Rev Esp Cardiol
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Multicenter Study
[Utility of NT-proBNP for diagnosing heart failure in a heterogeneous population of patients with dyspnea. Spanish multicenter study].
Recent studies have shown that brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are useful in the diagnosis of heart failure in patients presenting with dyspnea. However, the cutoff values used with these markers vary according to patient characteristics and dyspnea severity. The aim of this study was to investigate the diagnostic accuracy of using the plasma NT-proBNP level for identifying heart failure in a heterogeneous population of patients with dyspnea. ⋯ The plasma NT-proBNP concentration provides an accurate means of diagnosing heart failure. However, the negative predictive value found in this study was somewhat lower than the values found in previous studies involving more homogeneous patient populations.
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Randomized Controlled Trial Comparative Study
[Hemodynamic effects of levosimendan compared with dobutamine in patients with low cardiac output after cardiac surgery].
Levosimendan is an inotropic agent that is effective in the treatment of heart failure. However, experience with levosimendan in patients with reduced cardiac output following cardiopulmonary bypass is limited. The objective of this study was to compare the short-term hemodynamic effects of levosimendan with those of dobutamine in managing low cardiac output after cardiac surgery. ⋯ Both dobutamine and levosimendan are effective in managing postoperative low cardiac output. However, levosimendan induces non-specific systemic, venous and pulmonary vasodilation which can result in hypotension as a adverse event. In these patients, it is advisable to omit or reduce the loading dose.
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Editorial Comment Review
[Levosimendan in acute heart failure: past, present and future].
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Previous estimates of the incidence of cardiac complications following major elective surgery have all been obtained in populations with specific risk factors or in contexts that differ from those found in Spain. Our aims were to estimate the frequency of postoperative cardiac complications following major elective non-cardiac surgery in patients aged 40 years or more, and to identify associated risk factors. ⋯ Cardiac complications occurred in 1% of consecutive patients aged 40 years or more in the three months following major elective non-cardiac surgery.
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Comparative Study
[Myocardial disease mortality in children and young adults. A population-based observational study].
Few studies have investigated death due to myocardial disease in children and young adults. The aim of this study was to analyze the epidemiological, clinical, and pathologic characteristics of death in these cases. ⋯ Mortality due to myocardial disease in children and young adults is uncommon. Most deaths are sudden. However, some may be preventable. Preventative measures should be aimed at sudden death in adolescents and young males. There was a noticeable association between arrhythmogenic cardiomyopathy and sporting activity.