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J Calabuig

Publications and source records attributed to J Calabuig.

At least 19 recordsLinked to original sources
PubMed2003

Basal fat oxidation and after a peak oxygen consumption test in obese women with a beta2 adrenoceptor gene polymorphism.

The Glu27Glu genotype in the beta2-adrenergic receptor (ADRB2) has been linked to a higher fat deposition and obesity in females. Also, in our population, it has been described that physically active women carrying the Glu allele had a higher BMI as compared to non-carriers performing the same level of activity. Since exercise may counterbalance a gene predisposition to obesity, we tested the hypothesis of a potential different metabolic response among ADRB2 Gln27Gln versus Glu27Glu obese women when submitted to a peak oxygen consumption test on a treadmill. In our study, 10 obese women with the Gln27Gln genotype were compared to 9 matched obese women bearing the Glu27Glu genotype. The ADRB2 polymorphism was identified by PCR-RFLP, fat oxidation was determined by indirect calorimetry and blood measurements were carried out following conventional procedures. The ADRB2 Glu27Glu subjects had lower plasma glycerol levels (P = 0.026), while plasma triglycerides (P <0.001) and the insulin:glucose ratio were higher (P = 0.046) as compared to the Gln27Gln group along the peak oxygen consumption trial intervention. There was a significantly lower fat oxidation (P = 0.024) in the Glu27Glu obese women during the recovery compared to Gln27Gln obese individuals. These data suggest that exercise would not benefit equally the two ADRB2 polymorphism homozygous groups, since both lipolysis and fat oxidation promoted by a peak oxygen consumption test appear to be blunted in the polymorphic Glu27Glu obese group.

Adipose Tissue↗
PubMed2002

A maximal effort trial in obese women carrying the beta2-adrenoceptor Gln27Glu polymorphism.

The aim of this study was to observe the relationship of the beta2-adrenoceptor (ADRB2) gene polymorphism Gln27Glu in a group of obese female subjects submitted to an acute physical activity test. Six Glu27/Glu27 obese women were compared with six Gln27/Gln27 obese women (coupled by age, BMI, waist circumference, percentage of fat mass and absence of smoking). These groups were selected after having genotyped 91 obese subjects (BMI>30 kg/m2, age 20-60). Polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) were used to genotype the obese population. The physical activity challenge consisted of a Maximal effort trial (VO2 max) following the Bruce protocol on a walking treadmill. The frequency for the Glu allele was 0.42, which is similar to other Caucasian populations. In basal conditions, subjects with the Glu27/Glu27 genotype showed a higher value of plasma insulin, while circulating glucose levels were similar in both groups. Also, diastolic arterial pressure was higher in the Glu27/Glu27 obese women. After the VO2 max trial, the Glu27 group had a significantly higher respiratory exchange ratio than the Gln27 group suggesting a lower post- exercise fat oxidation. These results provide evidence about a possible impact of the Gln27Glu polymorphism in the ADRB2 gene concerning a better response to exercise in obese Gln27 female subjects, in which basal insulinemia may play a role.

Blood Glucose↗
PubMed2001

[Initial results and 6 month clinical follow-up after implantation of a silicon carbide coated coronary stent].

INTRODUCTION AND OBJECTIVES: To present the initial Spanish experience with the Tenax coronary stent, a laser sculpted from high-precision 316L stainless steel coated with hydrogen rich amorphous silicon carbide that reduces thrombogenecity and improves biocompatibility. PATIENTS AND METHODS: From July 1998 to July 1999, 206 patients (62 +/- 5 years) underwent implantation of 231 Tenax stents in 9 centers as the only revascularization procedure. The most frequent clinical indication was unstable angina (66%), and most of the lesions were complex (class B2 and C). The target vessels were the left anterior descending (51%) and right coronary arteries (36%). The ejection fraction was < 0.5 in 19% cases. RESULTS: Revascularization was complete in 70%, elective in 80%, and the implantation was direct in 25% of the cases. The procedure was successful in all the lesions, reducing stenosis from 62 +/- 16 to 16 +/- 10% and increasing the minimal luminal diameter from 0.81 +/- 0.40 to 2.61 +/- 0.59 mm. The TIMI flow was reduced in 30%, but normalized after the stent in all but one case. The incidence of cardiac events was minimal: 1 acute thrombosis (0.5%) resolved by a new angioplasty and 1 non-Q myocardial infarction (0.5%). At the 6-month clinical follow-up 10% of the patients presented complaints of angina greater than class II, and a new angioplasty was carried out in 1.9% of these cases. CONCLUSION: Clinical and angiographic data suggest that the hydrogenated silicon carbide coating of the Tenax coronary stent may indeed play a beneficial role in patient outcome, and should therefore be evaluated by prospective clinical trials.

