Person:
Luaces Méndez, María

First Name

María

Last Name

Luaces Méndez

URI

https://hdl.handle.net/20.500.14352/79477

Affiliation

Universidad Complutense de Madrid

Faculty / Institute

Medicina

Department

Fisiología

Area

Fisiología

Identifiers

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Now showing 1 - 10 of 16

Prognostic stratification of patients with left-sided endocarditis determined at admission
(The American Journal of Medicine, 2007) San Román, Jose Alberto; López, Javier; Vilacosta, Isidre; Sarriá, C; Revilla, A; Ronderos, R; Stoermann, W; Gómez, I; Fernández-Avilés Díaz, Francisco Jesús; Luaces Méndez, María
Background: The prognosis of patients with left-sided endocarditis remains poor despite the progress of surgical techniques. Identification of high-risk patients within the first days after admission to the hospital would permit a more aggressive therapeutic approach. Methods: We designed a prospective multicenter study to find out the clinical, microbiologic, and echocardiographic characteristics available within 72 hours of admission that might define the profile of high-risk patients. Of 444 episodes, 317 left-sided endocarditis cases were included and 76 variables were assessed. Events were surgery in the active phase of the disease and in-hospital death. A stepwise logistic regression analysis was undertaken to determine variables predictive of events. Results: Multivariate analysis of the clinical variables found to have statistical significance in the univariate analysis identified the following as predictive: patient referred from another hospital (odds ratio [OR]: 1.8; confidence interval [CI], 1.1-2.9), atrioventricular block (OR: 2.5; CI, 1.1-5.9), acute onset (OR: 1.7; CI, 1.1-2.9), and heart failure at admission (OR: 2.3; CI, 1.4-3.8). When the echocardiographic and microbiological variables statistically significant in the univariate analysis were introduced, the presence of heart failure at admission (OR: 2.9; CI, 1.8-4.8), periannular complications (OR: 1.8; CI, 1.1-3.1), and Staphylococcus aureus infection (OR: 2.0; CI, 1.1-3.8) retained prognostic power. Risk could be accurately stratified when combining the 3 variables with predictive power: 0 variables present: 25% of risk; 1 variable present: 38% to 49% of risk; 2 variables present: 56% to 66% of risk; and 3 variables present: 79% of risk. Conclusions: The risk of patients with left-sided endocarditis can be accurately stratified with the assessment of variables easily available within 72 hours of admission to the hospital.
Mitochondrial Oxidative Stress Promotes Cardiac Remodeling in Myocardial Infarction through the Activation of Endoplasmic Reticulum Stress
(Antioxidants, 2022) Souza Neto, Francisco V.; Islas, Fabián; Jiménez González, Sara; Luaces Méndez, María; Ramchandani, Bunty; Romero Miranda, Ana; Delgado Valero, Beatriz; Roldan Molina, Elena; Saiz Pardo, Melchor; Cerón Nieto, María Ángeles; Ortega Medina, Luis; Martínez Martínez, Ernesto; Cachofeiro Ramos, María Victoria
We have evaluated cardiac function and fibrosis in infarcted male Wistar rats treated with MitoQ (50 mg/kg/day) or vehicle for 4 weeks. A cohort of patients admitted with a first episode of acute MI were also analyzed with cardiac magnetic resonance and T1 mapping during admission and at a 12-month follow-up. Infarcted animals presented cardiac hypertrophy and a reduction in the left ventricular ejection fraction (LVEF) and E- and A-waves (E/A) ratio when compared to controls. Myocardial infarction (MI) rats also showed cardiac fibrosis and endoplasmic reticulum (ER) stress activation. Binding immunoglobulin protein (BiP) levels, a marker of ER stress, were correlated with collagen I levels. MitoQ reduced oxidative stress and prevented all these changes without affecting the infarct size. The LVEF and E/A ratio in patients with MI were 57.6 ± 7.9% and 0.96 ± 0.34, respectively. No major changes in cardiac function, extracellular volume fraction (ECV), or LV mass were observed at follow-up. Interestingly, the myeloperoxidase (MPO) levels were associated with the ECV in basal conditions. BiP staining and collagen content were also higher in cardiac samples from autopsies of patients who had suffered an MI than in those who had died from other causes. These results show the interactions between mitochondrial oxidative stress and ER stress, which can result in the development of diffuse fibrosis in the context of MI.
Non-invasive diagnosis of chylopericardium by cardiac magnetic resonance imaging
(European Heart Journal, 2009) Luaces Méndez, María; Perales, Isabel; Núñez-Gil, Iván J.; Cabezudo, Jorge
Bone fractures after cardiac transplantation
(Transplantation Proceedings, 2007) Luaces Méndez, María; Crespo-Leiro, María Generosa; Paniagua-Martín, María Jesús; García de Lara, Juan; Rivas, Raquel Marzoa; Piñón-Esteban, Pablo; Cursak, Guillermo; Ríos, Ramón; Leira, Carmen Naya; Alonso-Martín, Joaquín Jesús; Castro Beiras, Alfonso
