18 results on '"Jiménez Nacher JJ"'
Search Results
2. Prognostic implications of cardiac magnetic resonance feature tracking derived multidirectional strain in patients with chronic aortic regurgitation.
- Author
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Fernández-Golfín C, Hinojar-Baydes R, González-Gómez A, Monteagudo JM, Esteban A, Alonso-Salinas G, Fernández MA, García-Martín A, Santoro C, Pascual-Izco M, Jiménez-Nacher JJ, and Zamorano JL
- Subjects
- Echocardiography, Humans, Magnetic Resonance Imaging, Cine, Magnetic Resonance Spectroscopy, Predictive Value of Tests, Prognosis, Ventricular Function, Left, Aortic Valve Insufficiency diagnostic imaging, Ventricular Dysfunction, Left diagnostic imaging
- Abstract
Objective: Speckle-tracking echocardiography (STE) deformation parameters detect latent LV dysfunction in chronic aortic regurgitation (AR) and are associated with outcomes. The aim of the study was to evaluate cardiac magnetic resonance (CMR) feature tracking (FT) deformation parameters in asymptomatic patients with AR and implications in outcomes., Methods: Fifty-five patients with AR and 54 controls were included. Conventional functional CMR parameters, aortic regurgitant volume, and fraction were assessed. CMR-FT analysis was performed with a dedicated software. Clinical data was obtained from hospital records. A combined endpoint included all-cause mortality, cardiovascular mortality, aortic valve surgery, or cardiovascular hospital admission due to heart failure., Results: Left ventricular (LV) mechanics is impaired in patients with significant AR. Significant differences were noted in global longitudinal strain (GLS) between controls and AR patients (- 19.1 ± 2.9% vs - 16.5 ± 3.2%, p < 0.001) and among AR severity groups (- 18.3 ± 3.1% vs - 16.2 ± 1.6% vs - 15 ± 3.5%; p = 0.02 for AR grades I-II, III, and IV). In univariate and multivariate analyses, circumferential strain (GCS) and global radial strain (GRS) but not GLS were associated with and increased risk of the end point with a HR of 1.26 (p = 0.016, 1.04-1.52) per 1% worsening for GCS and 0.90 (p = 0.012, 0.83-0.98) per 1% worsening for GRS., Conclusions: CMR-FT myocardial deformation parameters are impaired in patients with AR not meeting surgical criteria. GLS decreases early in the course of the disease and is a marker of AR severity while GCS and GRS worsen later but predict a bad prognosis, mainly the need of aortic valve surgery., Key Points: • CMR feature tracking LV mechanic parameters may be reduced in significant chronic AR with normal EF. • LV mechanics, mainly global longitudinal strain, worsens as AR severity increases. • LV mechanics, specially global radial and circumferential strain, is associated with a worse prognosis in AR patients.
- Published
- 2021
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3. Geometrical and functional cardiac changes after cardiac surgery: a phisiopatological explanation based on speckle tracking.
- Author
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Moya Mur JL, García Martín A, García Lledó A, Lázaro Rivera C, Rincón Díaz LM, Miguelena Hycka J, Boretti I, Gimaraes C, Casas Rojo E, Jiménez Nacher JJ, Fernández-Golfín C, Rodríguez-Roda Stuart J, and Zamorano JL
- Subjects
- Adult, Aged, Aged, 80 and over, Biomechanical Phenomena, Female, Humans, Male, Middle Aged, Myocardial Contraction, Predictive Value of Tests, Prospective Studies, Treatment Outcome, Ventricular Dysfunction, Right etiology, Ventricular Dysfunction, Right physiopathology, Ventricular Function, Left, Cardiac Surgical Procedures adverse effects, Echocardiography methods, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Function, Right
- Abstract
Cardiac surgery induces geometrical and functional changes, which are not clearly explained. Objective: to investigate the physiopathology of the heart after cardiac surgery using advanced techniques of echocardiography. Thirty patients undergoing cardiac surgery had echocardiographic study prior and after surgery. Left and right ventricular (RV) longitudinal displacement and strain were studied with speckle-tracking. Using longitudinal displacement, we defined a static longitudinal reference-point (sLRP) to which the other segments moved during systole. Transversal displacement and global function were determined by conventional-echo. Left and RV segments showed systolic longitudinal displacement towards the apex, which was the sLRP before surgery; and towards the medium segment of lateral RV-wall one week after surgery. The displacement of basal RV segment towards this sLRP was smaller, causing decreased TAPSE. Apical segments showed an inverse displacement towards the new sLRP, and septum displacement was decreased or inverted towards the lateral RV-wall, causing paradoxus septal motion. RV-wall longitudinal strain was reduced (- 23.1 ± 8.6 vs. - 14.6 ± 5.3;p < 0.001), RV transversal fractional shortening was increased (36.5 ± 10.5 vs. 41.7 ± 13; p = 0.011), and the RV fractional area change was unchanged (46.7 ± 9.5 vs. 47.8 ± 11.7; p = 0.625). The medium segment of RV lateral wall, in contact with sternotomy, remains static after surgery and acts as a new sLRP towards which the rest of segments move, explaining the reduction of TAPSE and paradoxus septal motion. The longitudinal strain of the lateral RV-wall gets impaired, but an increase of transversal motion maintains global RV function.
