Publications by authors named "Zamorano J"

Aims: No study has analyzed the impact of guideline-directed medical therapy in preventing heart failure (HF) relapse in patients with arrhythmia-induced cardiomyopathy (AiCM) following left ventricular ejection fraction (LVEF) improvement.

Methods And Results: We analyzed data from a single-center cohort of 200 patients admitted for HF, LVEF <50% and cardiac arrhythmia considered by cardiologists to be the precipitating cause of the episode. The primary endpoint was time-to-HF relapse, defined as the composite of readmission for HF, Emergency Department (ED) visit for HF, or significant decline in LVEF.

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Despite the challenges associated with periprocedural imaging, transcatheter tricuspid valve interventions have shown important impact on outcomes. A comprehensive understanding of the anatomy of the right heart and surrounding structures is crucial. One way to optimize these interventions is by identifying the optimal fluoroscopic viewing angles along the S-curve of the tricuspid valve.

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: Mitral regurgitation (MR) is the second most common valve disease in Europe, and differences between men and women have been described in relation to aetiology or management, which might impact the decision for intervention and patients' clinical and economic outcomes. Thus, the objective was to analyse the burden of MR in Spain by aetiology and sex, and the management of all patients suffering from MR being admitted to hospital between 2016-2021. : An analysis was carried out with the Ministry of Health's database, including all patients in public and subsidised hospitals and defining two groups, general MR and those patients undergoing Transcatheter Edge-to-Edge repair (TEER), using a descriptive analysis of patients' characteristics, use of resources, and outcomes; standardised rates were calculated and observed outcomes were described.

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Aims: Clinical practice guidelines are commonly written by professional societies in high-income countries (HIC) with limited anticipation of implementation obstacles in other environments. We used heart failure (HF) guidelines as a paradigm to examine this concern, by conducting a survey to understand clinicians' ability to implement HF guidelines and their perceptions of the current HF guideline applicability in low- and middle-income countries (LMIC).

Methods And Results: An online survey of physicians in the database of the Translational Medicine Academy who treat HF patients was offered by email from 5 October to 27 November 2023, inquiring of participants' demographic information, experience, and views of HF guidelines as related to their practice.

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Background: Reducing mitral regurgitation (MR) during mitral transcatheter edge-to-edge repair (M-TEER) may come at the cost of increased mitral valve gradient (MVG). The combined impact of residual MR and MVG on clinical outcomes after M-TEER is unknown.

Objectives: This study sought to evaluate the impact of postprocedure MR and MVG on clinical outcomes after M-TEER.

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Numerous cardioprotective interventions have been reported to reduce myocardial infarct size (IS) in pre-clinical studies. However, their translation for the benefit of patients with acute myocardial infarction (AMI) has been largely disappointing. One reason for the lack of translation is the lack of rigor and reproducibility in pre-clinical studies.

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Vascular aging is associated with the development of cardiovascular complications, in which endothelial cell senescence (ES) may play a critical role. Nitric oxide (NO) prevents human ES through inhibition of oxidative stress, and inflammatory signaling by mechanisms yet to be elucidated. Endothelial cells undergo an irreversible growth arrest and alter their functional state after a finite number of divisions, a phenomenon called replicative senescence.

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Cardiovascular (CV) disease is the most common cause of death in Europe. Despite proven benefits, use of lipid-lowering therapy remains suboptimal. Treatment goals are often not achieved, even in patients at high risk with atherosclerotic CV disease (ASCVD).

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Background: Moderate secondary mitral regurgitation (SMR) represents a subgroup of heart failure (HF) patients with treatment restricted to medical therapy. Outcomes in patients with moderate SMR treated with mitral transcatheter edge-to-edge repair (M-TEER) are less well known.

Objectives: The aim of this study was to assess the safety and effectiveness of M-TEER in subjects with moderate SMR using the EXPANDed studies.