Angina, Unstable↗
PubMed1999

Randomized comparison of coronary stent implantation and balloon angioplasty in the treatment of de novo coronary artery lesions (START): a four-year follow-up.

OBJECTIVE: The purpose of this study was to test the hypothesis that stent implantation in de novo coronary artery lesions would result in lower restenosis rates and better long-term clinical outcomes than balloon angioplasty. BACKGROUND: Placement of an intracoronary stent, as compared with balloon angioplasty, has proven to reduce the rate of restenosis. However, the long-term clinical benefit of stenting over angioplasty has not been assessed in large randomized trials. METHODS: We randomly assigned 452 patients with either stable (129 patients) or unstable (323 patients) angina pectoris to elective stent implantation (229 patients) or standard balloon angioplasty (223 patients). Coronary angiography was performed at baseline, immediately after the procedure and six months later. End points were the rate of restenosis at six months and a composite of death, myocardial infarction (MI) and target vessel revascularization over four years of follow-up. RESULTS: Procedural success rate was achieved in 84% and 95% (balloon angioplasty vs. stent, respectively). The increase in the minimal luminal diameter was greater in the stent group both after the intervention (2.02 +/- 0.6 mm vs. 1.43 +/- 0.6 mm in the angioplasty group; p < 0.0001), and at six-month follow-up (1.98 +/- 0.7 mm vs. 1.63 +/- 0.7 mm; p < 0.001). The corresponding restenosis rates were 22% and 37%, respectively (p < 0.002). After four years, no differences in mortality (2.7% vs. 2.4%) and nonfatal MI (2.2% vs. 2.8%) were found between the stent and the angioplasty groups, respectively. However, the requirement for further revascularization procedures of the target lesions was significantly reduced in the stent group (12% vs. 25% in the angioplasty group; relative risk 0.49, 95% confidence interval 0.32 to 0.75, p = 0.0006); most of the repeat procedures (84%) were carried out within six months of entry into the study. CONCLUSIONS: Patients who received an intracoronary stent showed a lower rate of restenosis than those treated with conventional balloon angioplasty. The benefit of stenting was maintained four years after implantation, as manifested by a significant reduction in the need for repeat revascularization.

Aged↗
PubMed1999

[The characteristics, management and prognosis of the acute myocardial infarct patient in the Valencian Community in 1995: the results of the PRIMVAC Registry (The Registry Project of Acute Myocardial Infarct in Valencia, Alicante and Castellón). As representatives of the PRIMVAC investigators].

BACKGROUND AND OBJECTIVES: Regional registers of patients with acute myocardial infarction are scarce in Spain. The PRIMVAC register (Proyecto de Registro de Infarto agudo de Miocardio de Valencia, Alicante y Castellón) was initiated to obtain updated information on the management of these patients in the Valencia Autonomous Community. Data of the first twelve months of the register are presented. METHODS: The 17 participating hospitals cover 2,833,938 inhabitants. Demographic, clinical, procedural and outcome data as well as predictive variables of mortality were analysed in the patients with acute myocardial infarction during their stay in the coronary care units from 1 December 1994 to 30 November 1995. RESULTS: During 12 months, 2,377 patients were included. Mean age was 65.3 years (SD 11.9) and 23.2% were female. Left ventricular failure was present in 39.8%. Thrombolytic therapy was applied in 42.1% with a median time delay of 195 min from chest pain onset. This time was longer in the women (250 min) and in the elderly (210 min). The in-coronary-care-unit-mortality rate was 13.9%. Age, female gender, diabetes, previous myocardial infarction, Q wave and right ventricular infarction independently predicted increased early mortality. CONCLUSION: Present data show the feasibility of an acute myocardial infarction register in the Valencia Autonomous Community. Although an acceptable level of thrombolysis has been reached, the mortality rate is still high. The long delay in initiating thrombolysis, particularly in female and elderly patients is remarkable.