- Published
- 2018
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4. Three-dimensional full automated software in the evaluation of the left ventricle function: from theory to clinical practice.
- Author
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Barletta V, Hinojar R, Carbonell A, González-Gómez A, Fabiani I, Di Bello V, Jiménez-Nacher JJ, Zamorano J, and Fernández-Golfín C
- Subjects
- Automation, Cardiac Imaging Techniques, Female, Humans, Male, Middle Aged, Reproducibility of Results, Echocardiography, Three-Dimensional methods, Heart Ventricles diagnostic imaging, Software, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Function, Left
- Abstract
Left ventricular systolic function evaluation is an essential part of all transthoracic echocardiographic (TTE) studies. 3D echocardiography (3DE) is superior to 2D and is recommended as the method of choice. However, since it is time consuming and requires training, it is rarely performed. Different automatic analysis software tries to overcome these limitations but they need to be accurate and reproducible before they can be used clinically. The aim of this study was to test the accuracy and reproducibility of new 3D automatic quantitative software in everyday clinical practice. 69 patients referred to our Echo Lab for a clinically indicated echocardiographic examination were included. All patients underwent a full TTE with 3D image acquisition. Left ventricular volumes and ejection fraction (LVEF) were obtained using Heart Model software, and compared with conventional 3D volumetric data. Automated analysis was performed using three different sliders setting, with or without regional editing if necessary. 20 patients underwent a cardiac magnetic resonance (CMR) study the same day of the echo and automated measurements were also compared with a CMR reference. Intra- and inter-technique comparisons including linear regression with Pearson correlation coefficients and Bland-Altman analyses were calculated. Mean age of the patients was 59 years, with 49.3% male. The automated 3DE model demonstrated excellent correlation with the conventional 3DE measurements of LVEF, using three different sliders settings (r = 0.906; r = 0.898 and r = 0.940). Correlations with CMR values were very good as well (r = 0.888; r = 0.869; r = 0.913). Similarly, no significant differences were noted between the values of EDV and ESV, measured with the automated model or CMR, with excellent correlation (EDV: r = 0.892, r = 0.842, 0.910; ESV: r = 0.925, r = 0.860, r = 0.907). Finally, volumes calculated with the automated software were significantly greater than those obtained manually, but they showed a very good correlation (EDV: r = 0.875, r = 0.856, r = 0.891; ESV: r = 0.929, r = 0.879, r = 949). 3D automatic software for LV quantification is feasible and shows excellent correlations with both CMR and 3D echocardiography, considered the gold standard. No clinically relevant differences were noted when applying different border settings. This technique holds promise to facilitate the integration of 3D TTE into clinical practice.
- Published
- 2018
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5. Severe aortic stenosis patients with preserved ejection fraction according to flow and gradient classification: Prevalence and outcomes.
