Nuestros investigadores

Joaquín Barba Cosials

Publicaciones científicas más recientes (desde 2010)

Autores: Barba, Joaquín; Guembe, M. J. ; et al.
Revista: REVISTA ESPAÑOLA DE CARDIOLOGIA
ISSN 0300-8932  Vol. 70  Nº 4  2017  págs. 254 - 260
Introduction and objectives: There is currently increasing interest in epicardial adipose tissue (EAT) as a marker of cardiovascular disease. Our purpose was to describe EAT, measured by transthoracic echocardiography, and to assess its association with metabolic syndrome (MS) in the RIVANA population-based study. Methods: Physical examination was performed in 880 participants aged 45 to 74 years (492 of them with MS according to the harmonized definition). Fasting glucose, high-density lipoprotein cholesterol, triglyceride, and C-reactive protein concentrations were determined in a blood sample. In all participants, EAT thickness was measured with transthoracic echocardiography at end-systole. Results: Among participants without MS, the prevalence of EAT >= 5 mm significantly increased with age (OR > 65 years vs 45-54 years = 8.22; 95% CI, 3.90-17.35; P for trend < .001). Increasing EAT quintiles were significantly associated with MS (OR fifth quintile vs first quintile = 3.26; 95% CI, 1.59-6.71; P for trend = .001). Considering the different MS criteria, increasing quintiles of EAT were independently associated with low high-density lipoprotein cholesterol (OR fifth quintile vs first quintile = 2.65; 95% CI, 1.16-6.05; P for trend = .028), high triglycerides (OR fifth quintile vs first quintile = 2.22; 95% CI, 1.26-3.90; P for trend = .003), and elevated waist circumference (OR fifth quintile vs first quintile = 6.85; 95% CI, 2.91-16.11; P for trend < .001). Conclusions: In a subsample of the general population, EAT measured by echocardiography increased significantly and independently with age. Increased EAT thickness was independently associated with MS and with low high-density lipoprotein cholesterol, high triglycerides, and elevated waist circumference as individual criteria. (C) 2016 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Cardiologia.
Autores: Coma, María Isabel; Artaiz, Miguel; et al.
Revista: ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN 1137-6627  Vol. 40  Nº 1  2017  págs. 35 - 42
Background. Most acute coronary syndromes are caused by the fracture of a vulnerable atherosclerotic plaque. These plaques are thin cap fibroatheromas, which can only be detected with invasive coronary imaging techniques. It is necessary to find a non-invasive biomarker of these vulnerable plaques in order to identify patients at risk without a coronary angiography. Metalloproteinase-1 is an enzyme involved in extracellular matrix metabolism which has been correlated with the rupture of atherosclerotic plaques. Its serum levels in patients with vulnerable plaques remain unknown. Methods. Patients with suspected stable coronary artery disease undergoing coronary angiography in our hospital were included. The coronary arteries were studied with optical coherence tomography to detect vulnerable plaques. Blood samples were taken from a peripheral vein and from the coronary sinus, to assess metalloproteinase-1 levels. Results. Fifty-one patients were included, 13 of whom had at least one vulnerable plaque. There were not significant differences in clinical characteristics, lipid profile or C reactive protein levels, between patients with or without vulnerable plaques. Patients with vulnerable plaques had significant higher metalloproteinase-1 levels both in peripheral (7330 5541 vs 2894 1783 pg/ml, p=0.025) and coronary sinus serum (6012 3854 vs 2707 1252 pg/ml, p=0.047). Conclusions. Patients with vulnerable plaques had significantly higher metalloproteinase-1 serum levels. Further studies with clinical follow up are needed to assess the prognostic value of serum metalloproteinase-1.
Autores: Saura, D.; Rodríguez Palomares, J. F.; López Fernández, T.; et al.
Revista: REVISTA ESPAÑOLA DE CARDIOLOGIA
ISSN 0300-8932  Vol. 70  Nº 3  2017  págs. 212 - 213
Autores: Rodríguez Palomares, J. F.; Maceira González, A. M.; Saura, D.; et al.
Revista: REVISTA ESPAÑOLA DE CARDIOLOGIA
ISSN 0300-8932  Vol. 70  Nº 3  2017  págs. 214 - 215
Autores: González, A; Pueyo, Jesús Ciro; et al.