Chi-Square Distribution↗
PubMed1999

[Changes in the diameter of the coronary arteries in heart transplant recipients with angiographically normal vessels during five years].

INTRODUCTION: Diffuse or focal coronary artery narrowing is a frequent complication of cardiac transplantation. Coronary enlargement has also been described although it is less known. To study the changes of the coronary arteries in transplant recipients, we have performed a quantitative study throughout 5 years. METHODS: Serial coronary angiography was performed annually in all survivors of heart transplant. Forty four patients with visually normal coronary arteries and at least 5 years of evolution were selected for this study. Quantitative measurements of the diameter of the coronary arteries were performed in each angiogram at different levels: proximal, medium and distal left anterior descending coronary artery; proximal and distal left circumflex; proximal, medium and distal right coronary artery. Changes in diameter were compared throughout the 5 years. RESULTS: In the entire group of patients there was a small increase in the diameter of each segment. Taking each patient separately, an enlargement of the diameter of the proximal descending coronary artery was seen in 17 cases; medium descending coronary artery in 13; distal descending coronary artery in 8; proximal left circumflex in 11; distal left circumflex in 14; proximal right coronary artery in 18; medium right coronary artery in 18 and distal right coronary artery in 15. In total, 114 of 352 coronary segments (32%) underwent dilatation. Only 6 patients failed to have dilatation of any segment. CONCLUSIONS: Enlargement of the coronary arterial diameter was seen in 32% of segments of the main coronary arteries in heart transplant recipients with angiographically normal coronary arteries during 5 years of evolution. This could be due to intimal thickening with overcompensation by an additional vessel enlargement with net lumen gain.

Adult↗
PubMed1998

Coronary angioplasty and stenting following heart transplantation with older donors. Is this a rational approach?

The shortage of ideal donor hearts has led to an extension of the classical donor criteria of age. Higher incidence of focal coronary artery disease has been found in this older donor population requiring conventional angioplasty therapy. The authors present two patients with early coronary angiogram post transplantation, requiring angioplasty and stent in the lesions found.

Adult↗
PubMed1997

[The RICVAL study. Acute myocardial infarct in the city of Valencia. Data on 1,124 patients during the first twelve months of the registry (December, 1993--November, 1994)].

BACKGROUND AND OBJECTIVES: Information on the management of acute myocardial infarction in Spain is still scarce. The Register of Acute Myocardial Infarction of Valencia City (RICVAL) was established to collect, in a prospectively and uniformly way, data of patients with acute myocardial infarctions discharged from Valencia coronary care units, in order to obtain updated information on the management of these patients. Data of the first twelve months of the register are presented. METHODS: Using standardised variables, demographic, clinical, procedural and outcome data from patients with acute myocardial infarction were collected at the eight hospitals collaborating in the RICVAL, from 1 December 1993 to 30 November 1994. RESULTS: The eight participating hospitals cover 1,665,720 people. During 12 months, 1,124 patients were discharged from the participating coronary care units. Mean age was 65.1 years and 23.9% were female. The case fatality rate was 16.9%. Left ventricular failure (Killip 2, 3 and 4) was present in 42%. Thrombolytic therapy was applied in 43.5% with a median time delay of 210 minutes from chest pain onset. The delay time in initiating thrombolysis was longer in the women and in the elderly. CONCLUSION: Analysis of present data shows the feasibility of an acute myocardial infarction register in Valencia City. The RICVAL study will allow a better knowledge of demographic, clinical, procedural and outcome data in patients with myocardial infarction. The case fatality rate is still high when we consider that an acceptable level of thrombolytic therapy has been reached. The long delay time in initiating thrombolysis, particularly in the elderly and in the women, must be emphasized.