Objective: Bone loss and bone fractures are disabling complications after heart transplantation. Severe bone loss happens mainly during the first year posttransplantation. Steroids and cyclosporine alter bone metabolism in several ways. To counterbalance these effects, antiresorptive therapy is provided to these patients. The objective of this study was to assess the frequency of bone fractures after heart transplantation, considering previous comorbidities, immunosuppressive therapy, and osteoprotective treatment. Methods: From 1993 to 2005, 443 consecutive heart transplant recipients were followed for the occurrence of bone fractures, immunosuppressive therapy, clinical conditions, and antiresorptive treatment. Results: There were 41 fractures in 34 patients (7.6%, group I). The remainder of patients formed group II. Fractures commonly involved the lumbar spine. Postmenopausal women had more fractures than other patients (20.6% vs 7.8%, P = .02). When the initial immunosuppressive regimen included tacrolimus, fractures did not happen (P = .01, vs other regimens). Osteoprotective therapy was administered to 91.2% of patients in group I and 79% in group II (P = .08). Mean interval from transplantation to the first fracture was 1131.5 days. Overweight patients had a 61.8% incidence of fracture. Conclusions: Our series showed a low frequency of bone fractures. Postmenopausal women and overweight patients had more fractures. An initial immunosuppressive regimen using tacrolimus was associated with lower fracture rates.
Current Usefulness of Transesophageal Echocardiography in Patients Undergoing Transcatheter Aortic Valve Replacement
(Journal of Clinical Medicine, 2023) Alberto de Agustín, José; Pozo Osinalde, Eduardo; Olmos, Carmen; Mahia Casado, Patricia; Marcos Alberca, Pedro; Luaces Méndez, María; Gómez de Diego, José Juan; Nombela Franco, Luis; Jiménez Quevedo, Pilar; Tirado Conte, Gabriela; Collado Yurrita, Luis Rodolfo; Fernández Ortiz, Antonio Ignacio; Pérez Villacastín Domínguez, Julián
This review article describes in depth the current usefulness of transesophageal echocardiography in patients who undergo transcatheter aortic valve replacement. Pre-intervention, 3D-transesophageal echocardiography allows us to accurately evaluate the aortic valve morphology and to measure the valve annulus, helping us to choose the appropriate size of the prosthesis, especially useful in cases where the computed tomography is not of adequate quality. Although it is not currently used routinely during the intervention, it remains essential in those cases of greater complexity, such as for patients with greater calcification and bicuspid valve, mechanical mitral prosthesis, and “valve in valve” procedures. Three-dimensional transesophageal echocardiography is the best technique to detect and quantify paravalvular regurgitation, a fundamental aspect to decide whether immediate valve postdilation is needed. It also allows to detect early any immediate complications such as cardiac tamponade, aortic hematoma or dissection, migration of the prosthesis, malfunction of the prosthetic leaflets, or the appearance of segmental contractility disorders due to compromise of the coronary arteries ostium. Transesophageal echocardiography is also very useful in follow-up, to check the proper functioning of the prosthesis and to rule out complications such as thrombosis of the leaflets, endocarditis, or prosthetic degeneration.
Electrocardiographic criteria in Takotsubo cardiomyopathy and race differences: Asians versus Caucasians
(Journal of the American College of Cardiology, 2010) Núñez-Gil, Iván; Luaces Méndez, María; García- Rubira, Juan Carlos; Zamorano Gómez, José Luis
Thrombosis of an Apparently Normal Thoracic Aorta and Arterial Embolism
(Revista Española de Cardiología, 2007) Cañadas, Victoria; Vilacosta, Isidre; Luaces Méndez, María; Bustos García De Castro, Ana María; Ferreiros Domínguez, Joaquín; Aragoncillo Ballesteros, Paloma; Pérez De Isla, Leopoldo; Rodríguez Hernández, José Enrique
With the advent of new imaging techniques, the aorta has been increasingly identified as a source of arterial embolism. The majority of thrombi occur in aneurysms or are adherent to atherosclerotic lesions in the abdominal aorta. Thrombi in the thoracic aorta are much less common, particularly in apparently normal aortas. Consequently, the natural history and optimal treatment of these lesions are not well-defined. The aim of this article was to describe the clinical characteristics, treatment, and outcome in 3 patients with thoracic aorta thrombosis and arterial embolism. Currently available literature on this pathology is reviewed and the differential diagnosis of these lesions is discussed.