- Author
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González Gómez A, Fernández-Golfín C, Monteagudo JM, Izurieta C, Hinojar R, García A, Casas E, Jiménez-Nacher JJ, Moya JL, Ruiz S, and Zamorano JL
- Subjects
- Aged, Aged, 80 and over, Aortic Valve Stenosis mortality, Echocardiography, Doppler trends, Female, Follow-Up Studies, Humans, Male, Prevalence, Retrospective Studies, Treatment Outcome, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis physiopathology, Fractional Flow Reserve, Myocardial physiology, Severity of Illness Index, Stroke Volume physiology
- Abstract
Background: Clinicians often encounter patients with apparently discordant echocardiographic findings, severe aortic stenosis (SAS) defined by aortic valve area (AVA) despite a low mean gradient. A new classification according to flow state and pressure gradient has been proposed. We sought to assess the prevalence, characteristics and outcomes of patients with asymptomatic SAS with preserved left-ventricular ejection fraction (LVEF) according to flow and gradient., Methods and Results: In total 442 patients with SAS (AVAi<0.6 cm2/m2) and LVEF ≥50% (mean age 80+11years, 54,5% female) were included. Patients were classified according to flow state (≥ or <35ml/m
2 ) and mean pressure gradient (≥ or <40mmHg): Low Flow/Low Gradient (LF/LG): 21.3%(n=94); Normal Flow/Low Gradient (NF/LG): 32.1%(n=142); Low Flow/High Gradient (LF/HG): 6.8%(n=30); Normal Flow/High Gradient (NF/HG): 39,8%(n=176). Mean follow-up time was 20.5months (SD=10.3). Primary combined endpoint was cardiovascular mortality and hospital admission for SAS related symptom, secondary endpoint was aortic valve replacement (AVR), comparing HG group to LF/LG group. During follow-up 17 (18%) of LF/LG patients and 21 (10.2%) of HG patients met the primary endpoint. A lower free of event survival (cardiovascular mortality and hospital admission) was observed in patients with LF/LG AS (Breslow, p=0.002). Significant differences were noted between groups with a lower AVR free survival in the LF/LG group compared to HG groups (Breslow, p=0.002)., Conclusions: Our study confirms the high prevalence and worse prognosis of LF/LG SAS. Clinicians must be aware of this entity to ensure appropriate patient management., (Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.)- Published
- 2017
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6. Area strain from 3D speckle-tracking echocardiography as an independent predictor of early symptoms or ventricular dysfunction in asymptomatic severe mitral regurgitation with preserved ejection fraction.
- Author
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Casas-Rojo E, Fernández-Golfin C, Moya-Mur JL, González-Gómez A, García-Martín A, Morán-Fernández L, Rodríguez-Muñoz D, Jiménez-Nacher JJ, Martí Sánchez D, and Zamorano Gómez JL
- Subjects
- Aged, Asymptomatic Diseases, Biomechanical Phenomena, Case-Control Studies, Chi-Square Distribution, Disease Progression, Disease-Free Survival, Echocardiography, Doppler, Pulsed, Female, Heart Failure etiology, Heart Failure physiopathology, Humans, Kaplan-Meier Estimate, Linear Models, Male, Middle Aged, Mitral Valve physiopathology, Mitral Valve Insufficiency complications, Mitral Valve Insufficiency physiopathology, Mitral Valve Insufficiency surgery, Multivariate Analysis, Patient Selection, Predictive Value of Tests, Proportional Hazards Models, Prospective Studies, Risk Factors, Severity of Illness Index, Stress, Mechanical, Time Factors, Ventricular Dysfunction, Left etiology, Ventricular Dysfunction, Left physiopathology, Echocardiography, Three-Dimensional, Mitral Valve diagnostic imaging, Mitral Valve Insufficiency diagnostic imaging, Stroke Volume, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Function, Left
- Abstract
The indication for surgery in asymptomatic severe mitral regurgitation (SMR) with preserved left ventricular ejection fraction (LVEF) is controversial. We sought to study 3D myocardial mechanics in this population and test 3D-speckle tracking (3DST) parameters as possible predictors of events. 45 asymptomatic patients with SMR and LVEF >60 % and 20 control individuals without cardiac disease underwent 3DST echocardiography. MR group additionally underwent further clinical monitoring. Dyspnea, LVEF under 60 %, or admissions for heart failure were considered as events. When compared with control group, MR group showed lower percentage of global 3D strain, (35.4 ± 9.1 vs. 43.9 ± 10.6; p = 0.003), lower radial strain, lower area change rate and higher end-diastolic volume. In a follow-up time of 23.2 ± 14.5 months we found 15 events (33.3 %). When comparing the remaining patients with this new-onset HF group we found significant differences in longitudinal strain (-17.9 ± 3.3 vs. -15.8 ± 2.1; p = 0.036), area strain (AS) (-48.6 ± 4.6 vs. -43.7 ± 6.2; p = 0.006), circumferential strain (-35.8 ± 4.7 vs. -31.8 ± 6.1; p = 0.034), 3D LVEF (67.1 ± 4.6 vs. 63.0 ± 7.4; p = 0.034) and E/E' index (13.5 ± 3.9 vs. 19.3 ± 9.5; p = 0.006). In multivariate Cox regression AS alone was the only independent predictor. A cutoff value of AS greater than -41.6 % reached a hazard ratio of 4.41 (p = 0.004) for prediction of events. In asymptomatic patients with SMR and preserved ejection fraction, 3DST derived AS is a promising tool for predicting the development of heart failure. This finding may be useful for guiding the selection of patients for early mitral valve repair/replacement surgery even if they are asymptomatic.