Acute Disease↗
PubMed1993

[Aneurysm of the ascending aorta in patients with a prior aortic valve replacement].

INTRODUCTION AND OBJECTIVES: The purpose of this study is to show our experience in the treatment of aneurysms of the ascending aorta in patients with previous aortic valve surgery. METHODS: We studied retrospectively the clinical characteristics and operative methods of 9 patients who underwent surgery for aneurysm of the ascending aorta after previous aortic valve replacement. RESULTS: Time interval between the first and subsequent reoperation was 8.4 +/- 3.5 years (range 4-15 years). During the first operation there were 5 cases who presented with aortic regurgitation and dilatation of the ascending aorta. Isolated valvular aortic replacement was performed in these patients. Two patients underwent valvular replacement and implantation of supracoronary aortic graft. In two other cases valvular replacement was done with wedge resection of the aortic sinuses. Reoperation was performed because to the following reasons: valvular prosthesis disfunction and aneurysm of the ascending aorta (3), valvular prosthesis disfunction and aneurysm of the aortic remnant located between the prosthesis and the supracoronary aortic graft (2), thrombosis of the prosthesis (1), dissection of the ascending aorta (2) and superior vena cava syndrome (1). There was one hospital death. Another patient died after 26 months because of graft infection. The other 7 patients are in functional class I. CONCLUSIONS: We conclude that an aggressive surgical approach should be adopted in patients with degenerative aortic regurgitation and moderate dilatation of the ascending aorta because of the rapid progression of the aortic disease. We advise complete replacement of the aortic root.

Adult↗
PubMed1992

[Pleuro-pericardial effusion following the early intragraft thrombolysis of an occluded aortocoronary graft].

A case of contrast extravasation associated with pleuro-pericardial effusion occurring during recanalization of an early occluded aortocoronary bypass by intragraft fibrinolysis is reported. This is, to the best of our knowledge, the second report of angiographically demonstrated contrast extravasation from an aortocoronary bypass graft during this technique and the first associated with pleural effusion as a clinical manifestation.

Coronary Artery Bypass↗
PubMed1984

Diagnostic value of stress testing in the elderly.

The exercise tests performed by 197 patients aged 65 years or more (mean age 68.8) have been reviewed, including 43 healthy subjects, 20 with high blood pressure, 10 with mitral valve disease and 125 with demonstrated coronary artery disease. All tests were done on an electrical cycloergometer, with load increases of 30 W every 3 min. Eighty-four (42.6%) achieved at least 85% of their maximal predicted heart rate. The reasons for non-achievement of this heart rate were limitation by symptoms (30.2%), betablocker therapy (25.8), exhaustion (20.2%), pain in lower extremities (14%) and non-adaptation to cycloergometer (10%). The maximum load achieved and the duration of exercise were significantly lower in mitral and coronary patients. Functional aerobic capacity was decreased in coronary and mitral patients. The VO2 max was directly determined in 45 patients. Mean values (ml kg-1 min-1) were 33.3 +/- 3.5 in normals, 15.4 +/- 6.2 in coronary and 15.8 +/- 4.1 in mitral patients. The incidence of arrhythmias during exercise was higher in hypertensive (55%) than in mitral (40%), normal (33.3%) and coronary patients (32.8%). In 5 patients the test had to be interrupted because of ventricular tachycardia. The yield of ST depression (greater than 0.1 mV) or elevation (greater than 0.2 mV) in the diagnosis of coronary artery disease was 0.62 sensitivity and 0.93 specificity. We conclude that stress test is a useful tool in cardiovascular diagnosis among older patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