Revista: EUROPEAN JOURNAL OF HEART FAILURE
ISSN 1388-9842  Vol. 19  Nº Supl. 1  2017  págs. 123
Autores: López Fernández, T.; Saura, D.; Rodríguez Palomares, J. F.; et al.
Revista: REVISTA ESPAÑOLA DE CARDIOLOGIA
ISSN 0300-8932  Vol. 69  Nº 3  2016  págs. 286 - 293
Cardiac imaging 2015: A selection of topical Issues
Autores: Garcia-Bolao, I; Calvo, N; et al.
Revista: JOURNAL OF ATRIAL FIBRILLATION
ISSN 1941-6911  Vol. 8  Nº 5  2016  págs. 61-66
Autores: Ravassa, S; Beaumont Javier; Huerta, Ana; et al.
Revista: FREE RADICAL BIOLOGY AND MEDICINE
ISSN 0891-5849  Vol. 81  2015  págs. 1 - 12
Oxidative stress (OS) contributes to cardiovascular damage in type 2 diabetes mellitus (T2DM). The peptide glucagon-like peptide-1 (GLP-1) inhibits OS and exerts cardiovascular protective actions. Our aim was to investigate whether cardiac remodeling (CR) and cardiovascular events (CVE) are associated with circulating GLP-1 and biomarkers of OS in T2DM patients. We also studied GLP-1 antioxidant effects in a model of cardiomyocyte lipotoxicity. We examined 72 T2DM patients with no coronary or valve heart disease and 14 nondiabetic subjects. A median of 6 years follow-up information was obtained in 60 patients. Circulating GLP-1, dipeptidyl peptidase-4 activity, and biomarkers of OS were quantified. In T2DM patients, circulating GLP-1 decreased and OS biomarkers increased, compared with nondiabetics. Plasma GLP-1 was inversely correlated with serum 3-nitrotyrosine in T2DM patients. Patients showing high circulating 3-nitrotyrosine and low GLP-1 levels exhibited CR and higher risk for CVE, compared to the remaining patients. In palmitate-stimulated HL-1 cardiomyocytes, GLP-1 reduced cytosolic and mitochondrial oxidative stress, increased mitochondrial ATP synthase expression, partially restored mitochondrial membrane permeability and cytochrome c oxidase activity, blunted leakage of creatine to the extracellular medium, and inhibited oxidative damage in total and mitochondrial DNA. These results suggest that T2DM patients with reduced circulating GLP-1 and exacerbated OS may exhibit CR and be at higher risk for CVE. In addition, GLP-1 exerts antioxidant effects in HL-1 palmitate-overloaded cardiomyocytes. It is proposed that therapies aimed to increase GLP-1 may counteract OS, protect from CR, and prevent CVE in patients with T2DM.
Autores: Calvo, N; Salterain, Nahikari; H; et al.
Revista: EUROPACE
ISSN 1099-5129  Vol. 10  2015  págs. 1533-40
The combination of CA and percutaneous LAAC in a single procedure is technically feasible in patients with symptomatic drug-refractory AF, high risk of stroke, and contraindications to OACs, although it is associated with a significant risk of major complications
Autores: Mahía Casado, P.; García Orta, R.; Gómez de Diego, J. J.; et al.
Revista: REVISTA ESPAÑOLA DE CARDIOLOGIA
ISSN 0300-8932  Vol. 68  Nº 2  2015  págs. 129 - 135
En este artículo se realiza una revisión de las aportaciones de las técnicas de imagen más relevantes a la cardiología que se han publicado durante este año. El ecocardiograma sigue siendo la piedra angular en el diagnóstico y el seguimiento de las valvulopatías, con un esfuerzo continuo para mejorar su cuantificación y obtener parámetros pronósticos de seguimiento. El estudio de la función miocárdica regional se afianza en el diagnóstico de la disfunción ventricular subclínica, y el ecocardiograma transesofágico tridimensional se ha convertido en el perfecto aliado del intervencionismo en las cardiopatías estructurales. La cardiorresonancia y la tomografía computarizada cardiaca acaparan la mayoría de las publicaciones en imagen cardiaca relativas a la cardiopatía isquémica, reflejo de unas técnicas más que consolidadas en la práctica clínica. La medicina nuclear destaca en el estudio de la viabilidad miocárdica tras el intervencionismo en el síndrome coronario agudo y refuerza su rendimiento en el diagnóstico de la cardiopatía isquémica.
