despues los pacientes se sometieron a un cateterismo cardiaco derecho basal y de esfuerzo. Se definio evento como muerte o necesidad de reemplazo de valvula aortica quirurgico o percutaneo basado en las guias clinicas. Resultados Se sometio a 33 pacientes a cateterismo cardiaco derecho basal y de esfuerzo. El area valvular aortica media fue de 1,08 cm2 y el gradiente aortico medio, 39 mmHg. La presion arterial pulmonar media fue de 21 mmHg, con una presion de oclusion en la arteria pulmonar de 14 mmHg y un gasto cardiaco de 5,6 l/min. La presion pulmonar media en ejercicio maximo fue de 34 mmHg. Tras un seguimiento medio de 27 meses, 8 pacientes sufrieron un evento (24%). No hubo diferencias en las variables basales, el area valvular aortica o los parametros de ergoespirometria. Los pacientes con evento no tuvieron mayores presiones pulmonares o presiones de llenado en ejercicio maximo, pero el grupo con eventos mostro menor saturacion de oxigeno en la arteria pulmonar en esfuerzo (mediana, el 48 frente al 57%; p = 0,03). Conclusiones El cateterismo cardiaco de esfuerzo es seguro y factible en esta poblacion. La saturacion de oxigeno en la arteria pulmonar en esfuerzo podria identificar a un grupo de pacientes con un aumento del riesgo de eventos adversos graves.
Published: 2020
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36. Late Electrocardiographic Changes in Patients With New-Onset Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation

Author: François Philippon, Lluis Asmarats, Josep Rodés-Cabau, Jaime Elízaga, Jaume Francisco Pascual, Ignacio J. Amat-Santos, Laurent Faroux, Gabriela Veiga-Fernandez, Marc W. Deyell, Vicenç Serra, Marina Urena, John G. Webb, Dominique Himbert, Javier Castrodeza, Thomas Couture, Victoria Cañadas-Godoy, Antonio J. Muñoz-García, Marcel Alméndarez, Luis Nombela-Franco, José M. de la Torre, Guillem Muntané-Carol, Emilie Pelletier-Beaumont, Neal S. Kleiman, Jean Bernard Masson, Felipe Atienza, and Quentin Fischer
Subjects: Male, Pacemaker, Artificial, medicine.medical_specialty, medicine.medical_treatment, Bundle-Branch Block, Comorbidity, 030204 cardiovascular system & hematology, Prosthesis, Transcatheter Aortic Valve Replacement, Electrocardiography, 03 medical and health sciences, QRS complex, Postoperative Complications, 0302 clinical medicine, Internal medicine, Atrial Fibrillation, medicine, Humans, 030212 general & internal medicine, PR interval, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Left bundle branch block, Incidence, Incidence (epidemiology), Cardiac Pacing, Artificial, Atrial fibrillation, Recovery of Function, medicine.disease, Aortic Valve, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract: This study sought to determine, in patients with new-onset persistent left bundle branch block (NOP-LBBB) after transcatheter aortic valve implantation (TAVI), the incidence and factors associated with (i) LBBB recovery and (ii) permanent pacemaker implantation (PPI) at 1-year follow-up. This was a multicenter study including 153 patients (mean age: 81 ± 5 years, 56% of women) with NOP-LBBB post-TAVI (balloon-expandable valve in 112 patients). Delta PR (ΔPR) and delta QRS (ΔQRS) were defined as the difference in PR and QRS length between baseline and hospital discharge ECG, and the relative ΔPR and ΔQRS as absolute ΔPR and ΔQRS divided by baseline PR and QRS length, respectively. The patients had a clinical visit and 12-lead ECG at 1-year follow-up. LBBB recovery was observed in 50 patients (33%), and 14 patients (9%) had advanced conduction disturbances requiring PPI during the follow-up period. No clinical or ECG variables were associated with LBBB recovery, including prosthesis type (self- or balloon-expandable valve, p = 0.563), QRS width at baseline/discharge or absolute/relative ΔQRS (p >0.10 for all). The presence of atrial fibrillation at baseline (0.026), a longer PR interval at discharge (0.009), and a longer absolute and relative ΔPR (p = 0.002 and p = 0.004, respectively) were associated with an increased risk of PPI at 1-year follow-up. In conclusion, NOP-LBBB post-TAVI resolved in one-third of patients at 1-year follow-up, but no clinical or ECG variables were associated with LBBB recovery. Conversely, a nonsinus rhythm at baseline and a longer ΔPR were associated with an increased risk of PPI within the year after TAVI.
Published: 2020
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37. Durable ventricular assist device in Spain (2007-2020). First report of the REGALAD registry

Author: Manuel Gómez-Bueno, Enrique Pérez de la Sota, Alberto Forteza Gil, Daniel Ortiz-Berbel, Javier Castrodeza, María Dolores García-Cosío Carmena, Eduardo Barge-Caballero, Diego Rangel Sousa, Beatriz Díaz Molina, Rebeca Manrique Antón, Luis Almenar-Bonet, Aitor Uribarri González, Alfredo Barrio-Rodríguez, María Ángeles Castel Lavilla, Laura López-López, David Dobarro Pérez, Francisco Pastor Pérez, Virginia Burgos-Palacios, Jesús Álvarez-García, José Manuel Garrido-Jiménez, Óscar González-Fernández, Pau Codina, Amador López-Granados, Andrés Grau-Sepulveda, and José González-Costello
Subjects: General Medicine
Abstract: This report presents the clinical characteristics, outcomes and complications of all consecutive patients implanted with a long-term mechanical circulatory support device in Spain between 2007 and 2020.Analysis of the Spanish Registry of durable ventricular assist devices (REGALAD) including data form Spanish centers with a mechanical circulatory support program.During the study period, 263 ventricular assist devices were implanted in 22 hospitals. The implanted device was an isolated continuous-flow left ventricular assist device in 182 patients (69%), a pulsatile-flow device (58 isolated left ventricular and 21 biventricular) in 79 (30%), and a total artificial heart in 2 patients (1%). The strategy of the implant was as bridge to heart transplant in 78 patients (30%), bridge to candidacy in 110 (42%), bridge to recovery in 3 (1%) and destination therapy in 72 patients (27%). Overall survival at 6, 12 and 24 months was 79%, 74% and 69%, respectively, and was better in continuous-flow left ventricular assist devices (84%, 80%, and 75%). The main adverse events related to this therapy were infections (37% of patients), bleeding (35%), neurological (29%), and device malfunction (17%).Durable ventricular assist devices have emerged in Spain in the last few years as a useful therapy for patients with advanced heart failure. As in other international registries, the current trend is to use continuous-flow intracorporeal left ventricular devices, which are associated with better results. Adverse events continue to be frequent and severe.
Published: 2022

38. Treatment of Thoracolumbar Type A3 Fractures Using a Percutaneous Intravertebral Expandable Titanium Implant: Long-term Follow-up Results of a Pilot Single Center Study

Author: David C, Noriega, Jesus, Crespo-Sanjuan, Wayne J, Olan, Ruben, Hernandez-Ramajo, Douglas P, Bell, J Javier Castrodeza, Sanz, Gregorio de Jesus Labrador, Hernandez, Israel, Sanchez-Lite, and Francisco, Ardura
Subjects: Titanium, Fracture Fixation, Internal, Lumbar Vertebrae, Treatment Outcome, Humans, Spinal Fractures, Pilot Projects, Prospective Studies, Thoracic Vertebrae, Follow-Up Studies
Abstract: There are controversies about the optimal management of AO subtype A3 burst fractures. The most common surgical treatment consists of posterior fixation with pedicle screw and rod augmentation. Nevertheless, a loss of correction in height restoration and kyphotic reduction has been observed.The aim of this study was to assess long-term outcomes of a minimally invasive technique using a percutaneous intravertebral expandable titanium implant (PIETI).This prospective, single center, pilot study was carried out on a consecutive case series of 44 patients with acute (2 weeks) traumatic thoracolumbar fractures AO type A3. The average follow-up was 5.6 years.A single center in Castilla y Leon, SpainMETHODS: Clinical outcomes (pain intensity on visual analog scale [VAS], Oswestry Disability Index [ODI], analgesic consumption) and radiographic outcomes (anterior/mid/posterior vertebral body height, vertebral area, local kyphosis angle, traumatic regional angulation) were analyzed before surgery, at one month after surgery, and at the end of the follow-up period.At one-month postsurgery, significant improvements in VAS score and ODI score were observed. PIETI achieved significant vertebral body height restoration with median height increases of 2.9 mm/4.3 mm/2.3 mm for anterior/middle/posterior parts, respectively. Significant correction of the local kyphotic angle and improvement of the traumatic regional angulation were accomplished. All these improvements were maintained throughout the follow-up period. The only complication reported was a case of cement leakage.In our opinion, the main limitation of the study is the small number of patients. However, the sample is superior to that shown in other papers.This study showed that using a PIETI in the treatment of fractures type A3 is a safe and effective method that allows marked clinical improvement, as well as anatomical vertebral body restoration. Unlike with other treatments, results were maintained over time, allowing a better long-term clinical and functional improvement. The rate of cement leakage was lower than other reports.
Published: 2021

39. Late arrhythmias in patients with new-onset persistent left bundle branch block after transcatheter aortic valve replacement using a balloon-expandable valve

