12 results on '"Vera-Vera S"'
Search Results
2. Time to coronary angiography in a real-life cohort of NSTEACS patients: are guidelines too optimistic?
- Author
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Arbas Redondo, E, primary, Jurado Roman, A, additional, Jimenez Valero, S, additional, Galeote Garcia, G, additional, Moreno Gomez, R, additional, Tebar Marquez, D, additional, Poveda Pinedo, I D, additional, Rivero Santana, B, additional, Garcia Escobar, A, additional, Vera Vera, S, additional, Armada Romero, E, additional, Rey Blas, J R, additional, Garcia Garcia, A, additional, Gonzalez Davia, R, additional, and Lopez De Sa, E, additional
- Published
- 2022
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3. P4625Functional evolution of non-culprit lesions in acute myocardial infarction. A quantitative flow ratio study
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Cortes Villar, C, primary, Vera Vera, S, additional, Goncalves, L R, additional, Ramos, B, additional, Serrador, A, additional, Gutierrez, H, additional, Carrasco, M, additional, Gomez, I, additional, San Roman, J A, additional, and Amat-Santos, I J, additional
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- 2018
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4. A Prospective, Multicenter, Real-World Registry of Coronary Lithotripsy in Calcified Coronary Arteries: The REPLICA-EPIC18 Study.
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Rodriguez-Leor O, Cid-Alvarez AB, Lopez-Benito M, Gonzalo N, Vilalta V, Diarte de Miguel JA, López LF, Jurado-Roman A, Diego A, Oteo JF, Cuellas C, Trillo R, Travieso A, Alfonso F, Carrillo X, Vegas-Valle JM, Cortes-Villar C, Pascual I, Muñoz Camacho JF, Flores X, Vera-Vera S, Moreu J, Barreira de Sousa G, Martí D, Jimenez-Mazuecos J, Fuertes M, Ocaranza R, de la Torre Hernandez JM, Lozano F, Solana Martinez SG, Gómez-Lara J, and Perez de Prado A
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- Humans, Coronary Vessels, Prospective Studies, Treatment Outcome, Heart, Lithotripsy adverse effects, Acute Coronary Syndrome, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease therapy, Vascular Calcification diagnostic imaging, Vascular Calcification therapy
- Abstract
Background: Intravascular lithotripsy (IVL) has demonstrated effectiveness in the treatment of calcified lesions in selected patients with stable coronary disease., Objectives: The authors sought to assess the performance of coronary IVL in calcified coronary lesions in a real-life, all comers, setting., Methods: The REPLICA-EPIC18 study prospectively enrolled consecutive patients treated with IVL in 26 centers in Spain. An independent core laboratory performed the angiographic analysis and event adjudication. The primary effectiveness endpoint assessed procedural success (successful IVL delivery, final diameter stenosis <20%, and absence of in-hospital major adverse cardiovascular events [MACE]). The primary safety endpoint measured freedom from MACE at 30 days. A predefined substudy compared outcomes between acute coronary syndrome (ACS) and chronic coronary syndrome (CCS) patients., Results: A total of 426 patients (456 lesions) were included, 63% of the patients presenting with ACS. IVL delivery was successful in 99% of cases. Before IVL, 49% of lesions were considered undilatable. The primary effectiveness endpoint was achieved in 66% of patients, with similar rates among CCS patients (68%) and ACS patients (65%). Likewise, there were no significant differences in angiographic success after IVL between CCS and ACS patients. The rate of MACE at 30 days (primary safety endpoint) was 3% (1% in CCS and 5% in ACS patients [P = 0.073])., Conclusions: Coronary IVL proved to be a feasible and safe procedure in a "real-life" setting, effectively facilitating stent implantation in severely calcified lesions. Patients with ACS on admission showed similar angiographic success rates but showed a trend toward higher 30-day MACE compared with patients with CCS. (REPLICA-EPIC18 study [Registry of Coronary Lithotripsy in Spain]; NCT04298307)., Competing Interests: Funding Support and Author Disclosures The study sponsor, Fundación EPIC, has received an institutional research grant from Shockwave Medical (Santa Clara, California, USA) to cover the design and maintenance costs of the electronic case report form. Shockwave Medical has had no influence on the study design or protocol in any respect. Shockwave Medical was not involved in the conduct of the study, including inclusion, follow-up, data collection, analysis, interpretation of results, drafting, and final approval of the protocol, nor in the genesis of this paper. Dr Rodriguez-Leor has received speaker honoraria and consulting fees from Medtronic and World Medica. Dr Pérez de Prado has received speaker honoraria and consulting fees from iVascular, Boston Scientific, Terumo, B. Braun, and Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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5. Neutrophil-to-lymphocyte ratio an inflammatory biomarker, and prognostic marker in heart failure, cardiovascular disease and chronic inflammatory diseases: New insights for a potential predictor of anti-cytokine therapy responsiveness.