Mild heart failure is a mortality marker after a non-ST-segment acute myocardial infarction
(European Journal of Internal Medicine, 2010) Núñez Gil, Iván J.; García Rubira, Juan Carlos; Luaces Méndez, María; Vivas Balcones, Luis David; De Agustín, José Alberto; González Ferrer, Juan J.; Bordes, Sara; Macaya Miguel, Carlos; Fernández Ortiz, Antonio Ignacio
Background: The Killip classification categorizes heart failure (HF) in acute myocardial infarction, and has a prognostic value. Although non-ST-elevation myocardial infarction (NSTEMI) is increasing steadily, little information is available about the prognostic value of low Killip class in this scenario. Our aim was to assess the prognostic value of mild HF in NSTEMI. Methods: 835 patients with NSTEMI between 2005 and 2007 were prospectively recruited. Patients in Killip-1 (K1=684) or Killip-2 class (K2=113) were selected (38, with K>2, excluded). Clinical, angiographic, treatment strategies, and 30-day all-cause mortality, together with other cardiovascular outcomes were recorded. Results: K2 patients were mostly women (K1 27.9% vs K2 48.0%, p<0.001) and older (K1 66.6years vs K2 73.8years, p<0.001) with a higher frequency of diabetes mellitus (p<0.001) and hypertension (p<0.001). Smoking was less frequent in the K2-group (p=0.003). A previous infarction/revascularization history was similar in both groups. The infarction size, assessed by Troponin I/Creatin kinase, did not differ between groups (p=0.378 and p=0.855). Multivessel coronary disease and revascularization procedures were less common in group K2 (p=0.015 and p=0.005 vs group K1, respectively). Patients in K2 had a worse prognosis in terms of maximum Killip class, death and major adverse cardiovascular events (p<0.001). After multivariate analysis, mild HF at presentation was an independent risk factor for mortality (OR=6.50; IC 95%: 2.48-16.95; p<0.001). Conclusion: Mild HF at presentation in NSTEMI is linked to a poor prognosis, with increased short-term mortality. Thus, a more aggressive approach including early cardiac catheterization and revascularization should be considered.
Exercise during pregnancy improves maternal health perception: a randomized controlled trial
(American Journal of Obstetrics and Gynecology, 2011) Barakat, Ruben; Peláez García, María Teresa; Montejo, Rocio; Luaces Méndez, María; Zakynthinaki, Maria
Objective We have studied the effect of moderate physical activity that is performed by healthy women during their entire pregnancy on their perception of health status. Study Design Eighty sedentary women were assigned randomly to either an exercise group (n = 40) or a control group (n = 40). Maternal perception of health status and several pregnancy outcomes were recorded. Results Significant differences (P = .03) were found between study groups in the percentage of women who perceived their health status as “very good”; the values that corresponded to the exercise group (n = 18; 54.5%) were better than those of the control group (n = 9; 27.3%). In addition, the women of the exercise group gained less weight (11,885 ± 3146 g) than those of the control group (13,903 ± 2113; P = .03). Conclusion A moderate physical activity program that is performed over the first, second, and third trimester of pregnancy improves the maternal perception of health status.
Factores determinantes e implicaciones pronósticas del tamaño de la vegetación en el primer ecocardiograma transesofágico en la endocarditis infecciosa
(2010) Luaces Méndez, María; Macaya Miguel, Carlos; Vilacosta, Isidre
A pesar de todos los recientes avances diagnósticos y el amplio armamentario terapéutico, la endocarditis infecciosa sigue siendo una enfermedad grave que conlleva una elevada mortalidad intrahospitalaria. La vegetación es la lesión más característica de la enfermedad, y se considera un criterio diagnóstico. El ecocardiograma es la herramienta fundamental para su detección. Sin embargo, sigue existiendo controversia respecto a cuáles son los factores que determinan el tamaño de la vegetación. Es más, a pesar de ser una parte integral de la fisiopatología y diagnóstico de la enfermedad, la contribución del tamaño de la vegetación al pronóstico de la enfermedad sigue siendo objeto de debate. Se ha realizado un gran esfuerzo para identificar a los pacientes de alto riesgo que se podrían beneficiar de un tratamiento agresivas. Diferentes estudios han llegado a diferentes conclusiones, debido a la variabilidad en su metodología, a los criterios diagnósticos, al escaso número de pacientes incluidos, al carácter retrospectivo o prospectivo, y al uso del ecocardiograma transtorácico o transesofágico. Teniendo en cuenta las consideraciones anteriores, se ha llevado a cabo este estudio, basado en los hallazgos del primer ecocardiograma transesofágico en el episodio de endocarditis