- Published
- 2016
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7. Accuracy and reproducibility of novel echocardiographic three-dimensional automated software for the assessment of the aortic root in candidates for thanscatheter aortic valve replacement.
- Author
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García-Martín A, Lázaro-Rivera C, Fernández-Golfín C, Salido-Tahoces L, Moya-Mur JL, Jiménez-Nacher JJ, Casas-Rojo E, Aquila I, González-Gómez A, Hernández-Antolín R, and Zamorano JL
- Subjects
- Aged, Aged, 80 and over, Aorta diagnostic imaging, Aortic Valve Stenosis mortality, Automation, Cohort Studies, Echocardiography, Three-Dimensional instrumentation, Female, Humans, Male, Observer Variation, Patient Selection, Preoperative Care methods, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Software, Treatment Outcome, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Echocardiography, Three-Dimensional methods, Echocardiography, Transesophageal, Multidetector Computed Tomography methods, Transcatheter Aortic Valve Replacement methods
- Abstract
Aims: A specialized three-dimensional transoesophageal echocardiography (3D-TOE) reconstruction tool has recently been introduced; the system automatically configures a geometric model of the aortic root from the images obtained by 3D-TOE and performs quantitative analysis of these structures. The aim of this study was to compare the measurements of the aortic annulus (AA) obtained by the new model to that obtained by 3D-TOE and multidetector computed tomography (MDCT) in candidates to transcatheter aortic valve implantation (TAVI) and to assess the reproducibility of this new method., Methods and Results: We included 31 patients who underwent TAVI. The AA diameters and area were evaluated by the manual 3D-TOE method and by the automatic software. We showed an excellent correlation between the measurements obtained by both methods: intra-class correlation coefficient (ICC): 0.731 (0.508-0.862), r: 0.742 for AA diameter and ICC: 0.723 (0.662-0.923), r: 0.723 for the AA area, with no significant differences regardless of the method used. The interobserver variability was superior for the automatic measurements than for the manual ones. In a subgroup of 10 patients, we also found an excellent correlation between the automatic measurements and those obtained by MDCT, ICC: 0.941 (0.761-0.985), r: 0.901 for AA diameter and ICC: 0.853 (0.409-0.964), r: 0.744 for the AA area., Conclusion: The new automatic 3D-TOE software allows modelling and quantifying the aortic root from 3D-TOE data with high reproducibility. There is good correlation between the automated measurements and other 3D validated techniques. Our results support its use in clinical practice as an alternative to MDCT previous to TAVI., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)
- Published
- 2016
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8. Reproducibility of a novel echocardiographic 3D automated software for the assessment of mitral valve anatomy.