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García-Escobar A, Vera-Vera S, Tébar-Márquez D, Rivero-Santana B, Jurado-Román A, Jiménez-Valero S, Galeote G, Cabrera JÁ, and Moreno R
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- Humans, Neutrophils, Prognosis, Lymphocytes, Biomarkers, Chronic Disease, Cardiovascular Diseases diagnosis, COVID-19, Heart Failure diagnosis, Heart Failure drug therapy, Atherosclerosis
- Abstract
In the 20th century, research focused on cholesterol and lipoproteins as the key mechanism in establishing atherosclerotic cardiovascular disease (ASCVD). Given that some studies demonstrated subclinical atherosclerosis in subjects without conventional cardiovascular risk factors, the elevated low-density lipoprotein (LDL) levels alone cannot account for the entire burden of atherosclerosis. Hence, large-scale clinical trials demonstrated the operation of immune and inflammatory pathways in ASCVD. In this regard, the evidence establishes that cells of the immune system, both the innate (neutrophils, macrophages) and adaptive (T cell and other lymphocytes) limbs, contribute to atherosclerosis and atherothrombosis. Besides, basic science studies have identified proatherogenic cytokines such as interleukin (IL)-1, IL-12, and IL-18. In this regard, some studies showed that antiinflammatory therapy targeting the immune system by modulating or blocking interleukins, also known as anti-cytokine therapy, can reduce the risk of major cardiovascular adverse events. The neutrophils play a key role in the innate immune system, representing the acute phase of an inflammatory response. In contrast, lymphocytes represent the adaptive immune system and promote the induction of autoimmune inflammation, especially in the chronic inflammatory response. Through the literature review, we will highlight the inflammatory pathway for the physiopathology of ASCVD, HF, and COVID-19. In this regard, the neutrophil-to-lymphocyte ratio (NLR) integrates the innate immune and adaptive immune systems, making the NLR a biomarker of inflammation. In addition, we provided an update on the evidence showing that high NLR is associated with worse prognosis in heart failure (HF), ASCVD, and COVID-19, as well as their clinical applications showing that the normalization of NLR after anti-cytokine therapy is a potential predictor of therapy responsiveness and is associated with reduction of major adverse cardiovascular events., Competing Interests: Declaration of competing interest The authors do not have existing conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2023
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6. The role of vitamin D/calmodulin/calcium signalling/ACE2 pathway in COVID-19.
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García-Escobar A, Vera-Vera S, Tébar-Márquez D, Jurado-Román A, Jiménez-Valero S, Galeote G, Cabrera JÁ, and Moreno R
- Abstract
There has been suggestion that vitamin D may play a role in protection against severe infection with COVID-19, defined as the need of intensive care unit admission. In this article a potential mechanism involving angiotensin-converting enzyme 2 (ACE2) is proposed., Competing Interests: Conflicts of interest None declared., (Copyright © 2023 Medinews (Cardiology) Limited.)
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- 2023
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7. Percutaneous treatment of multiple fistulas associated with a giant aneurysm.
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Vera-Vera S, Jurado-Roman A, Moreno R, and Galeote G
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- Humans, Treatment Outcome, Coronary Angiography, Coronary Aneurysm complications, Coronary Aneurysm diagnostic imaging, Coronary Aneurysm therapy, Coronary Sinus, Fistula complications
- Abstract
Coronary fistulas are not common in patients undergo coronary angiography. It is described, even less frequently, that coronary fistulas may be associated with giant aneurysms along their course. These cases classically are treated surgically. We present a case treated fully percutaneously in a novel fashion., (© 2023 Wiley Periodicals LLC.)
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- 2023
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8. Subtle QRS changes are associated with reduced ejection fraction, diastolic dysfunction, and heart failure development and therapy responsiveness: Applications for artificial intelligence to ECG.
