Paravalvular leak closure with the Amplatzer Vascular Plug III device: immediate and short-term results.

Introduction And Objectives: Percutaneous paravalvular leak closure is a complex procedure with varying success rates; the lack of closure devices specifically designed for this purpose has hampered this technique. The characteristics of the Amplatzer Vascular Plug III appear to be well suited for paravalvular leak closures; however, the available data are limited to case reports or small series of patients. The aim of this study was to analyze the feasibility and efficacy of paravalvular leak with this device.

Significance of the learning curve in left atrial appendage occlusion with two different devices.

Objective: To evaluate the impact of learning on outcome with use of two different left atrial appendage (LAA) occlusion devices.

Background: Two self-expanding devices, the Watchman and the Amplatzer Cardiac Plug (ACP), have been used for LAA occlusion in the last few years. It has been demonstrated that complications associated with implantation decrease in frequency with operator experience.

Morphology of far-field electrograms and antitachycardia pacing effectiveness among fast ventricular tachycardias occurring in ICD patients: a multicenter study.

Introduction: Fast ventricular tachycardias (FVT) are less likely to be terminated by antitachycardia pacing (ATP). No information is available regarding the ability of far-field electrogram (Ff-EG) morphology (Ff-EGm) in predicting the result of the subsequent ATP. Our objective is to determine the relationship between Ff-EGm and ATP efficacy.

Influence of cycle length variations on antitachycardia pacing effectiveness among ICD patients.

Background: Antitachycardia pacing (ATP) fails to terminate 5% to 25% of ventricular tachycardias (VTs) occurring in implantable cardioverter-defibrillator patients. We speculated that small fluctuations in VT cycle length (CL) may be related to the efficacy of subsequent ATP.

Objective: The purpose of this study was to determine the relationship between the R-R variations of the last 12 R-R intervals before ATP and the efficacy of the first ATP attempt.

Prognostic significance of heart rate in hospitalized patients presenting with myocardial infarction.

Aim: To investigate the prognostic significance of resting heart rate in patients with acute coronary syndrome (ACS), independent of other known factors.

Methods: Patients 40 years of age or older who had been admitted with acute coronary syndrome (ACS) to one of the 94 hospitals participating in the Prevalence of Peripheral Arterial Disease in Patients with Acute Coronary Syndrome (PAMISCA) study were included. Patients were divided into two groups based on their resting heart rate (HR ≥ or < 70 bpm).

In-hospital prognosis in non-ST-segment elevation acute coronary syndrome derived using a new risk score based on electrocardiographic parameters obtained at admission.

Several electrocardiographic variables are of prognostic value in non-ST-segment elevation acute coronary syndrome (NSTEACS). From observations in 427 patients, we developed a new risk score (the ECG-RS) based on admission ECG findings that can be used to determine the likelihood of death or recurrent ischemia during hospitalization, which occurred in 36% of patients. Logistic regression analysis, which considered seven electrocardiographic variables and variables from the Thrombolysis in Myocardial Infarction (TIMI) risk score, identified the following significant predictors: corrected QT interval (QTc) > or =450 ms (odds ratio 4.

Influence of beta-blocker therapy on antitachycardia pacing effectiveness for monomorphic ventricular tachycardias occurring in implantable cardioverter-defibrillator patients: a dose-dependent effect.

Aims: To determine, in a non-selected population of 282 implantable cardioverter-defibrillator (ICD) patients with left ventricular dysfunction, the influence of the dose of beta-blockers on antitachycardia pacing (ATP) effectiveness and on the incidence of shock due to monomorphic ventricular tachycardias (VT).

Methods And Results: We followed 282 ICD patients along 26 +/- 19 months. Antitachycardia pacing and shock programming were standardized.

Relationship between the duration of the basal QRS complex and electrical therapies for ventricular tachycardias among ICD patients.

Background: In implantable cardioverter-defibrillators (ICD) patients, the duration of the basal QRS complex (QRSd) is not associated with a greater risk of developing ventricular tachyarrhythmias. QRSd could be inversely related to the effectiveness of antitachycardia pacing (ATP) because it may be associated with longer conduction times of the paced-impulses and hence, with a greater propensity to require shocks to terminate ventricular tachycardias (VTs).

Methods: We followed 216 ICD patients (pacing site: right ventricular apex; QRSd View Article and Find Full Text PDF

Association between -T786C NOS3 polymorphism and resistant hypertension: a prospective cohort study.

Background: It is estimated that 5% of the hypertensive patients are resistant to conventional antihypertensive therapy. Polymorphisms in the endothelial nitric oxide synthase (NOS3) gene have been associated with high blood pressure levels, but not with resistant hypertension. The aim of the present study was to investigate if the -786T>C and G894T (Glu298Asp) polymorphisms of the NOS3 gene were associated with resistant hypertension.

Early reduction of QT dispersion after primary percutaneous intervention in ST-segment elevation acute myocardial infarction. Mechanisms and clinical implications.

Objectives: To determine, in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI), the mechanisms and clinical implications of the acute changes in QT dispersion (QTd).