Author: Josep Rodés-Cabau, Emilie Pelletier-Beaumont, Neal S. Kleiman, François Philippon, Victoria Vilalta, Dominique Himbert, Eduard Fernandez-Nofrerias, Ignacio J. Amat-Santos, Francisco Campelo-Parada, Gabriela Veiga-Fernandez, Pierre Mondoly, Javier Castrodeza, Vicenç Serra, Marina Urena, Guillem Muntané-Carol, Chekrallah Chamandi, Thibault Lhermusier, Victoria Cañadas-Godoy, José M. de la Torre Hernández, Luis Nombela-Franco, Jaume Francisco-Pascual, and Pierre Baudinaud
Subjects: Bradycardia, Male, medicine.medical_specialty, Time Factors, Heart block, medicine.medical_treatment, Bundle-Branch Block, 030204 cardiovascular system & hematology, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, Valve replacement, Risk Factors, Physiology (medical), Internal medicine, Clinical endpoint, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, SAPIEN 3, Prospective cohort study, Aged, 80 and over, Pacemaker implantation, business.industry, Left bundle branch block, Incidence, Atrial fibrillation, Aortic Valve Stenosis, Transcatheter aortic valve replacement, medicine.disease, Bradyarrhythmia, Prosthesis Failure, Treatment Outcome, Aortic Valve, Heart Valve Prosthesis, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Atrioventricular block, Follow-Up Studies
Abstract: BACKGROUND The arrhythmic burden after discharge in patients with new-onset left bundle branch block (LBBB) undergoing transcatheter aortic valve replacement (TAVR) with the balloon-expandable SAPIEN 3 (S3) valve remains largely unknown. OBJECTIVE The purpose of this study was to determine the incidence of late arrhythmias in patients with new-onset LBBB undergoing TAVR with the balloon-expandable S3 valve. METHODS This was a multicenter, prospective study that included 104 consecutive TAVR patients with new-onset persistent LBBB following TAVR with the S3 valve. An implantable cardiac monitor (Reveal XT, Reveal LINQ) was implanted before discharge. The primary endpoint was the incidence of high-degree atrioventricular block or complete heart block (HAVB/CHB). RESULTS A total of 40 patients (38.5%) had at least 1 significant arrhythmic event, leading to a treatment change in 17 (42.5%). Significant bradyarrhythmias occurred in 20 of 104 patients (19.2%) (34 HAVB/CHB episodes, 252 severe bradycardia episodes), with 10 of 20 patients (50%) exhibiting at least 1 episode of HAVB/ CHB. Most HAVB/CHB episodes ( 60%) occurred within 4 weeks after discharge. Nine patients ( 8.7%) underwent permanent pacemaker implantation at 12 months based on the Reveal findings (6 HAVB/CHB, 3 severe bradycardia). CONCLUSION S3 valve recipients with new-onset LBBB have a high arrhythmic burden, with more than one-third of patients exhibiting at least 1 significant arrhythmic episode within 12 months (HAVB/ CHB in 10% of patients). About one-half of bradyarrhythmic events occurred within 4 weeks after discharge. These results should inform future strategies on the use of continuous electrocardiographic monitoring in TAVR S3 patients with new conduction disturbances following the procedure.
Published: 2021

40. Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Author: Jesús Rodríguez-Baño, Jerónimo Pachón, Jordi Carratalà, Pablo Ryan, Inmaculada Jarrín, María Yllescas, José Ramón Arribas, Juan Berenguer, Esther Aznar Muñoz, Pedro Gil Divasson, Patricia González Muñiz, Clara Muñoz Aguirre, Marta Díaz Menéndez, Fernando de la Calle Prieto, Marta Arsuaga Vicente, Elena Trigo Esteban, Ignacio Pérez Valero, Rosa de Miguel Buckley, Julen Cadiñaños Loidi, Beatriz Diaz Pollan, Luz Martín Carbonero, Juan Carlos Ramos Ramos, Belén Loeches Yagüe, Rocío Montejano Sánchez, Juan González García, Julio García Rodríguez, Margarita Ramírez, Isabel Gutiérrez, Francisco Tejerina, Teresa Aldámiz-Echevarría, Cristina Díez, Chiara Fanciulli, Leire Pérez-Latorre, Blanca Pinilla, Juan Carlos López, Ana Such Diaz, Elena Álvaro Alonso, Juan Torres Macho, Guillermo Cuevas Tascon, Eva Jiménez González de Buitrago, Fátima Brañas Baztán, Jorge Valencia de la Rosa, Mario Pérez Butragueño, Inés Fernández Jiménez, Gemma Muñiz Nicolás, Antonia Sepúlveda Berrocal, Alberto Gato Díez, María Pilar Toledano Sierra, María Paz García Butenegro, Ana Isabel Peláez Ballesta, Elena Morcillo Rodríguez, Isidoro Fernández Romero, Cristina Peláez Ballesta, María Isabel Guirado Torrecillas, Josune Goikoetxea Agirre, Elena Bereciartua Bastarrica, Laura Guio Carrión, Regino Rodríguez Álvarez, Marta Ibarrola Hierro, Isabel A. Pérez Hernández, Inés Pérez Zapata, Sergio Román Soto, Mohamed Kallouchi, Juan Ramón Domínguez Vicent, Rafae Silvariño Fernández, Jon Ugalde Espiñeira, Ainhoa Sanjuan López, Silvia García Martínez, Mikel Temprano Gogenola, Víctor Asensi, Silvia Suárez, Lucia Suárez, Carmen Yllera, María Rivas-Carmenado, Alberto Romero-Palacios, Jesús Ruiz Aragón, Patricia Jiménez Aguilar, Ma Luisa Fernández Ávila, Rosario Castilla Ortiz, Vanesa Alende Castro, Cristina Pérez García, Marta Fernández Morales, María Lorena María Valle Feijoo Begoña Rodríguez Ferreira, Joan Gómez-Junyent, Judit Villar-García, Inmaculada López-Montesinos, Itziar Arrieta-Aldea, Abora Rial-Villavecchia, Elisa García Vázquez, Aychel Elena Roura Piloto, Encarnación Moral Escudero, Alicia Hernández Torres, Helena Albendín Iglesias, David Vinuesa García, Clara Martínez Montes, Francisco Javier De la Hera Fernández, Francisco Anguita Santos, Andrés Ruiz Sancho, Vicens Díaz de Brito Fernández, Montserrat Sanmarti Vilamala, Sergio España Cueto, Daniel Molina Morant, Araceli González-Cuevas, Joel Elías Chara Cervantes, Guillem Policarpo Torres, Meritxell Ortega Montoliu, Mònica Angerri Nadal, Ariadna De Genover Gil, Eleni Patera, Rita Godoy Lorenzo, Evangelia Anna María Zioga, Virginia Isern Fernández, Carlos Enrique Sabbagh Fajardo, Ana Ferrer Ribera, Carlos Bea Serrano, Rosa Oltra Sempere, Sara Vela Bernal, Paloma Albiol Viñals, Miguel Pedromingo Kus, María Ángeles Garcinuño, Silvana Fiorante, Sergio Pérez Pinto, Alexandra de la Vega, María Carmen Fariñas Álvarez, Claudia González Rico, Francisco Arnaiz de las Revillas, Teresa Giménez, Jorge Calvo, Yolanda Meije Castillo, Alejandra Duarte Borges, Júlia Pareja Coca, Mercedes Clemente Presas, Xavier Sanz Salvador, Ma Teresa Pérez Rodríguez, Adrián Sousa, Alexandre Pérez González, Rebeca Longueira, Alejandro Araujo, Blanca Alonso Martínez, Laura García Escudero, Sara Lidia Kamel Rey, David Roa Alonso, Juan Pablo Avilés Parra, Iván Pelegrín Senent, Rosana Rouco Esteves Marques, Laia Raich Montiu, Jessica Souto Higueras, Manuel Alejandro Gálvez Bobadilla, Jorge Parra Ruiz, Violeta Ramos Sesma, Sara Velasco Fuentes, Laura García Pereña, Alfonso Lluna Carrascosa, Sergio Gilaberte Reyzábal, Mónica Liébana Gómez, Juan Salillas Hernando, Alberto Serrano Martínez, Miguel Torralba González de Suso, Patricia Martínez Martín, Isabel Rábago Lorite, Patricia González-Ruano Pérez, Beatriz Pérez-Monte Mínguez, Ángeles García Flores, Pere Comas Casanova, Andrea Martín Plata, Sergio Manuel Santana Báez, Oscar Sanz Peláez, Karim Mohamed Ramírez, José María Robaina Bordón, Helem Haydeé Vílchez Rueda, Melchor Riera Jaume, Gemma Mut Ramon, Meritxell Gavalda Manso, Lluis Planas Bibiloni, Laura Castelo Corral, Lucía Ramos Merino, Efrén Sánchez Vidal, María Rodríguez Mayo, Enrique Míguez Rey, José M. García de Lomas Guerrero, Javier De la Torre Lima, Ana Correa Ruiz, Fernando Fernández Sánchez, Nicolás Jiménez-García, José Luis Sierra-Monzón, Borja Gracia-Tello, María Hernández-Bonaga, Galadriel Pellejero, Marta Asín-Corrochano, Lucia Boix Palop, Esther Calbo, Cristina Badía, Beatriz Dietl, Gómez Lucía, Ángel Domínguez-Castellano, María José Ríos-Villegas, María D. del Toro, Zaira R. Palacios Baena, Elena Salamanca-Rivera, Elena Marín, Virginia Almadana, Salvador Pérez-Galera, Luisa González-Iglesias, Gabriela Abelenda-Alonso, Claudia Álvarez-Pouso, Francesc Escrihuela, Carlota Gudiol, Laia Lorenzo-Esteller, Jordi Niubó, Daniel Podzamczer, Miquel Pujol, Alexander Rombauts, Miguel Salvert Lletí, Ricardo Gil Sánchez, Marta Jiménez Escrig, Laura Parra Gómez, Mariona Tasias Pitarch, Marta Navarro Vilasaró, María Luisa Machado Sicilia, Aina Gomila Grange, Sonia Calzado Isbert, Nerea Carrasco Antón, Elizabet Petkova-Saiz, Alfonso Cabello Úbeda, Miguel Górgolas Hernández-Mora, Olga Sánchez-Pernaute, Carlos Dueñas Gutiérrez, Javier Martin Guerra, José Javier Castrodeza Sanz, Virginia Fernández Espinilla, Laura Rodríguez Fernández, Juan González-Moreno, Aroa Villoslada Gelabert, María Antonia Ribot Sanso, María Victoria Fernández-Baca, Almudena Hernández Milian, Miguel Ángel Morán Rodríguez, Zuriñe Ortiz de Zárate Ibarra, José Joaquin Portu Zapirain, Ester Saez de Adana Arroniz, Juan Carlos Gainzarain Arana, Olga Meca Birlanga, Ma Jesús del Amor Espín, Montserrat Viqueira González, Josefina García García, Onofre Martínez Madrid, Enrique Bernal Morell, Antonia Alcaraz, Ángeles Muñoz, Ignacio Pina, Vicente de la Rosa, Tamara Caínzos Romero, Sabela Sánchez Trigo, Ana Isabel Mariño Callejo, Hortensia Álvarez Díaz, Nieves Valcarce Pardeiro, Adriana Sánchez Serrano, Diana Piñar Cabezos, Eva Pilar García Villalba, Carmen Aguayo Jiménez, María Ruíz Campuzano, Virginia Naranjo Velasco, Marta Santos Peña, Juan Mora Delgado, Israel Sevilla Moreno, Cristina Lojo Cruz, Xabier Kortajarena Urkola, José Antonio Iribarren Loyarte, María Jesús Bustinduy Odriozola, Maialen Ibarguren Pinilla, Ignacio Álvarez Rodríguez, Francisco Javier Martínez Marcos, Francisco Javier Rodríguez Gómez, Isabel Asschert Agüero, Francisco Muñoz Beamud, Antonio José Ruiz Reina, Jara Llenas-García, Inmaculada González-Cuello, Elena Hellín-Valiente, Esther Martínez Birlanga, José Manuel Tafalla Torres, Jorge Calderón Parra, Gabriela Escudero López, Isabel Gutiérrez Martín, Ane Andrés Eisenhofer, Sonia García Prieto, Raquel Álvarez Franco, Daniel Roger Zapata, Blanca Martínez Cifre, Elena Aranda Rife, Irene Martín Rubio, André Barbosa Ventura, Javier Garrido, Concepción Gonzalo, Iván Piñero, Nieves de la Cruz Felipe, Eva Talavera García, Marta Lamata Subero, Paula Mendoza Roy, María Soledad García de Carlos, Justo Lajusticia Aisa, Lorea Arteche Eguizabal, Ainhoa Urrutia Losada, Saioa Domingo Echaburu, Pedro Ángel Cuadros Tito, Gurutz Orbe Narváez, Ma del Carmen Liébana Martos, Carolina Roldán Fontana, Carmen Herrero Rodríguez, Gaspar Duro Ruiz, Santiago Pérez Parra, Arantzazu Mera Fidalgo, Miquel Hortos Alsina, Ana Alberich Conesa, Lourdes Bladé Vidal, Nicolás Merchante Gutiérrez, Eva León Jiménez, Reinaldo Espíndola Gómez, María Erostarbe Gallardo, Pedro Martínez Pérez-Crespo, José Miguel Cisneros, Manuela Aguilar-Guisado, Teresa Aldabó, Claudio Bueno, Elisa Cordero-Matía, Ana Escoresca, Carmen Infante, Martín Guillermo, Sonsoles Salto, Francesca Gioia, Pilar Vizcarra, Jesús Fortún Abete, Pilar Martín Dávila, Santiago Moreno Guillén, José A. Oteo Revuelta, Concepción García-García, Paula Santibañez Sáenz, Cristina Cervera Acedo, José M. Azcona Gutiérrez, José María Reguera Iglesias, Antonio Plata Ciezar, Lucia Valiente de Santis, Beatriz Sobrino Diaz, Juan Diego Ruiz Mesa, Ministerio de Ciencia e Innovación, Fundación SEIMC/GeSIDA, Instituto de Salud Carlos III - ISCIII, European Regional Development Fund (ERDF/FEDER), Red Española de Investigación en SIDA, Red Española de Investigación en Patología Infecciosa, UAM. Departamento de Medicina, UAM. Departamento de Medicina Preventiva y Salud Pública y Microbiología, Universidad de Cantabria, SAM-COVID Study Group, [Rodríguez-Baño,J] Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, Sevilla, Spain. [Rodríguez-Baño,J, Pachón,J] Departamento de Medicina, Universidad de Sevilla, Spain. [Rodríguez-Baño,J, Pachón,J] Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain. [Pachón,J] Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Sevilla, Spain. [Carratalà,J] Servei de Malalties Infeccioses, Hospital Universitari de Bellvitge, Barcelona, Spain. [Carratalà,J] Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, Spain. [Carratalà,J] Universitat de Barcelona, Barcelona, Spain. [Ryan,P] Servicio de Medicina Interna, Hospital Universitario Infanta Leonor, Madrid, Spain. [Jarrín,I] Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain. [Yllescas,M] Fundación SEIMC/GeSIDA, Madrid, Spain. [Arribas,JR] Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain. [Arribas,JR] Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain. [Berenguer,J] Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain. [Berenguer,J] Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain., Ministerio de Ciencia e Innovación (España), Instituto de Salud Carlos III, Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF), Red de Investigación Cooperativa en Investigación en Sida (España), Red de Investigación Cooperativa en Investigación en Patología Infecciosa (España), Gilead Sciences, ViiV Healthcare, AbbVie Pharmaceuticals, Merck & Co, Janssen Biotech, Teva Pharmaceutical Industries, Ministerio de Ciencia, Innovación y Universidades (España), European Commission, Universidad de Sevilla. Departamento de Medicina, Instituto Carlos III (España), and Unión Europea
Subjects: 0301 basic medicine, Male, law.invention, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], chemistry.chemical_compound, 0302 clinical medicine, Organisms::Viruses::RNA Viruses::Nidovirales::Coronaviridae [Medical Subject Headings], Randomized controlled trial, law, Adrenal Cortex Hormones, Clinical endpoint, Medicine, 030212 general & internal medicine, Hospital Mortality, Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Demography::Vital Statistics::Mortality [Medical Subject Headings], Adrenocortical hormones, Hazard ratio, General Medicine, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Intubation::Intubation, Intratracheal [Medical Subject Headings], Middle Aged, Tocilizumab, Hospitalization, Infectious Diseases, Treatment Outcome, Diseases::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections [Medical Subject Headings], Drug Therapy, Combination, Female, Cohort study, Microbiology (medical), medicine.medical_specialty, Diseases::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections::Severe Acute Respiratory Syndrome [Medical Subject Headings], Combination therapy, Medicina, Hyperinflammatory state, 030106 microbiology, Estudios de cohortes, Antibodies, Monoclonal, Humanized, Article, 03 medical and health sciences, Internal medicine, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies [Medical Subject Headings], Intubation, Intratracheal, Mortalitat, Humans, Corticosteroids, Mortality, Corticoesteroides, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings], Aged, Proportional Hazards Models, Retrospective Studies, Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings], Inflammation, business.industry, SARS-CoV-2, COVID-19, Odds ratio, Chemicals and Drugs::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones [Medical Subject Headings], Corticosteroides, COVID-19 Drug Treatment, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Propensity Score [Medical Subject Headings], chemistry, Spain, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Propensity score matching, Mortalidad, Monoclonal antibodies, business, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Inflammation [Medical Subject Headings], Anticossos monoclonals
Abstract: © 2020 The Author(s)., [Objectives]: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters., [Methods]: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs)., [Results]: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22–0.47; p < 0.001) for tocilizumab, 0.82 (0.71–1.30; p 0.82) for IHDC, 0.61 (0.43–0.86; p 0.006) for PDC, and 1.17 (0.86–1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02–0.17; p < 0.001)., [Conclusions]: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situation., IJ has received honoraria for participating in an advisory board from Gilead Sciences, and for educational activities from ViiV. JB has received research grants from AbbVie, Gilead Sciences, Merck, and ViiV, and honoraria for being a speaker or advisory board participation from AbbVie, Gilead Sciences, Janssen, Merck, and ViiV. JRA received fees for participating in an advisory board, being a speaker, and research grant support from Viiv, Janssen, Gilead, MSD, Teva, Alexa and Serono. PR is involved as speaker or advisory board participant for Gilead Sciences, AbbVie and ViiV. JR-B, JP, JC and MY have no conflicts of interest to declare. SAM-COVID was funded by Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (COV20/01031) co-funded by European Union (ERDF/ESF, “Investing in your future”) and Fundación SEIMC/GeSIDA. In addition, Juan Berenguer, Jesús Rodríguez-Baño, Inmaculada Jarrín, Jordi Carratalá, Jerónimo Pachón, and José R Arribas received funding for research from Plan Nacional de I+D+i 2013-2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades – co- financed by European Development Regional Fund “A way to achieve Europe”, Operative program Intelligent Growth 2014–2020 through the networks: Spanish AIDS Research Network (RIS) [RD16/0025/0017 (JB), RD16/0025/0018 (JRA), RD16/0025/00XX (IJ)] and Spanish Network for Research in Infectious Diseases (REIPI)[RD16/0016/0001 (JRB), RD16/0016/0005 (JC), and RD16/0016/0009 (JP).
Published: 2021