- Author
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Aquila I, González A, Fernández-Golfín C, Rincón LM, Casas E, García A, Hinojar R, Jiménez-Nacher JJ, and Zamorano JL
- Subjects
- Aged, Female, Humans, Male, Prognosis, Reproducibility of Results, Retrospective Studies, Severity of Illness Index, Echocardiography, Three-Dimensional methods, Echocardiography, Transesophageal methods, Heart Valve Diseases diagnosis, Mitral Valve diagnostic imaging, Software
- Abstract
Background: 3D transesophageal echocardiography (TEE) is superior to 2D TEE in quantitative anatomic evaluation of the mitral valve (MV) but it shows limitations regarding automatic quantification. Here, we tested the inter-/intra-observer reproducibility of a novel full-automated software in the evaluation of MV anatomy compared to manual 3D assessment., Methods: Thirty-six out of 61 screened patients referred to our Cardiac Imaging Unit for TEE were retrospectively included. 3D TEE analysis was performed both manually and with the automated software by two independent operators. Mitral annular area, intercommissural distance, anterior leaflet length and posterior leaflet length were assessed., Results: A significant correlation between both methods was found for all variables: intercommissural diameter (r = 0.84, p < 0.01), mitral annular area (r = 0.94, p > 0, 01), anterior leaflet length (r = 0.83, p < 0.01) and posterior leaflet length (r = 0.67, p < 0.01). Interobserver variability assessed by the intraclass correlation coefficient was superior for the automatic software: intercommisural distance 0.997 vs. 0.76; mitral annular area 0.957 vs. 0.858; anterior leaflet length 0.963 vs. 0.734 and posterior leaflet length 0.936 vs. 0.838. Intraobserver variability was good for both methods with a better level of agreement with the automatic software., Conclusions: The novel 3D automated software is reproducible in MV anatomy assessment. The incorporation of this new tool in clinical MV assessment may improve patient selection and outcomes for MV interventions as well as patient diagnosis and prognosis stratification. Yet, high-quality 3D images are indispensable.
- Published
- 2016
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9. Four chamber right ventricular longitudinal strain versus right free wall longitudinal strain. Prognostic value in patients with left heart disease.
- Author
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García-Martín A, Moya-Mur JL, Carbonell-San Román SA, García-Lledó A, Navas-Tejedor P, Muriel A, Rodríguez-Muñoz D, Casas-Rojo E, Jiménez-Nacher JJ, Fernández-Golfín C, and Zamorano JL
- Subjects
- Aged, Echocardiography, Female, Follow-Up Studies, Heart Ventricles physiopathology, Humans, Male, Prognosis, Prospective Studies, Stroke Volume, Ventricular Dysfunction, Left diagnosis, Heart Ventricles diagnostic imaging, Ventricular Dysfunction, Left physiopathology, Ventricular Function, Right physiology
- Abstract
Background: There is no consensus on which right ventricle (RV) strain parameter should be used in the clinical practice: four chamber RV longitudinal strain (4CH RV-LS) or free wall longitudinal strain (FWLS). The aim of this study was to analyze which RV strain parameter better predicts prognosis in patients with left heart disease., Methods: One hundred and three outpatients with several degrees of functional tricuspid regurgitation severity secondary to left heart disease were prospectively included. 4CH RV-LS and FWLS were assessed using speckle tracking. Left ventricular (LV) systolic function was determined using LV ejection fraction and RV systolic function using tricuspid annular plane systolic excursion (TAPSE). Patients were followed up for 23.1 ± 12.4 months for an endpoint of cardiac hospitalization due to heart failure., Results: The cutoff value related to RV dysfunction (TAPSE < 17 mm) was lower, in absolute value, for 4CH RV-LS (4CH RV-LS = -17.3%; FWLS = -19.5%). There were 33 adverse events during the follow-up. Patients with 4CH RV-LS > -17.3% (log rank [LR] = 22.033; p < 0.001); FWLS > -19.5% (LR = 12.2; p < 0.001), TAPSE < 17 mm (LR = 17.4; p < 0.001) and LV systolic dysfunction (LR = 13.3; p < 0.001) had lower event-free survival (Kaplan Meier). In Cox multivariate analysis, 4CH RV-LS > -17.3% (hazard ratio [HR] = 3.593; p < 0.002), TAPSE < 17 (HR = 2.093; p < 0.055) and LV systolic dysfunction (HR = 2.087; p < 0,054) had prognostic value, whereas FWLS did not reach significance., Conclusions: Although both 4CH RV-LS and FWLS have prognostic value, 4CH RV-LS is a better predictor of episodes of heart failure in patients with left heart disease, providing additional information to that obtained by TAPSE.