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García-Escobar A, Vera-Vera S, Jurado-Román A, Jiménez-Valero S, Galeote G, and Moreno R
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- Humans, Stroke Volume physiology, Electrocardiography methods, Ventricular Function, Left physiology, Artificial Intelligence, Bundle-Branch Block, Arrhythmias, Cardiac, Heart Failure complications, Heart Failure diagnosis, Heart Failure therapy, Ventricular Dysfunction, Left complications, Ventricular Dysfunction, Left diagnosis, Ventricular Dysfunction, Left therapy
- Abstract
Background: Since the last century, the electrocardiogram (ECG) remains the non-invasive test, that is, most easily accessible, feasible, and inexpensive for cardiology assessment. In past years, many novel ECG indexes and patterns have been published that allow for a more advanced evaluation of what is currently being done, especially based on subtle QRS changes and patterns., Objective: The objective of the study was to provide an update on the evidence and clinical applications of these ECG subtle QRS changes and patterns associated with heart disease., Methods: Through the literature review, we will highlight the subtle QRS changes and patterns associated with heart disease, mainly focusing on QRS duration, voltage, morphology, axis, and QT interval., Results: Small increases in QRS duration are associated with a reduction in left ventricular ejection fraction (EF), increased cardiac chamber dimensions, and risk for incident heart failure (HF). Moreover, fragmentation of the QRS complex is associated with myocardial fibrosis and is a substrate for developing arrhythmic events. Besides, low amplitude QRS voltage is associated with congestive HF, and an increase in the voltage of the QRS complexes is associated with the effectiveness of diuresis treatment. Furthermore, small increases in QT interval are associated with diastolic dysfunction due to impaired sarcoplasmic reticulum calcium handling as occurs in myocardial ischemia, hypertension, or diabetes. On the other hand, in patients with left ventricular dysfunction, the QRS area is associated with clinical and echocardiographic response to cardiac resynchronization therapy regardless of the type of bundle branch block. In addition, subtle ECG changes and patterns in the left bundle branch block are associated with concomitant right ventricular dilation, mostly based on the QRS axis and voltage. Notwithstanding, to identify these subtle changes in QRS require exact manual measurements that can take time. In this regard, applying artificial intelligence (AI) to the ECG can make a quicker and more complete assessment, as well as provide a low cost when applied to large populations., Conclusion: We provided an update on the evidence and clinical applications of these subtle QRS changes and patterns associated with diastolic dysfunction, reduced EF, and HF development and therapy responsiveness, as well as their applications for AI to ECG., (© 2022 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.)
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- 2022
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9. Pseudo-aortic dissection after sudden cardiac death in coronary angiography a case report: Pearls and pitfalls in false aortic dissection artifacts.
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García-Escobar A, Vera-Vera S, Jurado-Román A, Jiménez-Valero S, Galeote G, and Moreno R
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Introduction and Importance: Various artifacts mimicked aortic dissection, such as streak artifacts generated by high-attenuation material, high-contrast interfaces, cardiac motion, periaortic structures, aortic wall motion, and normal aortic sinuses, have been described in the literature. Most artifacts that simulate ascending aortic dissection occur frequently on conventional CT. Their position is predictable and is related to systolic aortic motion. However, so far, to the best of our knowledge, this is the first pseudo-aortic dissection reported during coronary angiography in cardiac arrest., Case Presentation: We report a case of a middle-aged man transferred to our hospital after an out-of-hospital cardiac arrest. The coronary angiography revealed non-obstructive coronary arteries and an image of probable aortic dissection was observed. Given the persistent asystole despite a prolonged advance cardiopulmonary resuscitation and the possibility of aortic dissection, a prompt in-room heart team discussion was performed. It was decided to stop and withdraw potentially life-sustaining treatment due to futility. The necropsy study revealed the aorta with some mild atherosclerotic plaques but without either aneurysm or thrombosis. The coronary arteries were reported as with patency, but in the proximal left anterior descending artery (LAD), the intima layer presented a thickness that decreased 50 % of the luminal area without signs of complicated acute plaques., Clinical Discussion: In this case, the systolic aortic motion theory cannot explain the false-aortic dissection image in the coronary angiography because the patient was under cardiac arrest. Studies with arterial and venous pressures devices recording in cardiac arrest, demonstrated an abnormal hemodynamic flow, suggesting that the hemodynamic flow might be backward during cardiopulmonary resuscitation Therefore, in the setting of this abnormal hemodynamic flow, the injection of contrast may have an abnormal distribution and flow in the aorta creating an image of pseudo-aortic dissection., Conclusion: Although the exact mechanism of this false-positive aortic dissection in cardiac arrest remains unknown, operators should be aware of this entity during coronary angiography in the setting of cardiac arrest with mechanical chest compressions to avoid diagnostic errors in clinical practice., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2022
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10. Excimer Laser Coronary Atherectomy to Treat Calcified Lesions.
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Vera-Vera S, Garcia A, Jimenez-Valero S, Galeote G, Moreno R, and Jurado-Roman A
- Abstract
Competing Interests: Disclosure: The authors have no conflicts of interest to declare.