41. Arrhythmic burden in patients with new-onset persistent left bundle branch block after transcatheter aortic valve replacement: 2-year results of the MARE study

Author: Gabriela Veiga-Fernandez, Jaume Francisco Pascual, Marina Urena, Josep Rodés-Cabau, Emilie Pelletier-Beaumont, Javier Castrodeza, José M. de la Torre Hernández, Neal S. Kleiman, Dominique Himbert, John G. Webb, Vicenç Serra, Antonio J. Muñoz-García, Felipe Atienza, Marc W. Deyell, Jean Bernard Masson, François Philippon, Jaime Elízaga, Victoria Cañadas-Godoy, Luis Nombela-Franco, Guillem Muntané-Carol, Ignacio J. Amat-Santos, and Lluis Asmarats
Subjects: Tachycardia, Bradycardia, medicine.medical_specialty, medicine.medical_treatment, 030204 cardiovascular system & hematology, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, Physiology (medical), Internal medicine, medicine, 030212 general & internal medicine, Prospective cohort study, Bradyarrhythmias, Pacemaker implantation, Left bundle branch block, business.industry, Atrial fibrillation, medicine.disease, Transcatheter aortic valve replacement, Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Atrioventricular block
Abstract: Aims We determined the incidence and type of arrhythmias at 2-year follow-up in patients with new-onset persistent left bundle branch block (LBBB) following transcatheter aortic valve replacement (TAVR). Methods and results Multicentre prospective study including 103 consecutive patients with new-onset persistent LBBB post-TAVR (SAPIEN XT/3: 53; CoreValve/Evolut R: 50). An implantable cardiac monitor (Reveal XT, Reveal Linq) was implanted before hospital discharge and patients had continuous monitoring for up to 2 years. Arrhythmic events were adjudicated in a central core lab. 1836 new arrhythmic events (tachyarrhythmias: 1655 and bradyarrhythmias: 181) occurred at 2 years. Of these, 283 (15%) occurred beyond 1 year (tachyarrhythmias 212, bradyarrhythmias 71) in 33 (36%) patients, without differences between valve type. Most late (>1 year) arrhythmic events were asymptomatic (94%) and led to a treatment change in 17 (19%) patients. A total of 71 late bradyarrhythmias [high-degree atrioventricular block (HAVB): 3, severe bradycardia: 68] were detected in 17 (21%) patients. At 2 years, 18 (17%) patients had received a permanent pacemaker (PPM) or implantable cardiac-defibrillator. PPM implantation due to HAVB predominated in the early phase post-TAVR, with only 1 HAVB event requiring PPM implantation after 1 year. Conclusion Patients with new-onset LBBB post-TAVR exhibited a very high burden of arrhythmic events within the 2 years post-procedure. While new tachyarrhythmic events were homogeneously distributed over time, the vast majority of new HAVB episodes leading to PPM implantation occurred early after the procedure. These results should help to guide the management of this challenging group of patients. (clinicaltrials.gov: NCT02153307)
Published: 2021