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Article Synopsis
  • - This study analyzes the effects of mitral transcatheter edge-to-edge repair (M-TEER) on hospitalization rates for patients with functional mitral regurgitation (FMR) and symptomatic heart failure (HF), aiming to clarify conflicting results from previous research.
  • - The results indicate that patients who underwent M-TEER experienced significantly lower rates of recurrent heart failure hospitalizations and cardiovascular (CV) deaths over a 24-month period, as well as an improved quality of life compared to those in the control group.
  • - Specifically, patients in the M-TEER group spent fewer days in the hospital due to HF or CV issues, with a statistically significant reduction in total days lost due to these health complications.
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  • The study examined the effectiveness of transcatheter mitral-valve repair in patients suffering from heart failure and functional mitral regurgitation, comparing it to standard medical therapy.
  • In a trial with 505 patients, results showed that those who received the device had significantly lower rates of hospitalizations for heart failure and cardiovascular death compared to those who only received medical therapy.
  • Additionally, patients in the device group experienced a greater improvement in health status, as measured by the Kansas City Cardiomyopathy Questionnaire, indicating better outcomes with the transcatheter procedure.
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Introduction And Aims: Fabry disease (FD) causes glycosphingolipid accumulation in the vascular endothelium, with predominantly cardiac and renal involvement. Its prevalence in patients with concomitant involvement of these two organs is unknown. The objective of the study was to determine the prevalence of FD in patients with left ventricular hypertrophy and any degree of chronic kidney disease.

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Objective: Concerns exist about the possible detrimental effects of exercise training on aortic size and valve function in individuals with bicuspid aortic valve (BAV). This multicentre international study aimed to determine the characteristics of aortic size and valve function in athletes versus non-athletes with BAV and athletes with tricuspid aortic valve (TAV).

Methods: We enrolled competitive athletes with BAV and age- and sex-matched athletes with TAV and non-athletes with BAV.

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Introduction: Pulsed-field ablation (PFA) is a novel nonthermal energy that shows unique features that can be of use beyond pulmonary vein ablation, like tissue selectivity or proximity rather than contact dependency.

Methods And Results: We report three cases of right focal atrial tachycardias arising from the superior cavoatrial junction and the crista terminalis, in close relationship with the phrenic nerve, effectively ablated using a commercially available PFA catheter designed for pulmonary vein isolation without collateral damage.

Conclusion: PFA can be useful for treating right atrial tachycardias involving sites near the phrenic nerve, avoiding the need for complex nerve-sparing strategies.

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  • Atrial fibrillation (AF) is a common issue in cancer patients, and this study aims to evaluate their clinical characteristics and management, particularly focusing on antithrombotic medications.
  • The study involved 1,514 patients with recent cancer diagnoses and confirmed AF, finding high rates of cardiovascular diseases and a significant number of patients not receiving optimal anticoagulation treatment upon admission.
  • Results indicate a significant underuse of appropriate antithrombotic therapy, suggesting the necessity for improved cardiovascular assessments in the care of cancer patients with AF.
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  • Early discharge following a STEMI (heart attack) can benefit patients and healthcare systems, but its implementation is limited due to safety concerns.* -
  • In a study involving 1,105 patients who had primary PCI for STEMI, 453 patients (41%) were discharged within 48 hours, with an average age of about 62 years.* -
  • The results showed that early discharge was safe, with only 0.2% experiencing a non-fatal heart event, and only 1.1% requiring readmission for cardiovascular issues.*
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Article Synopsis
  • * The SPREAD study is a multinational research project aimed at understanding the impact of sports on BAV disease through two phases: a comparative cross-sectional analysis and a longitudinal follow-up.
  • * The ultimate goal of the study is to provide data that can help guide decisions on sports participation and assess risk for individuals with BAV.
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Aim: The RESHAPE-HF2 trial is designed to assess the efficacy and safety of the MitraClip device system for the treatment of clinically important functional mitral regurgitation (FMR) in patients with heart failure (HF). This report describes the baseline characteristics of patients enrolled in the RESHAPE-HF2 trial compared to those enrolled in the COAPT and MITRA-FR trials.

Methods And Results: The RESHAPE-HF2 study is an investigator-initiated, prospective, randomized, multicentre trial including patients with symptomatic HF, a left ventricular ejection fraction (LVEF) between 20% and 50% with moderate-to-severe or severe FMR, for whom isolated mitral valve surgery was not recommended.

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