Autores:  et al.
Revista: REVISTA CLINICA ESPAÑOLA
ISSN 0014-2565  Vol. 215  Nº 1  2015  págs. 63 - 64
Autores: García Orta, R.; Mahía Casado, P.; Gómez De Diego, J. J.; et al.
Revista: REVISTA ESPAÑOLA DE CARDIOLOGIA
ISSN 0300-8932  Vol. 67  Nº 2  2014  págs. 127 - 134
La imagen cardiaca es la piedra angular del diagnóstico en cardiología, así como un instrumento esencial en la valoración pronóstica y las decisiones terapéuticas. Este año, la ecocardiografía destaca como guía en el intervencionismo y en la elección del tamaño de las prótesis. Se consolida la entidad de la estenosis aórtica de bajo flujo y bajo gradiente. El método tridimensional avanza en el conocimiento anatómico y la cuantificación valvular. Los parámetros de deformación muestran su poder predictor en valvulopatías y en el seguimiento en la cardiotoxicidad inducida por fármacos. La tomografía computarizada por emisión monofotónica y la tomografía por emisión positrónica consolidan su utilidad en cardiopatía isquémica y destacan en el diagnóstico de inflamaciones e infecciones cardiacas. La tomografía computarizada cardiaca afianza su papel en la coronariografía no invasiva, el manejo del dolor torácico en urgencias, la valoración de las oclusiones crónicas y el estudio morfológico de la placa. La resonancia magnética cardiaca permanece como técnica de referencia en la caracterización tisular tanto en cardiopatía isquémica como en las miocardiopatías y afianza su papel en el estudio de estrés y la valoración de la viabilidad.
Autores: Ravassa, S; Barba, Joaquín; Coma, María Isabel; et al.
Revista: CARDIOVASCULAR DIABETOLOGY
ISSN 1475-2840  Vol. 12  2013  págs. 143
Background: Patients with type 2 diabetes mellitus (T2DM) present subclinical left ventricular systolic and/or diastolic dysfunction (LVD). Dipeptidyl peptidase-4 (DPP4) inactivates peptides that possess cardioprotective actions. Our aim was to analyze whether the activity of circulating DPP4 is associated with echocardiographically defined LVD in asymptomatic patients with T2DM. Methods: In this cross-sectional study, we examined 83 T2DM patients with no coronary or valve heart disease and 59 age and gender-matched non-diabetic subjects. Plasma DPP4 activity (DPP4a) was measured by enzymatic assay and serum amino-terminal pro-brain natriuretic peptide (NT-proBNP) was measured by enzyme-linked immunosorbent assay. LV function was assessed by two-dimensional echocardiographic imaging, targeted M-mode recordings and Doppler ultrasound measurements. Differences in means were assessed by t-tests and one-way ANOVA. Associations were assessed by adjusted multiple linear regression and logistic regression analyses. Results: DPP4a was increased in T2DM patients as compared with non-diabetic subjects (5855 +/- 1632 vs 5208 +/- 957 pmol/min/mL, p < 0.05). Clinical characteristics and echocardiographic parameters assessing LV morphology were similar across DPP4a tertiles in T2DM patients. However, prevalence of LVD progressively increased across incremental DPP4a tertiles (13%, 39% and 71%, all p < 0.001). Multivariate regression analysis confirmed the independent associations of DPP4a with LVD in T2DM patients (p < 0.05). Similarly, multiple logistic regression analysis showed that an increase of 100 pmol/min/min plasma DPP4a was independently associated with an increased frequency of LVD with an adjusted odds ratio of 1.10 (95% CI, 1.04 to 1.15, p = 0.001). Conclusions: An excessive activity of circulating DPP4 is independently associated with subclinical LVD in T2DM patients. Albeit descriptive, these findings suggest that DPP4 may be involved in the mechanisms of LVD in T2DM.
Autores: Ravassa, S; Beloqui, Óscar; Varo, N; et al.