42. Identification and validation of clinical phenotypes with prognostic implications in patients admitted to hospital with COVID-19: a multicentre cohort study

Author: Jaime Fernández-Bujarrabal Villoslada, Beatriz Dietl Gómez-Luengo, Daniel Ortiz-Sánchez, José Ramón Blanco Ramos, Bartolomé Gómez-Arroyo, Martín Sebastián Ruiz Grinspan, Ester Sáez de Adana Arróniz, Daniel Daniel López, Judit Villar-García, Begoña De Dios García, Josefina García García, Nuria Rabella García, Ana Rodríguez-Revillas, Lydia Martín González, Mercedes San Franco, Elena Martinez Robles, Teresa González Alegre, Elena Morcillo Rodríguez, Oriol Gasch Blasi, Laura Prieto Pérez, Isabel Jiménez Martínez, Elena Isaba Ares, Ricardo Deza-Palacios, Helena Mendez del Sol, Melchor Riera Jaume, Mercedes Rodriguez-Gutiérrez, Daniel Podzamczer, Mikel Urroz, Luis Ramos Ruperto, María Paniagua, Sergio Alcolea-Batres, Mar Masiá Canuto, Rubén Soriano-Arroyo, Paloma Merino Amador, Berta Antón-Huguet, Gabriela Alcaraz, Pablo Ryan, Carlos Franco, Leyre Díez-Porres, Juan Carlos Figueiras, Sara Lidia Kamal, Mónica Hernández, Lorena Barrera-López, Germán Ramírez-Olivencia, Kapil Laxman Nanwani Nanwani, Alberto Oreja, Montserrat Laguno, José Javier Castrodeza Sanz, Belén Loeches Yagüe, Maria Vargas, Luis Eduardo López-Cortés, Isabel Gutiérrez, Sara Vela Berna, P. Martín, Miguel Pedromingo Kus, Jesús Sanz Sanz, Mº Antonia Sepúlveda Berrocal, Carmen Yera Bergua, Juan Cuadros González, Julen Cadiñanos Loidi, Josefa Serralta Buades, María Concepción Prados Sánchez, Francesca Gioia, Iris Pedrola Gorrea, Francisco Arnaiz de las Revillas, Xabier Kortajarena Urkola, Laia Lorenzo-Esteller, Ruth Bravo-Lizcano, Angel Iniesta, Sofía González-García, Belén Martínez López, Agustín Rojas-Vieyra, Concepción García García, Raquel Cavallé-Pulla, Lucía Gómez García, Alicia Herrero, Carlos Jesús Dueñas Gutiérrez, Loreto Vidaur Tello, Carmen Fernández-Capitán, Victoria Lo-Iacono García, Cecilia Gómez-Domínguez, Adalgisa Falcone, María José Ruiz Rodríguez, Arancha Castellano, Miquel Hortos Alsina, María Concepción Nuñez, María Luisa Fernández Vidal, Jésica Abadia Otero, Natalia Moya-González, Albert Sabater Gil, Pedro de la Oliva, Ylenia María Conde-Alonso, Laura Castelo Corral, José Mº García de Lomas Guerrero, Verónica Pérez-Blanco, Isabel San Juan, Martina Archinà, Júlia Sellarés, Juan Carlos Ramos, Cintia María Martínez Mateu, Belén Fernández-Puntero, Andrea Torrecillas-Mainez, Luis Falgueras López, Carlos Carpio-Segura, María Gandullo-Moro, Francisco Abellán Martínez, Cristina Díez, Pilar Martín Dávila, Silvia Gómez-Zorrilla, María Pilar García García, Renzo Tejada-Sorados, María Dolores del Toro, E. Álvarez-Rojas, Gema Muñiz, Lucía Cajuela, María Novella Mena, Estel Pons Viñas, Andrea Pérez Rodríguez, Benito Almirante, Mónica Gozalo, Patricia Girón De Velasco-Sada, Camilo Sanz Zamudio, Ángeles García Flores, Joaquín López-Contreras González, Blanca Fabre-Estremera, Pelayo Fernández Cidón, María Martínez-Redondo, Paula Alejandra Hernández-Liebo, Juan Herrero, Marta Duque-Alcorta, María Teresa García Morales, Concepción Amador Prous, Alex Soriano, Raquel Hernando Nieto, Raquel Álvarez Franco, Alfonso Cabello Úbeda, Luis Force Sanmartín, Laura Mao Martín, Daniel Prieto-Arribas, Mario Pérez-Butragueño, Pere Domingo Pedrol, Henar Serrano-Martín, Mónica Zubimendi, M. Rodríguez-Rubio, David Pujol-Pocull, Manuel García-Gutiérrez, Carlos Manrique de Lara, Lucy Abella Vázquez, Marta Navarro Vilasaró, Carlota Cascajares-Sanz, Berta Torres, Daniel Ceniza-Pena, Isidro Moreno Gómez-Limón, María Rodríguez Mahía, Alí Martakoush, Antonio Buño-Soto, Patricia Serrano de la Fuente, Claudia González Rico, Teresa Pedraz, Conchita Pérez-Jorge Peremarch, Elena Trigo Esteban, Rosana Rouco Esteves Marques, Juan Mora Delgado, Inés Pérez Zapata, Sandra Pérez-Recio, María Ángeles Domínguez, Manuel Cervantes García, Francisco Reinoso-Lozano, M. Martí De Gracia, Carmina Oltra, Beatriz Pérez-Monte Mínguez, Guillermina Bejarano-Redondo, Sara Heili Frades, María Paz García Butenegro, Miguel Torralba González de Suso, Elena Álvaro-Alonso, Víctor J Moreno Cuerda, Gonzalo Garzón, Marcelo Daltro-Lage, Alberto Serrano Martínez, José María Aguado, Mar Mosquera, Ruth Figueroa Cerón, Juan Carlos Martin Gutiérrez, Javier Oliver Ortega, Esteban Martínez, Cristina Gómez-Ayerbe, Nerea Carrasco Antón, María Carmen Fariñas Álvarez, José Antonio Ruiz, Justo Menéndez, Lucía Díaz, José L. Casado, Pilar Vizcarra, Javier Veganzones, Miguel Ángel Moran Rodríguez, Mercedes López-Martinez, Emilio Letang, Paloma Romero Gallego-Acho, Julia Vasquez-Manau, Alexander Rombauts, Marta Robledo del Prado, Luis Puente, Beatriz Alvarez, Juan Emilio Losa García, José Tomas Algado Rabasa, Rafael Torres Perea, Angélica Rivera-Núñez, Esther Expósito Palomo, Antonio J. Carcas, Lucía Platero-Dueñas, Irene Martín Rubio, Miguel Salavert Lletí, Claudia García-Vaz, Antonio Martínez-Verdasco, Jorge Díaz-Garzón, Javier Nieto Arana, Fernando Cadenas-Gota, Richard Rojas, Abelardo García de Lorenzo, Juan Carlos López, Pedro Luis Martinez Hernández, Manuela de Pablos-Gómez, Pablo Alonso, Enrique Seco, María García-López, Lorena López-Corcuer, Celia Blasco-Andres, Delia Romera-Cano, José M. Azcona Gutiérrez, Almudena Gutiérrez-Arroyo, Paula Mendoza Roy, Ignacio De los Santos Gil, Miguel Angel Sánchez-Castellano, Sara Medrano Pardo, Mikel del Álamo Martínez de Lagos, Rocío Martínez Avilés, Elisabet Martínez-Cerón, José Manuel Vázquez Comendador, Marta Virgós-Varela, Alejandra Álvarez Brandt, Carmen Herrero Rodríguez, Jorge Martínez Jordán, Antonio Rezusta López, Marta Vizcaíno Callejón, Manuela Simon-Velasco, Jorge Ignacio Alonso-Eiras, Elisa García Vázquez, Mercè Gurguí Ferrer, Mónica González Bardanca, Nataly Cancelliere-Fernández, José Luis Díaz de Tuesta del Arco, María Larrosa, Alejandro García García, Carmen Román-Hernández, Elena Calvin-García, José Sanz Moreno, Miguel Silvestre-Niño, Nieves Valcarce Pardeiro, Maria Teresa Corcuera-Pindado, Enrique Monteoliva, Aina Gabarrell Pascuet, Elena María Aranda Rife, Aina Gomila Grange, Alba Alastrué Violeta, Daniel Roger Zapata, Jaime Montserrat, Eduardo Malmierca Corral, Marco Palma, Blanca Martínez Cifre, Gema Domínguez de Pablos, Emilio Cuesta, Eva Perales, Silvia Hernáez Crespo, Juan Torres-Macho, Adrián Sánchez Montalvá, Rocío Montejano Sánchez, Eva Van den Eynde Otero, Silvia Castañeda Espinosa, Virginia Pérez Doñate, Adriana Hernández Belmonte, Laura Iglesias Llorente, María Sanz de Pedro, Juan Espinosa Pereiro, Lubna Dani Ben-Abdellah, Raquel Barrós González, Iván Piñero, Araceli López-Tofiño, Ana Such-Diaz, Karim Mohamed Ramírez, Pilar Toledano Sierra, Rebeca Izquierdo, Guillermo Cuevas, Andrés Felipe Cardona Arias, Ileana Gabriela-Tomoiu, David Vinuesa García, Ander González Sarria, Stephan Stuart, José María Fernández, Javier Torres-Cortés, Elisabet Delgado Sánchez, María Varela-Cerdeira, Gemma Bassani, Berta Román Bernal, Isabel García, Paula Betancort de la Torre, Yolanda Martínez-Abad, Beatriz Arizcun, Juan José Cabanillas-Martín, Guillermo Estrada Fernández, Oscar del Río Pérez, Inmaculada Martín Pérez, Andony García, Luis Gómez-Carrera, Alexander Agrifoglio, Alberto M. Borobia, Jordi Niubó, Vanessa Alende Castro, Lara Montes Andújar, Alexandra De la Vega, Efrén Sánchez Vidal, Isabel A. Pérez Hernández, Laura Frade-Pardo, Ana Josefa Tebar-Martinez, Silvia Álvarez Kaelis, Sara De la Fuente Moral, Luz Martin Carbonero, Juan Cantón De Seoane, María Dolores Montero-Vega, Juan Carlos Gainzarain Arana, Sergio España Cueto, Rocío Nuñez-Cabetas, María Sánchez-Martín, Constanza Muñoz Hornero, Ana Gómez-Zamora, Javier Díaz Luperena, Patricia González-Donapetry, José Miguel Cisneros, Lucía Hernández-Rivas, Patricia González Ruano, Andrea Espigares Correa, Rocío González-León, Nicolás García-Arenzana, Omar Cervera, Andrés Canut Blasco, Ana Isabel Cañabate, Mercedes Villarreal García-Lomas, Melania Íñigo Pestaña, Maria Álvarez de Castro, Ana Correa Ruiz, Belén Civantos, Lydia Pascual-García, Paula Villares Fernández, Mikel Rico-Briñas, María José Alcaide-Martín, Adoración Valiente, Victoria Arnalich-Montiel, Pilar Retamar, Jesús Mingorance, Eva María Romay Lema, Pablo Galindo-Ballesteros, M. Teresa Pérez-Rodríguez, Rosario Maria Torres Santos-Olmo, Inmaculada Pinilla, Elie Dahdouh, Beatriz Tejero-Soriano, Cristina