Publications by authors named "Francisco Jose Hernandez-Perez"
Antibodies directed against donor-specific human leukocyte antigens (HLAs) can be detected de novo after heart transplantation and play a key role in long-term survival. De novo donor-specific antibodies (dnDSAs) have been associated with cardiac allograft vasculopathy, antibody-mediated rejection, and mortality. Advances in detection methods and international guideline recommendations have encouraged the adoption of screening protocols among heart transplant units.
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- Endomyocardial biopsy (EMB) is important for diagnosing fulminant myocarditis in adults, but its timing and effects on patient outcomes are still being studied.
- In a study involving 419 patients across 36 centers, those who had an early EMB (within 2 days of ICU admission) showed significantly better survival rates (63%) without needing heart transplants or LVAD compared to those with delayed EMB (40%).
- The research suggests that early EMB is associated with lower mortality rates and better overall outcomes, supporting its prompt use in ICU patients suspected of having fulminant myocarditis.
Article Synopsis
- A study was conducted to assess the prevalence and prognostic significance of donor-transmitted coronary artery disease (TCAD) in heart transplant patients across 11 Spanish hospitals from 2008 to 2018.
- Out of 1,918 heart transplant patients, 937 had coronary angiography (c-angio) within the first three months, revealing that 18.3% had TCAD, with 6.9% having significant TCAD (s-TCAD) and 11.4% having nonsignificant TCAD (ns-TCAD).
- The study found that while s-TCAD did not significantly impact overall survival, it was linked to a higher risk of cardiovascular death and major adverse cardiovascular events, indicating a
Article Synopsis
- Despite advances in mechanical circulatory support, patients with cardiogenic shock still have a poor prognosis, prompting the need for improved rapid care initiatives.
- This document emphasizes the importance of a structured "SC code" to enhance the organization, activation, and care flow for cardiogenic shock patients.
- The authors aim to outline the unique aspects of cardiogenic shock, team logistics, management strategies, and the challenges of implementing an SC code in both adult and pediatric cases.
Article Synopsis
- - The LEONE-HT study investigates the poor heart transplant (HT) survival rates and the role of anti-HLA antibodies, which may cause cardiac allograft dysfunction in patients receiving heart transplants.
- - It involves a cohort of HT patients, comparing those with positive anti-HLA antibodies to those without, utilizing advanced assessment methods like imaging and immunological analyses to understand the extent of myocardial damage.
- - Ethical standards for the study are met, adhering to global guidelines, and findings will be shared through patient associations and registered on clinicaltrials.gov for transparency.
Article Synopsis
- There is limited understanding of how gender affects the clinical presentation, treatment, and outcomes of patients experiencing cardiogenic shock (CS), particularly in a hospital setting.
- The study aimed to explore gender-related differences in characteristics, management, and in-hospital mortality among CS patients, while also evaluating the prognostic accuracy of the SCAI classification for predicting mortality by sex.
- An analysis of 163 CS patients showed that women were less likely to smoke and had lower rates of certain conditions compared to men, but in-hospital survival rates were similar across genders, indicating no significant differences in outcomes.
Introduction And Objectives: Endomyocardial biopsy (EMB) is the only technique able to establish an etiological diagnosis of myocarditis or inflammatory cardiomyopathy (ICM). The aim of this study was to analyze the clinical profile, outcomes, and prognostic factors of patients with suspected myocarditis/ICM undergoing EMB.
Methods: We retrospectively analyzed the clinical characteristics, histological findings, and follow-up data of all patients with suspected myocarditis or ICM who underwent EMB between 1997 and 2019 in a Spanish tertiary hospital.
Article Synopsis
- Controlled donation after circulatory death (cDCD) is an emerging method to expand the organ donor pool, with new techniques allowing heart transplants from cDCD donors to become viable.
- A case in Spain involved a 43-year-old female donor whose heart was successfully procured using thoraco-abdominal normothermic regional perfusion, contrasting with traditional methods that required ex-situ devices.
- This case demonstrates the potential for effective heart transplantation from cDCD donors while also paving the way for increased multiorgan donation opportunities.
Article Synopsis
- Early recognition and risk stratification are important for managing cardiogenic shock (CS), but there are concerns about lower adherence to recommendations in women with cardiovascular diseases.
- Data from the Red-Shock registry included 793 patients, revealing that women were older and had different health backgrounds but showed similar treatment approaches and in-hospital mortality rates compared to men.
- Both CardShock and IABP-SHOCK II risk scores were effective in predicting in-hospital mortality for both men and women, indicating that gender does not significantly affect management or outcomes in CS.
Article Synopsis
- The study focuses on improving outcomes for patients with cardiogenic shock (CS), particularly those requiring mechanical circulatory support (MCS), by analyzing a care program implemented by a multidisciplinary team in a regional hospital network from 2014 to 2019.
- A total of 130 patients were examined, with a majority being middle-aged men; most cases were due to heart failure or myocardial infarction, and 81% of patients used MCS, primarily extracorporeal membrane oxygenation (ECMO).
- The program achieved a 57% survival rate to discharge, suggesting that a coordinated approach with specialized teams significantly benefits patients in critical conditions like refractory CS.
Article Synopsis
- Cardiac amyloidosis (CA) is caused by amyloid fiber buildup in the heart, primarily from light chains (AL) or transthyretin (ATTR), and this study aimed to describe its diagnosis and treatment outcomes in a Spanish hospital.
- The study involved 180 patients diagnosed with CA, where the majority were diagnosed with ATTR, showing that heart failure was the most common symptom, but AL patients had higher mortality rates.
- The research highlighted significant diagnostic delays for ATTR patients and identified key mortality predictors, emphasizing the need for improved early detection and treatment strategies for CA.
Article Synopsis
- The study investigates the use of paracorporeal pulsatile-flow ventricular assist devices (VADs) as a bridge to transplant (BTT) in adults, highlighting their advantages and limitations compared to continuous-flow devices.
- A retrospective analysis of patients treated with the EXCOR VAD from 2009 to 2015 was conducted, revealing that 80% of patients successfully received heart transplants after an average of 112 days of support.
- The main complications encountered included infections, neurological issues, bleeding, and device malfunctions, indicating the need for close monitoring in patients using this VAD method.
A ventricular septal defect (VSD) is a rare complication of blunt chest trauma. This report presents the case of a 44-year-old man who developed a VSD as a result of high-energy closed chest trauma. We describe the initial surgical and medical management of the cardiac rupture.
View Article and Find Full Text PDFIntroduction And Objectives: The beneficial effect of coronary collateral circulation (CC) in patients with ST-segment elevation myocardial infarction is controversial. The aim of this study was to evaluate the impact of CC before reperfusion with primary angioplasty (PA) on the long-term prognosis of these patients.
Methods: Retrospective observational study of a cohort of 947 patients treated with PA and TIMI grade ≤ 1 flow in a single center from 2005 to 2013.
Article Synopsis
- Targeted therapies, especially when combined with chemotherapy, have shown to enhance response rates and improve survival in various solid tumors.
- Trastuzumab is a key monoclonal antibody that has beneficial effects on breast cancer cells but also poses risks to heart health due to shared signaling pathways.
- Current research is focused on developing better monitoring and risk management strategies to ensure more patients can safely receive trastuzumab, rather than limiting its use.