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- 2022
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11. Calcium Signaling Pathway Is Involved in the Shedding of ACE2 Catalytic Ectodomain: New Insights for Clinical and Therapeutic Applications of ACE2 for COVID-19.
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García-Escobar A, Vera-Vera S, Jurado-Román A, Jiménez-Valero S, Galeote G, and Moreno R
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- Catalytic Domain, Humans, Angiotensin-Converting Enzyme 2 metabolism, COVID-19 metabolism, Calcium Signaling, Renin-Angiotensin System, SARS-CoV-2 metabolism
- Abstract
The angiotensin-converting enzyme 2 (ACE2) is a type I integral membrane that exists in two forms: the first is a transmembrane protein; the second is a soluble catalytic ectodomain of ACE2. The catalytic ectodomain of ACE2 undergoes shedding by a disintegrin and metalloproteinase domain-containing protein 17 (ADAM17), in which calmodulin mediates the calcium signaling pathway that is involved in ACE2 release, resulting in a soluble catalytic ectodomain of ACE2 that can be measured as soluble ACE2 plasma activity. The shedding of the ACE2 catalytic ectodomain plays a role in cardiac remodeling and endothelial dysfunction and is a predictor of all-cause mortality, including cardiovascular mortality. Moreover, considerable evidence supports that the ACE2 catalytic ectodomain is an essential entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Additionally, endotoxins and the pro-inflammatory cytokines interleukin (IL)-1β and tumor necrosis factor-alpha (TNFα) all enhanced soluble catalytic ectodomain ACE2 shedding from the airway epithelia, suggesting that the shedding of ACE2 may represent a mechanism by which viral entry and infection may be controlled such as some types of betacoronavirus. In this regard, ACE2 plays an important role in inflammation and thrombotic response, and its down-regulation may aggravate COVID-19 via the renin-angiotensin system, including by promoting pathological changes in lung injury. Soluble forms of ACE2 have recently been shown to inhibit SARS-CoV-2 infection. Furthermore, given that vitamin D enhanced the shedding of ACE2, some studies reported that vitamin D treatment is associated with prognosis improvement in COVID-19. This is an updated review on the evidence, clinical, and therapeutic applications of ACE2 for COVID-19.
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- 2022
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12. Self-expandable transcatheter heart valves for aortic stenosis. Short-term outcome and matched hemodynamic performance.
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Vera Vera S, Nombela-Franco L, Santos-Martínez S, Moreno R, Jiménez-Díaz VA, Rodríguez-Gabella T, Catalá P, Castro-Mejía AF, Galeote G, Baz JA, Gutiérrez H, Serrador A, García-Gómez M, Redondo A, Baladrón C, Arnold R, Jiménez-Quevedo P, Carrasco-Moraleja M, Gómez Salvador I, San Román JA, and Amat-Santos IJ
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- Aortic Valve diagnostic imaging, Aortic Valve surgery, Hemodynamics, Humans, Prosthesis Design, Stroke Volume, Treatment Outcome, Ventricular Function, Left, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement
- Abstract
Introduction and Objectives: Aortic self-expandable (SE) transcatheter aortic valve implantation (TAVI) devices are particularly useful for patients with aortic stenosis and small/tortuous vessels, small aortic annuli, or low coronary ostia. However, it is unclear whether the growing range of SE devices shows comparable hemodynamic and clinical outcomes. We aimed to determine the differential hemodynamic (residual valve area and regurgitation) and clinical outcomes of these devices in comparable scenarios., Methods: All patients were enrolled from 4 institutions and were managed with 4 different SE TAVI devices. Baseline and follow-up clinical data were collected and echocardiographic tests blindly and centrally analyzed. Patients were compared according to valve type and a 1:1 matched comparison was performed according to degree of calcification, aortic annulus dimensions, left ventricular ejection fraction, and body surface area., Results: In total, 514 patients were included (Evolut R/PRO, 217; ACURATE neo, 107; ALLEGRA, 102; Portico, 88). Surgical risk scores were comparable in the unmatched population. No differences were observed in the post-TAVI regurgitation rate and in in-hospital mortality (2.7%). The rate of pacemaker implantation at discharge was significantly different among devices (P=.049), with Portico showing the highest rate (23%) and ACURATE neo the lowest (9.5%); Evolut R/PRO and ALLEGRA had rates of 15.9% and 21.2%, respectively. The adjusted comparison showed worse residual TAVI gradients and aortic valve area with ACURATE neo vs ALLEGRA (P=.001) but the latter had higher risk of valve embolization and a tendency for more cerebrovascular events., Conclusions: A matched comparison of 4 SE TAVI devices showed no differences regarding residual aortic regurgitation and in-hospital mortality., (Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2021
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