- Published
- 2016
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10. Aortic fibroelastoma: detailed preoperative analysis with 3D echocardiography.
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Moya-Mur JL, Silva-Guisasola J, Casas-Rojo E, Martín-García M, de Pablo-Zarzosa C, Jiménez-Nacher JJ, and Zamorano-Gomez JL
- Subjects
- Aged, Aortic Valve diagnostic imaging, Aortic Valve surgery, Diagnosis, Differential, Fibroma surgery, Heart Valve Diseases surgery, Humans, Male, Echocardiography, Three-Dimensional, Fibroma diagnostic imaging, Heart Valve Diseases diagnostic imaging, Preoperative Care
- Published
- 2015
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11. 'Tri-leaflet mitral valve morphology': a new phenotypic expression in hypertrophic cardiomyopathy?
- Author
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Moya-Mur JL, García-Martín A, Jiménez-Nacher JJ, Fernández-Golfín C, and Zamorano-Gómez JL
- Subjects
- Aged, Female, Humans, Mitral Valve Insufficiency etiology, Phenotype, Cardiomyopathy, Hypertrophic complications, Echocardiography, Transesophageal, Mitral Valve abnormalities, Mitral Valve diagnostic imaging, Mitral Valve Insufficiency diagnostic imaging
- Published
- 2015
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12. Nonvalvular atrial aneurysmal dilation.
- Author
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Moya-Mur JL, Becker-Filho D, Jiménez-Nacher JJ, García-Lledó A, Fernández-Golfin C, and Zamorano-Gómez JL
- Subjects
- Aged, Aged, 80 and over, Aortic Aneurysm complications, Aortic Aneurysm diagnostic imaging, Echocardiography, Female, Heart Diseases etiology, Humans, Male, Aortic Aneurysm pathology
- Published
- 2013
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13. Right atrial rupture in angiosarcoma.
- Author
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Moya Mur JL, Oliva Danquin E, Jiménez Nacher JJ, Fernández-Golfin C, and Zamorano J
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- Adult, Chest Pain etiology, Echocardiography, Echocardiography, Doppler, Color, Echocardiography, Transesophageal, Hemangiosarcoma surgery, Humans, Imaging, Three-Dimensional, Male, Mediastinal Neoplasms surgery, Neoplasm Invasiveness, Rupture diagnostic imaging, Rupture etiology, Heart Atria diagnostic imaging, Heart Atria injuries, Hemangiosarcoma diagnosis, Mediastinal Neoplasms diagnosis
- Published
- 2013
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14. Double-orifice tricuspid valve in Ebstein's anomaly.
- Author
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Moya Mur JL, González Ferrer E, Jiménez Nacher JJ, Centella T, and Zamorano J
- Subjects
- Adult, Ebstein Anomaly physiopathology, Electrocardiography methods, Humans, Male, Sensitivity and Specificity, Severity of Illness Index, Tricuspid Valve diagnostic imaging, Ultrasonography, Doppler, Color methods, Ebstein Anomaly diagnostic imaging, Echocardiography methods, Imaging, Three-Dimensional, Tricuspid Valve abnormalities
- Published
- 2013
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15. Indexed left atrial volume is a more sensitive indicator of filling pressures and left heart function than is anteroposterior left atrial diameter.