Pizarro-Sanchez, Félix Gutiérrez Rodero, Luis Jara-Palomares, María Hernández-Gancedo, Cristina Chico Chumillas, Sergio Gilaberte Reyzábal, Manuel González-Viñolis, Ana Martínez Sapiña, Francisco Parras, Teresa Rubio Obanos, Iker Falces-Romero, Adriana Sánchez Serrano, Teresa Álvarez de Espejo Montiel, Jorge Valencia, Miquel Pujol, José Luis Velasco Garrido, Belén Calderón-Llopis, Álvaro Varela Plaza, Abel Caro, Juan José González-Garcia, Miguel Sampedro Núñez, María Fernández-Velilla, Emilio Cendejas-Bueno, María Cecilia Cánepa, José Luis Santiago Blanco, Alicia Rico-Nieto, Mónica Liébana Gómez, Sarah Caro Bragado, Susana Sánchez-Rico, José María Marimón Ortiz de Zárate, Paloma Dorao, Cristina Plaza-Moreno, Isabel Valbuena, Natividad Benito Hernández, Ginger Giorgiana Cabrera Tejada, Jordi Carratalà, Sara Fernández Rodríguez, Vicente Ferrer Díaz De Brito Fernández, Pilar Catalán, Pablo Mariscal-Aguilar, Germán Daroca-Bengoa, Rafael Fernandez, Raquel Casitas-Mateo, Ester Zamarrón de Lucas, Úrsula Quesada, Julio Yagüe, María Isabel Quijano Contreras, Trinidad Baselga-Puente, Lourdes Herrera Pacheco, Carlota Gudiol, Alazne Lartategi Iraurgi, Estefanía Martinez-Chavez, Silvia Valero Rovira, Alba Bergas, Zaida Ruiz de Azua, Teresa Prim, Cristina García-Quero, Pilar Hernández Machín, Rubén Gomez-Rioja, María Pavón-Masa, María de las Mercedes Valentín-Pastrana Aguilar, Ilduara Pintos Pascual, Lucía Brieba-Plata, María Jesús Domínguez Santalla, Francisco Javier Membrillo de Novales, Raúl Galera-Martínez, Ana Lérida Urteaga, Miguel Cervero, Alberto Mangas-Moro, José Hernández Quero, Teresa Sancho Bueso, María Angustias Quesada Simón, Luz Parra-Gordo, Sofía Díaz-Carrasco, Juan Carlos Abad Almendro, Andrés Javier Ruiz Fernández, Estíbaliz Molina Iturritza, Aurea Díez-Tascón, Yale Tung-Chen, Marta Rava, Carlos Villasante, Gabriel Gaspar Alonso-Vega, Clara Cabré-Verdiell Surribas, Esther Fraile Villarejo, Aida Gutiérrez García, Ana Robustillo-Rodela, Rafael Padrós Selma, Jesús Rodríguez-Baño, Frank Perdomo-García, Lydia de la Fuente Regaño, María del Mar Arenas-Miras, Cristina Rodríguez Roca, Blanca Montero-San Martín, Gema Crespo-Sánchez, Miguel Ramírez-Verdyguer, Alberto Diaz de Santiago, Marta Díaz Menéndez, María de la Luz Padilla Salazar, Silvia Arribas-Terradillos, Sadaf Zafar Iqubal-Mirza, Isabel Rábago Lorite, Belén Estébanez, Maite Ganchegui Aguirre, André Barbosa Ventura, Estefanía Fernandez-Cerezo, Maria Eulalia Valencia, Zaira R. Palacios-Baena, Beatriz Diaz Pollan, Lidia Martín, Sara Fabra-Cadenas, José Miguel Cantero-Escribano, Carmen Busca Arenzana, Emilia Guasch-Arévalo, Virginia Fernández Espinilla, Ainhoa Urrutia Losada, Oscar Noya González, Raquel Aranega, Alejandro Rodríguez Saenz de Urturi, María Jesús Jaras Hernandez, Charbel Maroun Eid, Marta Mora Rillo, Antonio Ramos Martínez, Meritxell Ortega Montoliu, Jose María Mostaza, Sonia García Calvo, Cristina Verdú, Celia Salamanca, Cristina Cervera Acedo, Mónica Martínez, Miren Urrestarazu Larrañag, Carmen Barroso Castro, Ivo Vives-Beltrán, Lorea Arteche Eguizabal, Ana Montero, Javier Balsa Vázquez, Amparo Perez-Garcia Morillón, Alejandra Pérez García, Isabel Pérez-Tamayo, Rafael Cantón Moreno, Antonio Marín-García, Inmaculada Jarrín, Núria Trullen, Ines Fernandez-Jimenez, Guillermo Ruiz-Carrascosa, Almudena Villa Martí, Jamil Cedeño, Marcos Díez Martínez, Carlos Lahoz, Lorena De la Mora, Javier Sánchez-Lora, Ana María Martínez-Virto, Irene Sanjosé Muñiz, Adrian Peña-Hidalgo, Cristina López Mestanza, Carola Gutiérrez, Ana Laila Qasem-Moreno, Irene Salvo García, Lucía Fernández de Orueta, Jorge Parra Ruiz, Sergio Pérez Pinto, Carlos García-Mochales Fortún, Esteban García de las Heras, Patricia González Muñiz, Mario Fernández-Ruiz, Anna Ferrer Santolaria, Olga Sánchez Pernaute, Julieta Latorre, Jesús Manzanares, Miguel Angel Martinez Gallego, Helena Notario, Ángel Rodríguez-Villodres, Eva Fernández-Bretón, Encarnación Moral Escudero, Mónica Sánchez-Santiuste, Carmen Martínez Cilleros, Ricardo Fernández Roblas, María Yllescas, Eva Soria-Alcaide, Marta Arsuaga Vicente, Marta Gómez-López, Regina Cabrera-Gamero, Natalia Carrasco Fons, Diana Piñar Cabezos, Begoña Sánchez-Sánchez, Francisca Garcia-Iglesias, Raquel Marín-Baselga, Alberto Arranz Caso, Virginia Guedez-López, Lucia Boix Palop, Íñigo Gredilla Zubiría, María Hidalgo-Sánchez, Laura López-Tappero Irazábal, José Ignacio Bernardino de la Serna, Javier Queiruga, Natalia Guadalupe Barrera-López, María López-Jodar, Jorge Calderón Parra, Diego Rodríguez-Álvarez, José Molina, María Luisa Montes, Beatriz Rodríguez-Alonso, Daniel Useros Brañas, Maria Gracia Liras-Hernández, Lucía Romero-Imaz, Nieves Jaén Sánchez, Marta Segovia-Amaro, Marta Vara, Maribel Zamora Cintas, Montaña Jiménez Álvaro, Alberto Moreno Fernandez, Asunción Díaz, Jordi Mancebo Cortés, Francisco Javier De Castro Vega, Álvaro Navarro Batet, Francisco Javier Sagra, Alexandre Pérez González, Luis Castro, Isabel Barrio López, Marta Ruiz-Alguero, Silvia Ossaba-Vélez, Alberto Martín-Vega, Maria Jesus Bustinduy Odriozola, Sivia Pastor-Yvorra, Nuria Espinosa, Elena Múñez Rubio, María E García-Leoni, Sandra Rosillo, Cristina Carbonell, Iván Navas Clemente, Paula Arriola Martínez, Marta Peña, Lucía Martínez de Soto, Roberto Mora-Corcovado, Alberto Iglesias-Sigüenza, Rocío Ruíz-Hueso, Elena Alvar, Pedro Camacho, Jesús Sojo-Dorado, Remedios Alemán Valls, Ines Ponz, Esmeralda Palmier Peláez, María Arcos Rueda, Guillermo Maestro de la Calle, Ramón Pérez Tanoira, Ana Martínez Vidal, Cristina Amodeo, Marina Pacheco Martínez-Atienza, Clara Muñoz Aguirre, Felipe Villar Álvarez, Giorgina Salgueiro, Xavier Sanz Salvador, César Pérez-Romero, Beatriz Álvarez Zapatero, Nelsa González-Aguado, Robert Torres Sánchez del Arco, Enrique Míguez Rey, Merce Sirisi, Xavier Bonfill Cosp, Marta Yagüe-Barrado, Elena Pérez-Costa, Sandra Casares, Eva Estirado, Jorge Alvarez Troncoso, Cristina Martín-Carrasco, Diana Sande Llovo, Melchor Álvarez de Mon Soto, Arantzazu Mera Fidalgo, Francisco Marqués-González, Agustín Valido-Morales, Luis Alberto Nieto Fernández del Campo, Helem Haydee Vilchez, María Rivas-Carmenado, Francisco Moreno, Ignacio Fernández-Fernández, Henar Calvo Sánchez, Ana González-Cordón, Isabel Fernández-Navarro, María Simón Sacristán, Eva Jiménez-González de Buitrago, M. Muñoz, María Laplaza-González, Rosa de Miguel Buckley, Marta Redondo-Gutierrez, Paula Santibáñez Sáenz, Raquel Martínez Goñi, Marta Rico Rodríguez, Carlos Toro-Rueda, Francisco Arnalich, Ana Santiago-Recuerda, Clara Soto Abanedes, María Dolores Herrero Mendoza, Aquilino Sanchez Purificación, Diego Franch Llasat, María Velasco Arribas, Alejandro Martín-Quirós, Jorge Alba Fernández, Elena Ramírez, Amparo López-Bernus, Marta Alvarado, María Rexach Fumaña, Martín Pilares-Barco, Carmen Liébana Martos, Yolanda Martínez Martínez, Nicolas Merchante Gutiérrez, Maria José Asensio, Ianire Virto Peña, Lucía Mejuto-Illade, María Angeles Martinez-López, Pilar López-Pirez, Alejandro Suárez, Cristóbal Manuel Rodríguez Leal, Sara Garcia-Bellido Ruiz, Jorge Guisández Martín, Lucia Cachafeiro, Pedro Gil Divasson, Almudena Quintás-Viqueira, Laura Currás-Sánchez, Alverio Seiz-Martinez, Mario Ruiz-Bastián, Juan José Menéndez, Jorge Orihuela Martín, María Dolores Nieto Martín, Cristina Arévalo, Rebeca Marinas, Susana Casas Rodríguez, Zuriñe Ortiz de Zárate Ibarra, Yolanda Posada Franco, Joan Gómez-Junyent, Ana María Garijo Saiz, Marina Alguacil-Guillén, Ana Alguacil, Esther Aznar Muñoz, Sara Bañón Escandell, Juan Salillas Hernando, Chiara Fanciulli, Rosa Gómez-Gil, Francisco García-Río, Moncef Belhassen-García, Belén Gutierrez Sancerni, Sonia Vega Molpeceres, Inés Suárez-García, Leire Pérez-Latorre, Elena Chamarro Martí, Carmen Rosario Herrero Gil, Belén Gutiérrez-Gutiérrez, Tatiana Mata Forte, Francesca Sánchez Martínez, Lucía Ramos Merino, Santiago Yus, Mº Ángeles Marcos, Susana Martínez-Álvarez, Alexy Inciarte, Manuel Quintana-Díaz, Lucía Serrá, Belén Alejos, Guillem Policarpo Torres, José Román Muñoz del Rey, Irene Blanco-Bartolomé, Alberto Bahamonde Carrasco, Victoria Hernando, Jhon Rojas, David Roa, María Ángeles Garcinuño, Aránzazu Villasante de la Puente, Patricia Pérez-Palacios, Jesús Ruiz Aragón, Valvanera Ibarra Cucalón, Lucía Ortega Enciso, Ismail Zakariya-Yousef Breval, Jorge Navarro López, Gema Barbeito