Biomedical subjects

Luis Almenar Bonet

Publications and source records attributed to Luis Almenar Bonet.

7 recordsLinked to original sources

PubMed2006

[Natriuretic peptides in heart failure].

The fact that the heart is able to secrete hormones, which are released in significant amounts in advance of certain cardiac conditions, has resulted in a wide range of opportunities and raised a multitude of questions. These hormones, named natriuretic peptides, possess diuretic, natriuretic and vasodilatory properties. The ones used in daily clinical practice are atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and their N-terminal fragments NT-proANP and NT-proBNP, respectively. Although most studies currently involve the use of BNP, the number involving NT-proBNP is expected to increase substantially in coming years because its level is less variable and its half-life longer. Nevertheless, at present there appears to be sufficient evidence to suggest that the plasma levels of these hormones will be extremely useful for the diagnosis, prognosis, screening, pharmacological monitoring, and treatment of patients with heart failure.

Atrial Natriuretic Factor↗

PubMed2006

[Imaging techniques in heart failure].

Imaging techniques play a vital clinical role in patients with heart failure, not only in diagnosis, but also in determining prognosis and evaluating treatment. The more established imaging modalities of echocardiography, nuclear cardiology and computerized tomography, which have been developed in recent years, have been supplemented by nuclear magnetic resonance imaging, a technique that is being rapidly introduced and increasingly used in the field of cardiology. The wide range of imaging techniques available makes it advisable for us to improve our knowledge of their performance, benefits and drawbacks so that we can select the most appropriate techniques for studying this clinical syndrome. This article contains a review of the usefulness of and indications for the different imaging techniques used in managing patients with heart failure.

Cardiomyopathies↗

PubMed2006

[Spanish Heart Transplantation Registry. 17th official report of the Spanish Society of Cardiology Working Group on Heart Failure, Heart Transplantation, and Associated Therapies (1984-2005)].

INTRODUCTION AND METHODS: This article summarizes the general characteristics of heart transplantation in Spain and the results achieved, once data for 2005 have been included. RESULTS: In the course of the last year, 287 heart transplantations were performed, which brings the total to 4967 since 1984. Clinically, the typical Spanish heart transplant patient is male, aged about 50 years, has blood group A or O, has non-revascularizable coronary disease or idiopathic dilated cardiomyopathy, and is in New York Heart Association functional class IV/IV. The percentage of emergency heart transplants carried out was 22%, which is considerably lower than in the previous year (i.e., 35%) and slightly lower than the average for the last 5 years (i.e., 23%). The early mortality rate was 10%, which is similar to that in the previous year and lower than the average for the last 5 years (i.e., 12%). After adding the 2005 results to those of previous years, the survival probabilities at 1, 5, and 10 years were 75%, 65%, and 50%, respectively. On calculating survival curves for separate historical periods, a significant improvement could be seen for the last 5 years, in which the 1- and 5-year survival probabilities were 80% and 70%, respectively. The most frequent cause of death in the first month was acute graft failure; in the first year, infection and rejection were most common; and, in the long term, tumors and the combination of graft vascular disease with sudden death. CONCLUSIONS: Comparative analysis of survival rates showed that short-, medium-and long-term outcomes in Spain are consistent with those reported in the world literature, including a continuing trend towards better survival over the years.

Cause of Death↗

PubMed2004

[Spanish Registry of Heart Transplantation. 15th Official Report of the Working Group on Heart Failure, Heart Transplantation and Other Therapeutic Alternatives of the Spanish Society of Cardiology (1984-2003)].

This paper outlines the general characteristics and results obtained with heart transplantation in Spain after including the data for the year 2003. In 2003, 290 heart transplants were performed. Since 1984, a total of 4386 procedures have been performed. The average clinical profile of patients receiving a heart transplant in Spain is that of a man about 50 years old, blood group A, with nonrevascularizable coronary artery disease and functional status IV/IV (NYHA). The percentage of emergency heart transplantations was 29%, which is higher than in the previous year (26%) and the mean for the preceding 5 years (20%). The early mortality rate was 13%, which is similar to the mean for the preceding 5 years (13%). After combining the 2003 results with those of the previous years, the probability of survival at 1, 5 and 10 years was 76%, 66% and 54%, respectively. When survival rates for separate periods were considered, a significant improvement was seen in the last 5 years, with survival rates at of 81% at 1 year and 74% at 5 years. The most frequent causes of death were acute graft failure in the first month, infection and rejection in the first year, and a combination of vascular disease of the graft with sudden death in the long term. Comparative analysis of survival rates shows that our long-term results are slightly better than those published in the literature, with a gradual tendency for survival rate to improve in recent years.

