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Ruben Leta

Publications and source records attributed to Ruben Leta.

7 recordsLinked to original sources
PubMed2006

Morphological and functional evidences of the helical heart from non-invasive cardiac imaging.

The non-invasive study of cardiac mechanics has been improved after the recent introduction of advanced magnetic resonance and echocardiographic imaging techniques. Tagged and diffusion-sensitive cardiac magnetic resonance allows the study of myocardial torsion dynamics as well as the anatomical disposition of myocardial fibers. Local myocardial strain and synchronicity of myocardial contraction can also be determined with Doppler tissue imaging (DTI) echocardiography. Published results with these techniques demonstrate a mechanical behavior that is a consequence of a myocardial helical fiber orientation and strongly support the evidence of the double-loop single muscular band model described by Torrent-Guasp.

Diffusion Magnetic Resonance Imaging↗
PubMed2006

Utility of contrast-enhanced cardiovascular magnetic resonance (CE-CMR) to assess how likely is an infarct to produce a typical ECG pattern.

OBJECTIVES: For over 50 years, Q-wave myocardial infarction (MI) location has been based on pathologic ECG studies. Although contrast-enhanced magnetic resonance (CE-CMR) is currently the "gold standard" technique for location and quantification of necrotic areas, we found no large study in the literature devoted to establish which ECG patterns corresponds to different MI location detected by CE-CMR. We hypothesized that CE-CMR would be very accurate for evaluating different ECG patterns and its sensitivity (SE) and specificity (SP) for locating MI in different LV areas. METHODS AND RESULTS: CE-CMR/ECG correlation was studied in 48 patients who presented a first MI due to acute coronary syndrome (ACS) with ST-segment elevation and in whom CE-CMR was performed in chronic phase. We evaluated the ECG patterns that best correlated with the 7 prespecified necrotic areas assessed by CE-CMR, 4 in anteroseptal zone (septal, apical/anteroseptal, extensive anterior, and limited anterolateral) and 3 in inferolateral zone (inferior, lateral and inferolateral). The global concordance between CE-CRM and ECG was of 75% and 7 ECG patterns were stablished. CONCLUSION: The capacity of CE-CMR to detect ECG patterns for necrotic area location presents highly acceptable concordance. Thanks to CE-CMR, we defined 7 ECG patterns for MI detection according to the 7 areas of the LV studied. The areas that present more cases with normal ECG are limited anterolateral and the areas of the inferolateral zone.

Chronic Disease↗
PubMed2005

Transient biventricular dysfunction following pericardiocentesis.

We report the case of a 41-year-old woman admitted to the hospital due to cardiac tamponade as the first manifestation of a pulmonary neoplasm. The patient developed an early biventricular dysfunction and pulmonary edema after removal of the pericardial effusion, with complete recovery within ten days. Since transient ventricular dysfunction after pericardiocentesis is a very unusual complication, we present a review of the different mechanisms suggested in the literature to explain the pathophysiology of this rare phenomenon.

Adult↗
PubMed2004

Aorto-cavitary fistulous tract formation in infective endocarditis: clinical and echocardiographic features of 76 cases and risk factors for mortality.

AIMS: To investigate the clinical features, echocardiographic characteristics, management, and prognostic factors of mortality of aorto-cavitary fistulization (ACF) in infective endocarditis (IE). Extension of infection in aortic valve IE beyond valvular structures may result in peri-annular complications with resulting necrosis and rupture, and subsequent development of ACF. Aorto-cavitary communications create intra-cardiac shunts, which may result in further clinical deterioration and haemodynamic instability. METHODS AND RESULTS: In a retrospective multi-centre study over 4681 episodes of IE, a total of 76 patients with ACF [1.6%, confidence interval (CI) 95%: 1.2-2.0%] diagnosed by echocardiography or during surgery were identified. Fistulae were found in 1.8% of cases of native valve IE and in 3.5% of cases of prosthetic valve IE from the general population and in 0.4% of drug abusers. PVE was present in 31 (41%) cases of ACF. Transthoracic and transoesophageal echocardiography detected the fistulous tracts in 53 and 97% of cases, respectively. Peri-annular abscesses were detected in 78% of cases, fistulae originated in similar rates from the three sinuses of Valsalva, and the four cardiac chambers were equally involved in the fistulous tracts. Heart failure (HF) developed in 62% of cases and surgery was performed in 66 (87% CI 95% 77-93%) patients with a mortality of 41% (95% CI 30-53%) in the overall population. Multivariate analysis identified HF (OR 3.4, CI 95% 1.0-11.5), prosthetic IE (OR 4.6, CI 95% 1.4-15.4) and urgent or emergency surgical treatment (OR 4.3, CI 95% 1.3-16.6) as variables significantly associated with an increased risk of death. Major complications during follow-up (death, re-operation, or re-admission for HF) among the five operative survivors with residual fistulae occurred in 20 and 100% of patients at 1 and 2 years, respectively. CONCLUSION: Aorto-cavitary fistulous tract formation is an uncommon but extremely serious complication of IE. In-hospital mortality was exceptionally high despite aggressive management with surgical intervention in the majority of patients. Prosthetic IE, urgent surgery, and the development of HF identify the subgroup of patients with IE and ACF that have significantly increased risk of in-hospital death.

Adolescent↗