Castiñeiras, Clara Sala Jofre, Nora Molina Torres, Manuel Poyato, Inmaculada Poquet Catala, Virginia Pomar Solchaga, María Pilar Romero-Gómez, Clara Hernández, Helena Mozas Moriñigo, Mercedes Guillamón Sánchez, Zineb Karroud, Arianna Catino, Violeta Ramos Sesma, Santos del Campo, Pilar Fernández-Calle, Ana Fernández Cruz, Fernando Salvador, Rosa Mayayo-Alvira, Pilar Barco Núñez, Ana Isabel Peláez Ballesta, Silvia Suárez Diaz, Beatriz María Sanjuan, Nora Izko Gartzia, Teresa Aldámiz-Echevarría, Cecilia Tortajada Alamilla, Pau Bosch-Nicolau, María del Mar Alonso Socas, Sonia Calzado Isbert, Jose R. Arribas, Juan Fernández-Lahera, Elizabet Petkova Saiz, Eva Jiménez, Gabriela Abelenda-Alonso, Alba Ribera Puig, Pascual Sanabria-Carretero, Sara Rodrigo González, Irene Díaz de la Torre, Tamara Manso Gómez, Carmen Sáez Barberá, Roi Suárez Gil, Paloma García-Clemente, Héctor Meijide Míguez, Elsa Izquierdo-García, Josune Goikoetxea Agirre, Olalla Martínez Macia, Jesús Santos González, Guillermo Jiménez Álvarez, Cristina Marcelo-Calvo, Javier Coy Coy, Isabel Arenas-Berenguer, Julio García Rodríguez, Natalia Yustas-Benitez, Sarai Quirós-Fernández, Marina Noguerol-Gutiérrez, María Adalid Moll, Iván Bloise-Sánchez, Mario José Rodriguez Dominguez, Elena Salamanca, Francisco Mora Gómez, Lucio García-Fraile, Pablo Millán, C Gutiérrez, Montserrat Rodríguez, José Antonio Oteo Revuelta, Joseba Portu Zapirain, Cristina Moreno, Irene Carrillo Acosta, Jorge Calvo, Ana Mariño Callejo, David Romero-Ribate, Blanca Alonso, Elena Muñoz del Val, Elena Resino Foz, Olaia Rodriguez-Fraga, Miguel Villamarín, Irene Amores-Hernández, Laura Muñoz López, Esther García Almodóvar, Ismael Casares Guerrero, Angélica Villanueva-Freije, Nuria Parra Arribas, Montserrat Sanmarti Vilamala, Macarena Lerín-Baratas, Mercedes Castro-Martínez, Melissa Carreres Candela, Lucia Suárez Pérez, Jose Manuel Iturzaeta-Sánchez, Thamires Silva-Freire, José Antonio Peregrina, María Luisa Machado Sicilia, Sergio Zurita, Daniel Molina Morant, Olga González-Peña, Fernando Lázaro-Perona, Paloma Oliver-Saez, Beatriz Mestre-Gómez, Luis Díaz Díez Picazo, Silvia García-Bujalance, Francisco Rodríguez Gómez, Pere Comas Casanova, Carlos Ruiz Martínez, Alberto Delgado-Iribarren, Berta Alonso-González, Isabel Moreno-Parra, Teresa Gómez-Ballesteros, Araceli Menéndez, Jose Manuel Añón, Ruth Jorge García, Jonathan Cámara Fernández, Miguel Górgolas Hernández-Mora, Itziar Diego Yagüe, Miriam Latorre-Millán, Covadonga Morcate Fernández, M. Río-García, Elisabet Lerma-Chippirraz, Carmen Yllera Gutiérrez, Francesc Albertí, Eva Flores, Carmen R. Uña Orejón, Patricio González-Pizarro, Neila Rodriguez-Roca, Miguel Fernández-Huerta, Inés Ferrer Ortiz, María José Blanco Vidal, Juan Pablo Avilés, Alicia Lorenzo Hernández, Mireia Puig Campmany, José Bravo-Ferrer, Gonzalo Martínez-Alés, Pablo Marguenda Contreras, M. Sánchez, Antonio García Pardo, Yolanda Meije, Francisco Tejerina, Carolina Hernández Carballo, Victoria Moreno, Daniel Laorden-Escudero, Ana Barrios Blandino, Alexia Costanza Espiño Álvarez, Ana Milagro Beamonte, Jerónimo Pachón, S San José-Villar, Marta Morando, María del Carmen Navarro Sáez, Rodolfo Álvarez-Sala Walther, Jon Ugalde Espiñeira, Fernando De la Calle Prieto, Nuria Fernández, Iván Pelegrín Senent, Alba Rueda López, Cristina Schüffelmann, Marcelino Hayek Peraza, Laura Labajo-Montero, Angel Robles Marhuenda, Pilar Durán, Ana Esteban-Romero, María Rosa Oltra Sempere, Ana Cosmen Sánchez, Alex Smithson Amat, Margarita Ramírez-Schacke, Marco Antonio Sempere Alcocer, Paloma Carrera-Vázquez, M Miarons, Teresa García Delange, Amelia Rodriguez-Mariblanca, Eva Talavera García, Roberto Vates Gómez, Óscar Sanz Peláez, José María Muñoz-Ramón, José Luis García Fogeda, Isabel Arroyo-Rico, Verónica Cano Llorente, Fernando González-Romo, Alberto Alonso-Babarro, Fátima Brañas, Fabricio Iannuccelli, Pilar Álvarez Padín, Luis Metola Sacristán, Vicente Boix, Víctor Hontañón, Juan Berenguer, José Luís Del Pozo León, Patricia Sorní Moreno, Maria Isabel Torres, Rafael Mican Rivera, Amparo Blasco Claramunt, Carmen Ardanuy, Aychel Elena Roura Piloto, María Ángeles Molina, Isabel Asschert Agüero, Julía Alvárez del Vayo, Consuelo García-Sánchez, Begoña Reche-Martínez, Guillermo Cuervo, Carlos Iniesta, María Antonia Gómez-Mendieta, Ana María Noblejas Mozo, Andres Bartrina-Tarrio, Carmen De la Higuera Arranz, Yeray Untoria Tabares, Andrés Enrique Suárez-Plaza, Jesús Frías, Paloma López-Arévalo, Irene María Llorente-Cortijo, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación (España), and Fundación SEIMC-GESIDA
Subjects: Male, Prognostic variable, medicine.medical_specialty, Databases, Factual, Coronavirus disease 2019 (COVID-19), 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, 030212 general & internal medicine, Aged, Retrospective Studies, Models, Statistical, SARS-CoV-2, business.industry, Mortality rate, COVID-19, Retrospective cohort study, Articles, Middle Aged, Prognosis, medicine.disease, Phenotype, Hospitals, Hospitalization, Logistic Models, Infectious Diseases, Spain, Cohort, Female, Lymphocytopenia, business, Cohort study
Abstract: REIPI-SEIMC COVID-19 group and COVID@HULP group., [Background] The clinical presentation of COVID-19 in patients admitted to hospital is heterogeneous. We aimed to determine whether clinical phenotypes of patients with COVID-19 can be derived from clinical data, to assess the reproducibility of these phenotypes and correlation with prognosis, and to derive and validate a simplified probabilistic model for phenotype assignment. Phenotype identification was not primarily intended as a predictive tool for mortality., [Methods] In this study, we used data from two cohorts: the COVID-19@Spain cohort, a retrospective cohort including 4035 consecutive adult patients admitted to 127 hospitals in Spain with COVID-19 between Feb 2 and March 17, 2020, and the COVID-19@HULP cohort, including 2226 consecutive adult patients admitted to a teaching hospital in Madrid between Feb 25 and April 19, 2020. The COVID-19@Spain cohort was divided into a derivation cohort, comprising 2667 randomly selected patients, and an internal validation cohort, comprising the remaining 1368 patients. The COVID-19@HULP cohort was used as an external validation cohort. A probabilistic model for phenotype assignment was derived in the derivation cohort using multinomial logistic regression and validated in the internal validation cohort. The model was also applied to the external validation cohort. 30-day mortality and other prognostic variables were assessed in the derived phenotypes and in the phenotypes assigned by the probabilistic model., [Findings] Three distinct phenotypes were derived in the derivation cohort (n=2667)—phenotype A (516 [19%] patients), phenotype B (1955 [73%]) and phenotype C (196 [7%])—and reproduced in the internal validation cohort (n=1368)—phenotype A (233 [17%] patients), phenotype B (1019 [74%]), and phenotype C (116 [8%]). Patients with phenotype A were younger, were less frequently male, had mild viral symptoms, and had normal inflammatory parameters. Patients with phenotype B included more patients with obesity, lymphocytopenia, and moderately elevated inflammatory parameters. Patients with phenotype C included older patients with more comorbidities and even higher inflammatory parameters than phenotype B. We developed a simplified probabilistic model (validated in the internal validation cohort) for phenotype assignment, including 16 variables. In the derivation cohort, 30-day mortality rates were 2·5% (95% CI 1·4–4·3) for patients with phenotype A, 30·5% (28·5–32·6) for patients with phenotype B, and 60·7% (53·7–67·2) for patients with phenotype C (log-rank test p, [Interpretation] Patients admitted to hospital with COVID-19 can be classified into three phenotypes that correlate with mortality. We developed and validated a simplified tool for the probabilistic assignment of patients into phenotypes. These results might help to better classify patients for clinical management, but the pathophysiological mechanisms of the phenotypes must be investigated., [Funding] Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, and Fundación SEIMC/GeSIDA., Funding: Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, and Fundación SEIMC/GeSIDA.
Published: 2021