Adolescent↗

PubMed2003

[Spanish Registry on Heart Transplantation. 14th official report of the working group on heart failure, heart transplantation and other therapeutic alternative of the Spanish Society of Cardiology (1984-2002)].

This report describes the general characteristics and outcomes of heart transplantation in Spain after data from 2002 were added to the registry. In 2002, 310 heart transplantations were performed. Since 1984, a total of 4,096 procedures have been performed. The average clinical profile of patients receiving a heart transplant in Spain is that of a man about 50 years old, blood group A, with nonrevascularizable coronary artery disease and functional status IV/IV (NYHA). The percentage of emergency heart transplantations was 26%, which is higher than the previous year (19%) and the mean for the preceding five years (22%). The early mortality rate was 10%, which is significantly lower than the mean for the preceding five years (14%). After combining the 2002 results with those of previous years, an increase in survival rate was seen. Thus, the probability of survival in the first, fifth and tenth years was 76%, 66%, and 54%, respectively. When survival rates for separate periods were considered, a clear improvement was seen from the first year (80%) to the fifth year (72%). The most frequent causes of death were acute graft failure in the first month, infection and rejection in the first year, and tumors and the combination of vascular disease of the graft with sudden death in the long term. Comparative analysis of survival rates shows that our long-term results are slightly better than those published worldwide, with a clear tendency for survival rate to improve as a consequence of the experience acquired in all stages of this cross-disciplinary procedure.

Heart Failure↗

PubMed2002

[Prognostic value of fibrinogen in patients admitted with suspected unstable angina and non-q-wave myocardial infarction].

INTRODUCTION AND OBJECTIVE: In recent years, the relation between biological markers of inflammation and prognosis in patients suffering from acute coronary syndromes has been investigated. The aim of this study was to evaluate the association between baseline fibrinogen concentrations and the development of clinical events in patients admitted with suspicion of unstable angina and non-Q-wave myocardial infarction. MATERIAL AND METHOD: Levels of fibrinogen at enrollment were analyzed in 325 consecutive patients with acute coronary syndromes. Fibrinogen values were divided into tertiles and the incidence of clinical events was evaluated at each level. The combination of death and/or myocardial infarction was the main endpoint. RESULTS: Fibrinogen levels were significantly higher in patients who subsequently had myocardial infarction, cardiac death, or both during follow up. The probabilities of death and/or myocardial infarction were 6%, 13%, and 29% (p < 0.0001), respectively, in patients grouped by fibrinogen tertiles (304, 305-374 and 375 mg/dl). Multivariate predictors of combined events were age, previous angina, ST-segment depression in the admission ECG, and fibrinogen into tertiles. The adjusted hazard ratio (95% CI) for patients in the upper tertile was 4.8 (1.6-14; p = 0.004). CONCLUSIONS: High fibrinogen levels were related to a less favorable long-term or short-term outcome in patients admitted for suspicion of unstable angina and non-Q-wave myocardial infarction. This association persists after adjustment for other classical risk factors such as age, prior angina, and ST-segment depression in the ECG.

Aged↗

PubMed2002

[Spanish registry on heart transplantation. 13th official report of the working group on heart transplantation of the Spanish Society of Cardiology (years 1984-2001)].

This report describes the general characteristics and results of heart transplantation in Spain after including the data from 2001. In that year 341 heart transplantations were performed. Since 1984, a total of 3,786 procedures have been performed. The average clinical profile of the patient receiving a heart transplant in Spain is a male about 50 years-old, blood group A, with a non-revascularizable coronary artery disease and IV/IV functional condition (NYHA). The percentage of emergency heart transplantations performed in 2001 was 19%, slightly lower than 20% to 25% in earlier years. The average early mortality rate in the last 10 years is 15%. After adding the 2001 results to those of previous years, a slight increase can be seen in the survival rate. The probability of survival in the first, fifth and tenth years was 76%, 63%, and 50%, respectively. The most frequent cause of death is acute graft failure in the first month, infection and rejection in the first year, and tumors and the combination of vascular disease of the graft with sudden death in the long term. Comparative analysis of survival rates shows that our long-term results are slightly better than those published in literature. However, we face a real challenge in our efforts to improve the early results of transplantation.

Cardiology↗