Methods: In this prospective study we included 216 patients admitted with a STEMI of <12 h of evolution. All were treated with PPCI.

[Hemodynamic and inflammatory markers of sleep apnea-hypopnea syndrome and nocturnal hypoxemia: effects of treatment with nasal continuous positive airway pressure].

Objective: In this study, we assessed factors associated with cardiovascular risk in patients with sleep apnea-hypopnea syndrome (SAHS) through analysis of plasma concentrations of N-terminal prohormone brain natriuretic peptide (NTproBNP) and high-sensitivity C-reactive protein (hsCRP). In addition, we analyzed the effect of nasal continuous positive airway pressure (nCPAP) on these markers.

Patients And Methods: Forty-two patients with SAHS (mild to moderate in 15 cases and severe in 27) were compared with 14 individuals without SAHS.

Importance of the relationship between sinus cycle length and junctional rhythm cycle length (occured during radiofrequency ablation) in predicting the successful modification of the slow pathway in Atrioventricular Nodal Re-entrant Tachycardias.

Background: In atrioventricular nodal re-entrant tachycardias (AVNRT), the achievement of Junctional Rhythms (JR) during Radiofrequency Ablation (RF) is a sensitive but non-specific marker of success. Our aim is to analyze prospectively the predictors of non-inducibility of AVNRT, focusing on the characteristics of the JR.

Methods: We included 75 patients with reproducibly inducible AVNRT.

Identification of serum endoglin as a novel prognostic marker after acute myocardial infarction.

Endoglin is a proliferation-associated and hypoxia-inducible protein expressed in endothelial cells. The levels of soluble circulating endoglin and their prognostic significance in patients with acute myocardial infarction (AMI) are not known. In this observational prospective study serum endoglin levels were measured by ELISA in 183 AMI patients upon admission to hospital and 48 hrs later and in 72 healthy controls.

Association between self-replicating calcifying nanoparticles and aortic stenosis: a possible link to valve calcification.

Aims: Among various hypotheses proposed for pathological tissue calcification, recent evidence supports the possibility that self-replicating calcifying nanoparticles (CNPs) can contribute to such calcification. These CNPs have been detected and isolated from calcified human tissues, including blood vessels and kidney stones, and are referred to as nanobacteria. We evaluated calcific aortic valves for the presence of CNP.

Relationship between the QTc interval at hospital admission and the severity of the underlying ischaemia in low and intermediate risk people studied for acute chest pain.

Background: The corrected QT interval (QTc) is prolonged in the setting of acute coronary artery disease. However, very little data are available concerning the relationship between the QTc obtained soon after an episode of acute chest pain (ACHP) and the magnitude and severity of the myocardial ischaemia objectified in subsequent stress tests (STS).

Methods: This was a prospective and observational study in which we investigated the relationship between the QTc determined on the hospital admission electrocardiogram (AQTc) using Bazett's formula and the results of the STS performed subsequently in 206 patients consecutively admitted to the Emergency Department for ACHP without persistent ST-elevation.

Short- and long-term prognostic value of the corrected QT interval in the non-ST-elevation acute coronary syndrome.

Background And Purpose: Myocardial ischemia prolongs the QTc interval. Very little data exists about its prognostic implications in the non-ST-elevation acute coronary syndromes (NST-ACS).

Methods: This is and observational and prospective study in which we evaluated the prognostic implications of the QTc obtained at admission (AQTc) in the short- and long-term of the NST-ACS.

[Spanish Society of Cardiology ethical framework (executive summary)].

The Spanish Society of Cardiology (SEC) has produced an Ethical Framework Document. This document is divided into two distinct parts that deal, respectively, with the responsibilities of the SEC as an organization and the responsibilities of its professional members. The SEC makes recommendations on how its members should carry out their daily clinical practice, provides a professional perspective on public commitments as a scientific association, and aims to ensure that any views, recommendations, and advice expressed provide the basis for an informed debate on ethical problems in our field of work.

Homocysteine and outcome in young patients with acute coronary syndromes.

Background: Despite the well-known pro-thrombotic and pro-inflammatory plasma homocysteine effects, it remains uncertain whether these effects can be associated with an adverse cardiac outcome in young patients admitted with acute coronary syndromes.

Methods: Homocysteine levels were determined within 24 h after admission in 244 consecutive patients aged less than 56 years who presented with an acute coronary syndrome. We evaluated the relationship between homocysteine and both short-term (death, myocardial [re]infarction), and long-term prognosis (death, recurrent acute coronary syndrome and/or ischemic stroke), after 3.

[Imbalance between the supply and demand for cardiologists in Spain. Analysis of the current situation, future prospects, and possible solutions].

Planning cardiology provision in Spain requires knowledge of the resources available and the demand, both now and in the future. In this report, we present the results of a study carried out by the Spanish Society of Cardiology on the availability of and demand for cardiologists in the country. The current situation is characterized by an imbalance of around 14% between the number of active cardiologists and the estimated number required.