43. Use of sacubitril-valsartan in blood pressure control with left ventricular assist devices

Author: Carles Díez-López, David Dobarro, José González-Costello, Antonio Gonçalves, Javier Tobar, María Melendo-Viu, David Couto-Mallón, Manuel Gómez-Bueno, Scott McKenzie, Javier Castrodeza, and Carlos Ortiz
Subjects: Pulmonary and Respiratory Medicine, Blood pressure control, Male, medicine.medical_specialty, Blood Pressure, Ventricular Function, Left, Angiotensin Receptor Antagonists, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Heart Failure, Transplantation, business.industry, Aminobutyrates, Biphenyl Compounds, Stroke Volume, Middle Aged, Drug Combinations, Treatment Outcome, Cardiology, Valsartan, Surgery, Female, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business, Sacubitril, Valsartan, Follow-Up Studies
Published: 2020

44. Arrhythmic Burden as Determined by Ambulatory Continuous Cardiac Monitoring in Patients With New-Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Replacement

Author: Ignacio J. Amat-Santos, François Philippon, Jean Bernard Masson, Jaime Elízaga, Victoria Cañadas-Godoy, Josep Rodés-Cabau, Felipe Atienza, José M. de la Torre, Marina Urena, Marc W. Deyell, Jaume Francisco Pascual, Gabriela Veiga-Fernandez, Lluis Asmarats, Neal S. Kleiman, Javier Castrodeza, Vicenç Serra, Dominique Himbert, Antonio Munoz-Garcia, John G. Webb, Luis Nombela-Franco, and Emilie Pelletier-Beaumont
Subjects: Male, Time Factors, medicine.medical_treatment, Action Potentials, 030204 cardiovascular system & hematology, Ventricular tachycardia, 0302 clinical medicine, Valve replacement, Heart Rate, Risk Factors, atrial fibrillation, Prospective Studies, 030212 general & internal medicine, Aged, 80 and over, medicine.diagnostic_test, Left bundle branch block, Incidence, Atrial fibrillation, Europe, Treatment Outcome, cardiovascular system, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Canada, medicine.medical_specialty, bradyarrhythmias, Bundle-Branch Block, Sudden death, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Humans, left bundle branch block, cardiovascular diseases, Atrial tachycardia, Aged, business.industry, Arrhythmias, Cardiac, Aortic Valve Stenosis, medicine.disease, United States, Electrocardiography, Ambulatory, pacemaker implantation, business, Electrocardiography, Atrioventricular block
Abstract: Objectives The authors sought to determine: 1) the global arrhythmic burden; 2) the rate of arrhythmias leading to a treatment change; and 3) the incidence of high-degree atrioventricular block (HAVB) at 12-month follow-up in patients with new-onset persistent left bundle branch block (LBBB) following transcatheter aortic valve replacement (TAVR). Background Controversial data exist on the occurrence of significant arrhythmias in patients with LBBB post-TAVR. Methods This was a multicenter prospective study including 103 consecutive patients with new-onset persistent LBBB post-TAVR with the balloon-expandable SAPIEN XT/3 valve (n = 53), or the self-expanding CoreValve/Evolut R system (n = 50). An implantable cardiac monitor (Reveal XT, Reveal Linq) was implanted at 4 (3 to 6) days post-TAVR, and patients had continuous electrocardiogram monitoring for 12 months. All arrhythmic events were adjudicated in a central electrocardiography core lab. Primary endpoints were the incidence of arrhythmias leading to a treatment change, and the incidence of HAVB at 12-month follow-up. Results A total of 1,553 new arrhythmic events were detected in 44 patients (1,443 episodes of tachyarrhythmia in 26 patients [atrial fibrillation/flutter/atrial tachycardia: 1,427, ventricular tachycardia 16]; 110 episodes of bradyarrhythmia in 21 patients [HAVB 54, severe bradycardia 56]). All arrhythmic events were silent in 34 patients (77%), the arrhythmic event led to a treatment change in 19 patients (18%), and 11 patients (11%) required pacemaker or implantable cardioverter-defibrillator implantation (due to HAVB, severe bradycardia, or ventricular tachycardia episodes in 9, 1, and 1 patient, respectively). A total of 12 patients died at 1-year follow-up, 1 from sudden death. Conclusions A high incidence of arrhythmic events was observed at 1-year follow-up in close to one-half of the patients with LBBB post-TAVR. Significant bradyarrhythmias occurred in one-fifth of the patients, and PPM was required in nearly one-half of them. These data support the use of a cardiac monitoring device for close follow-up and expediting the initiation of treatment in this challenging group of patients. (Ambulatory Electrocardiographic Monitoring for the Detection of High-Degree Atrio-Ventricular Block in Patients With New-onset PeRsistent LEft Bundle Branch Block After Transcatheter Aortic Valve Implantation [MARE study]: NCT02153307)
Published: 2018
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45. Adequacy of usual macronutrient intake and macronutrient distribution in children and adolescents in Spain: A National Dietary Survey on the Child and Adolescent Population, ENALIA 2013–2014

Author: Rosa Sanchidrián, Victoria Marcos, José Javier Castrodeza-Sanz, Aránzazu Aparicio, Sara Santos, Carmen Villar-Villalba, Josefa Rubio, M. Ángeles Dal-Re, Teresa Robledo, Rosa M. Ortega, Ana M. López-Sobaler, Napoleón Pérez-Farinós, and María José Yusta-Boyo
Subjects: Male, 0301 basic medicine, Adolescent, Population, Medicine (miscellaneous), Distribution (economics), 030209 endocrinology & metabolism, Target population, Child and adolescent, 03 medical and health sciences, Age Distribution, 0302 clinical medicine, Age groups, Environmental health, Dietary Carbohydrates, Humans, Medicine, Dietary survey, Child, education, Carbohydrate intake, education.field_of_study, 030109 nutrition & dietetics, Nutrition and Dietetics, business.industry, Infant, Dietary surveys, Original Contribution, Nutrients, Nutrition Surveys, Dietary Fats, Nutrient intake, Diet Records, Diet, Europe, Cross-Sectional Studies, Usual intake, Spain, Dietary Reference Intake, Child, Preschool, Female, Dietary Proteins, Energy Intake, business
Abstract: Objectives To describe the nutritional profile and assess the National Dietary Survey on the Child and Adolescent Population project in Spain (ENALIA) regarding usual total energy and macronutrient intake. Methods A cross-sectional nationally representative sample of 1862 children and adolescents (age 6 months to 17) was surveyed between 2013 and 2014 following European methodology recommendations. Dietary information was collected using two methods, dietary records (for children from age 6 months to 9 years) and 24-h dietary recall (participants age 10 and older). Usual intake was estimated by correcting for within-person intake variance using the Iowa State University (ISU) method. A probability analysis was used to assess compliance with dietary reference intakes in the target population. Results Protein consumption in the age 1–3 group as a percentage of total energy exceeded the upper limit of the Acceptable Macronutrient Distribution Range (AMDR) by 4.7% for boys and 12.1% for girls. 42.9% of girls age 4–8 were under the lower limit of the AMDR for carbohydrates. 43.4% of boys and 46.9% of girls between 4 and 17 exceeded the AMDR in total fat intake, saturated fatty acids (SFAs) accounting for 12.3% of total energy. Conclusions The results suggest that Spanish children and adolescents could improve macronutrient distribution by reducing fat and increasing carbohydrate intake across all age groups, and decreasing protein intake, especially in young children. Electronic supplementary material The online version of this article (10.1007/s00394-018-1676-3) contains supplementary material, which is available to authorized users.
Published: 2018
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46. La insuficiencia tricúspide, y no la insuficiencia mitral, determina la mortalidad en pacientes que presentan insuficiencia mitral no grave previa a TAVI