- Author
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Moya-Mur JL, García-Martín A, García-Lledó A, Ruiz-Leria S, Jiménez-Nacher JJ, Megias-Sanz A, Taboada D, and Muriel A
- Subjects
- Adult, Aged, Aged, 80 and over, Blood Pressure, Female, Humans, Image Enhancement methods, Male, Middle Aged, Organ Size, Reproducibility of Results, Sensitivity and Specificity, Young Adult, Algorithms, Blood Pressure Determination methods, Echocardiography methods, Heart Atria diagnostic imaging, Image Interpretation, Computer-Assisted methods, Imaging, Three-Dimensional methods
- Abstract
Introduction: Left atrial (LA) size is an indicator of the pressure to which it is chronically subjected. Although guidelines recommend measuring it using volume indexed to body surface, the anteroposterior diameter is still normally used., Aim: To evaluate which of these measurements correlates better with atrial pressure-related echocardiographic parameters., Methods: Atrial diameter and volume, together with parameters of systolic function, diastolic function, pressure, and degree of mitral regurgitation, were measured in 121 consecutive outpatients., Results: Atrial diameter correlated with its indexed volume (r: 0.69) with a low degree of agreement for detecting dilation (Kappa: 0.51). Atrial diameter was related to the parameters associated with atrial pressure: E/E' (r: 0.44), pulmonary vein systolic/diastolic rates quotient (r: 0.25) and degree of mitral regurgitation (r: 0.19). The correlations improved when volume indexed to body surface was measured (r: 0.52; 0.38 and 0.44, respectively). In a multiple regression analysis that included E/E', pulmonary vein flow and degree of mitral regurgitation, LA diameter depended entirely on E/E' (r: 0.44; B: 0.04; P: 0.000). The relationship improved when the diameter was corrected for body surface or the volume was measured (r: 0.54 and 0.54, respectively), and in particular when volume indexed to body surface was measured (r: 0.66). In this case, pulmonary vein flow (B: 6.8; P: 0.03), degree of mitral regurgitation (B: 5.2; P: 0.000) and E/E' ratio (B: 0.8; P : 0.000) were included in the equation., Conclusions: Indexed atrial volume correlates better with LA pressure surrogates than the anteroposterior diameter, even when this is corrected for body surface., (© 2010, Wiley Periodicals, Inc.)
- Published
- 2010
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16. [Familial form of noncompaction cardiomyopathy associated with polycystic kidney disease].
- Author
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Briongos-Figuero S, Ruiz-Rejón F, Jiménez-Nacher JJ, and Megías A
- Subjects
- Aged, Female, Humans, Isolated Noncompaction of the Ventricular Myocardium genetics, Male, Middle Aged, Polycystic Kidney Diseases genetics, Isolated Noncompaction of the Ventricular Myocardium complications, Polycystic Kidney Diseases complications
- Published
- 2010
- Full Text
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17. [Platelet activation and inhibition. Old and new platelet antiaggregants].
- Author
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López Bescós L and Jiménez Nacher JJ
- Subjects
- Humans, Platelet Aggregation drug effects, Platelet Glycoprotein GPIIb-IIIa Complex antagonists & inhibitors, Angina, Unstable blood, Angina, Unstable drug therapy, Platelet Aggregation Inhibitors therapeutic use
- Abstract
Aggregates of activated platelets, at the level of a plaque fissure, seem to have a pivotal role in acute coronary syndromes. The glycoprotein IIb-IIIa receptors of the platelet surface are thought to be the final common pathway of platelet aggregation. The possibility of using a basic treatment to control platelet aggregation, in the whole clinical spectrum of acute coronary syndromes is attractive. The results of different clinical studies show evidence that glycoprotein IIb-IIIa antagonists, given intravenously, are effective in the management of acute coronary intervention with high thrombogenic risk, and also help to control the early phase of acute coronary syndromes. In patients who have responded to the acute i.v. infusion, the chronic oral administration of those agents might contribute to their clinical stabilization and reduce the risk of further coronary events.
- Published
- 1999
18. [Esophago-mediastinal fistula in a patient with lymphatic tuberculosis and human immunodeficiency virus infection].
- Author
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Salavert Lleti M, Navarro Ibáñez V, Nieto García A, Ferrer Tuset C, Jiménez Nacher JJ, and López Chulia F
- Subjects
- Adult, Female, Humans, Acquired Immunodeficiency Syndrome complications, Esophageal Fistula etiology, Fistula etiology, Mediastinal Diseases etiology, Tuberculosis, Lymph Node complications
- Abstract
A case of a 27 year old female diagnosed as having TB and AIDS, who had a mediastinal lymph node fistulized to the esophagus, is presented. We correlate this description to 2 important aspects: 1) lymph node TB as the most frequent cause of extrapulmonary TB; 2) The association of TB and AIDS. We analysed the rareness of this association, suggesting the possible mechanism of production, commenting on the main clinical features and diagnostic/therapeutic attitudes of esophago-mediastinal fistula of TB origin.
- Published
- 1989
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