Author: Javier Ruano, José M. de la Torre Hernández, Silvio Vera, Ignacio J. Amat-Santos, Itziar Gómez, Maria Del Trigo, Rishi Puri, Josep Rodés-Cabau, José Alberto San Román, Juan G. Córdoba-Soriano, Javier Tobar, Antonio J. Muñoz-García, José M. Hernández-García, Javier Castrodeza, Pilar Jiménez-Quevedo, Manuel Carrasco-Moraleja, Luis Nombela-Franco, Carolina Hernández-Luis, Ana González-Mansilla, and Enrique Gutiérrez-Ibañes
Subjects: Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, Medicine, 030212 general & internal medicine, 030204 cardiovascular system & hematology, Cardiology and Cardiovascular Medicine, business
Abstract: Resumen Introduccion y objetivos Muchos pacientes sometidos a implante percutaneo de valvula aortica (TAVI) presentan insuficiencia mitral (IM) de grado moderado o menor. El impacto de la insuficiencia tricuspidea (IT) sigue sin resolverse. Se analiza el impacto de la IM moderada frente a leve-ausente y su evolucion, y de la IT concomitante y su interaccion con la IM. Metodos Estudio retrospectivo multicentrico de 813 pacientes tratados con TAVI entre 2007 y 2015 con IM ≤ 2 y abordaje transfemoral. Resultados La edad media fue 81 ± 7 anos y el Society of Thoracic Surgeons-score fue de 6,9 ± 5,1%. El 37,3% presento IM moderada, con resultados comparables intrahospitalarios y de mortalidad a 6 meses frente a IM 2 tras el TAVI. La presencia de IT moderada/grave se asocio con una mortalidad intrahospitalaria y de seguimiento del 13 y el 34,1%, independientemente del grado de IM. La IT moderada-grave fue predictor independiente de mortalidad (HR = 18,4; IC95%, 10,2-33,3; p Conclusiones La presencia de IM moderada no supuso mayor mortalidad a corto-medio plazo tras el TAVI, pero asocio mas rehospitalizaciones. La presencia de IT moderada/grave implico mayor mortalidad. Esto sugiere que una evaluacion minuciosa de los mecanismos subyacentes entre ambas insuficiencias valvulares debe realizarse para determinar la mejor estrategia para evitar la futilidad relacionada con TAVI.
Published: 2018
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47. Tricuspid but not Mitral Regurgitation Determines Mortality After TAVI in Patients With Nonsevere Mitral Regurgitation

Author: Juan G. Córdoba-Soriano, Javier Tobar, Silvio Vera, Ignacio J. Amat-Santos, Josep Rodés-Cabau, José Alberto San Román, José M. de la Torre Hernández, José M. Hernández-García, Pilar Jiménez-Quevedo, Rishi Puri, Enrique Gutiérrez-Ibañes, Luis Nombela-Franco, Javier Ruano, Ana González-Mansilla, Antonio J. Muñoz-García, Manuel Carrasco-Moraleja, Maria Del Trigo, Itziar Gómez, Carolina Hernández-Luis, and Javier Castrodeza
Subjects: Male, Cardiac Catheterization, medicine.medical_specialty, New York Heart Association Class, Regurgitation (circulation), 030204 cardiovascular system & hematology, Risk Assessment, Severity of Illness Index, Statistics, Nonparametric, Cohort Studies, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Cause of Death, Internal medicine, medicine, Humans, In patient, Hospital Mortality, 030212 general & internal medicine, Aged, Retrospective Studies, Aged, 80 and over, Mitral regurgitation, business.industry, Mortality rate, Mitral Valve Insufficiency, Retrospective cohort study, Aortic Valve Stenosis, General Medicine, Tricuspid Valve Insufficiency, Echocardiography, Doppler, Color, Surgery, Survival Rate, Treatment Outcome, Concomitant, Multivariate Analysis, Cardiology, Female, Tricuspid Valve Regurgitation, business, Follow-Up Studies
Abstract: Introduction and objectives Many patients undergoing transcatheter aortic valve implantation (TAVI) have concomitant mitral regurgitation (MR) of moderate grade or less. The impact of coexistent tricuspid regurgitation (TR) remains to be determined. We sought to analyze the impact of moderate vs none-to-mild MR and its trend after TAVI , as well as the impact of concomitant TR and its interaction with MR. Methods Multicenter retrospective study of 813 TAVI patients treated through the transfemoral approach with MR ≤ 2 between 2007 and 2015. Results The mean age was 81 ± 7 years and the mean Society of Thoracic Surgeons score was 6.9% ± 5.1%. Moderate MR was present in 37.3% of the patients, with similar in-hospital outcomes and 6-month follow-up mortality to those with MR P = .257). However, they experienced more rehospitalizations and worse New York Heart Association class ( P = .008 and .001, respectively). Few patients (3.8%) showed an increase in the MR grade to > 2 post-TAVI. The presence of concomitant moderate/severe TR was associated with in-hospital and follow-up mortality rates of 13% and 34.1%, respectively, regardless of MR grade. Moderate-severe TR was independently associated with mortality (HR, 18.4; 95%CI, 10.2-33.3; P Conclusions The presence of moderate MR seemed not to impact short- and mid-term mortality post-TAVI, but was associated with more rehospitalizations. The presence of moderate or severe TR was associated with higher mortality. This suggests that a thorough evaluation of the mechanisms underlying concomitant mitral and tricuspid valve regurgitation should be performed to determine the best strategy for avoiding TAVI-related futility.
Published: 2018
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48. Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral

Author: José Alberto San Román, Silvio Vera, Ignacio J. Amat-Santos, Hipólito Gutiérrez, Pablo Catalá, Paol Rojas, L. Renier Goncalves-Ramírez, Javier Castrodeza, Manuel Carrasco, and Javier Tobar
Subjects: Male, Stroke rate, medicine.medical_specialty, Time Factors, Percutaneous, Transcatheter aortic, medicine.medical_treatment, Subclavian Artery, Disease, 030204 cardiovascular system & hematology, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Catheterization, Peripheral, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Dialysis, Aged, Aged, 80 and over, business.industry, Acute kidney injury, Aortic Valve Stenosis, General Medicine, Odds ratio, medicine.disease, Femoral Artery, Stenosis, Treatment Outcome, Aortic Valve, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract: AIMS Empirically, transfemoral (TF) approach is the first choice for transcatheter aortic valve implantation (TAVI). We aimed to investigate whether transubclavian (TSc) and TF approaches present comparable major outcomes according to current evidence. METHODS We systematically searched PubMed, EMBASE, and Cochrane database for studies with symptomatic aortic stenosis patients who underwent TAVI through TF or TSc/axillary access from January/2006 to January/2017. Searched terms were: ("aortic stenosis" OR "transcatheter aortic" OR "TAVI" OR "TAVR") and ("transfemoral" OR "transaxillary" OR "transubclavian"). Major outcomes according to Valve Academic Research Consortium-2 criteria were gathered. The odds ratio (OR) was used as a summary statistic. A random-effects model was used. A fully percutaneous TSc TAVI case from our institution illustrates minimalist approach. RESULTS Final analysis was made with six studies including 4,504 patients (3,886 TF and 618 TSc). Baseline characteristics of compared groups in individual studies were similar, with the exception of a higher logistic EuroSCORE in the TSc group (23.7 ± 1.92 vs. 21.17 ± 3.51, P = 0.04) and higher prevalence of coronary and peripheral artery disease with OR = 0.67 [95% CI: 0.54-0.83] (P = 0.0003) and OR = 0.08 [95% CI: 0.05-0.12] (P
Published: 2018
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49. Prophylactic percutaneous circulatory support in high risk transcatheter aortic valve implantation

Author: Inés Sayago Silva, Ignacio J. Amat-Santos, Javier Castrodeza, José Alberto San Román, and Ana Mª Serrador Frutos
Subjects: medicine.medical_specialty, Percutaneous, Text mining, Transcatheter aortic, business.industry, Internal medicine, Circulatory system, medicine, Cardiology, General Medicine, Cardiology and Cardiovascular Medicine, business, Interventional Cardiology
Published: 2019
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50. Gripe en tiempos de coronavirus

Author: Iván Sanz Muñoz, José María Eiros Bouza, Sonia Tamames Gómez, Vanesa Matías del Pozo, María Nazaret Sánchez Sierra, Hugo Gonzalo Benito, Pedro José Martínez de Paz, Virginia Fernández Espinilla, Cristina Hernán García, Silvia Rojo Rello, Marta Domínguez-Gil González, Laura Sánchez de Prada, Diana Pérez San José, Santiago Vega García, José Javier Castrodeza Sanz, Raúl Ortiz de Lejarazu Leonardo, Iván Sanz Muñoz, José María Eiros Bouza, Sonia Tamames Gómez, Vanesa Matías del Pozo, María Nazaret Sánchez Sierra, Hugo Gonzalo Benito, Pedro José Martínez de Paz, Virginia Fernández Espinilla, Cristina Hernán García, Silvia Rojo Rello, Marta Domínguez-Gil González, Laura Sánchez de Prada, Diana Pérez San José, Santiago Vega García, José Javier Castrodeza Sanz, and Raúl Ortiz de Lejarazu Leonardo
Abstract: Es evidente que este año no podemos hablar solo de gripe, pues el SARS-CoV-2 continúa activo y con gran virulencia. Es por ello que un gran equipo de autores, tras el éxito alcanzado por el anterior libro publicado en abril de 2020, 50 preguntas y respuestas sobre el coronavirus (COVID-19) y tras la experiencia clínica adquirida, ofrecen con este nuevo libro poder responder a algunas cuestiones que la experiencia y la evidencia ha proporcionado. La evidencia nos muestra que se está produciendo una tercera ola pandémica en 2021, que se prolongará durante el año y donde los expertos vaticinan la posibilidad de que sucedan brotes epidémicos en los próximos 3-5 años Por otro lado, el creciente interés por saber más sobre cómo afecta el virus que nos visita todos los años como es el de la gripe, el cual supone un importante problema para la salud pública, y que hoy preocupa por la coincidencia con el SARS-CoV-2. Se aventura un periodo que probablemente será complicado y difícil, pues al encontrarnos en plena expansión de ambos virus, por lo que se hace más necesaria la prevención a través de la vacunación en el caso de la gripe; sin embargo, al no ser esto posible de momento con el SARS-CoV-2, es clave la información para minimizar algunos riesgos tanto en el personal sanitario como en la población en general. Esta es la misión de la obra que tiene en sus manos, conocer algunas respuestas que se nos plantean en pleno episodio epidémico y pandémico.
Published: 2021

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