Revista: JOURNAL OF HYPERTENSION
ISSN 0263-6352  Vol. 31  Nº 3  2013  págs. 587 - 594
Objectives: Cardiotrophin-1 (CT-1) induces hypertrophic growth and contractile dysfunction in cardiomyocytes. This cross-sectional study was aimed to analyze CT-1 associations with echocardiographically assessed left ventricular systolic properties taking into account the influence of left ventricular growth [i.e. left ventricular hypertrophy (LVH) and inappropriate left ventricular mass (iLVM)] in asymptomatic hypertensive patients. Methods: Serum CT-1 was measured by ELISA in 278 asymptomatic hypertensive patients with a left ventricular ejection fraction more than 50% and in 25 age and sex-matched normotensive patients. Results: Serum CT-1 was increased in hypertensive patients as compared to normotensive patients. CT-1 was directly correlated with parameters of left ventricular mass (LVM) and inversely correlated with parameters assessing myocardial systolic function and left ventricular chamber contractility in hypertensive patients, these associations being independent of a number of potential confounding factors. Interestingly, the associations of CT-1 with myocardial systolic function were independent of LVM even in patients with LVH or iLVM. In addition, there was a significant increment of serum CT-1 in hypertensive patients with LVH or iLVM, especially in those in whom LVH or iLVM were accompanied by impaired myocardial systolic function, as compared to the remaining hypertensive patients and normotensive patients. Plasma amino-terminal pro-brain natriuretic peptide was not correlated with any of the assessed left ventricular systolic parameters in either group of patients. Conclusion: These findings suggest that serum CT-1 is associated with myocardial systolic dysfunction in asymptomatic hypertensive patients, independently of LVM, even in those patients with pathologic left ventricular growth.
Autores: Gómez De Diego, J. J.; García Orta, R.; Mahía Casado, P.; et al.
Revista: REVISTA ESPAÑOLA DE CARDIOLOGIA
ISSN 0300-8932  Vol. 66  Nº 3  2013  págs. 205 - 211
La imagen cardiaca es uno de los pilares de la cardiología actual. La cantidad de situaciones en que las técnicas de imagen aportan información importante en clínica o investigación es sencillamente interminable, por lo que es imposible recoger en el formato reducido de un artículo todas las novedades importantes sobre imagen cardiaca que han aparecido en la literatura médica en el año 2012. Resumimos las publicaciones más importantes del año, entre las que destacan el desarrollo progresivo de las técnicas de deformación miocárdica y la ecocardiografía tridimensional y la incorporación creciente al trabajo clínico diario de la resonancia magnética y la tomografía computarizada.
Autores: Gállego, Jaime; Irimia, Pablo; Martínez Vila, E.; et al.
Revista: JOURNAL OF CLINICAL ULTRASOUND
ISSN 0091-2751  Vol. 40  Nº 8  2012  págs. 479 - 485
Background. The assessment of carotid intima-media thickness (CIMT) may improve cardiovascular risk prediction. The optimal protocol for CIMT measurement is unclear. CIMT may be measured in the common carotid artery (CCA), carotid bifurcation (CB), and internal carotid artery (ICA), but measurements from CB and ICA are more difficult to obtain. We studied the influence of body mass index (BMI) and atheroma plaques on the capacity to obtain CIMT measurements at different carotid sites. Methods. Using an automatic system, CIMT was measured in 700 subjects aged 4575, in the near and far walls of CCA, CB, and ICA bilaterally. The presence of atheroma plaques, BMI and vascular risk factors were recorded. Results. CIMT measurements in CCA were possible in all except one subject. It was not possible to obtain CIMT measurements at CB or ICA in 24.1% of normal weight and 58.8% of obese subjects. The likelihood of obtaining CIMT measurement at all carotid sites decreased as the BMI increased. Atheroma plaques in a carotid segment did not preclude CIMT measurement at this site. Conclusions. CIMT measurements in distal carotid segments are more challenging in obese subjects. Measuring CIMT at CCA remains feasible in obese subjects and should be the primary endpoint in these subjects. Nevertheless, CB and ICA measurements, when feasible, would improve risk classification.
Autores: Beaumont Javier; López, B; et al.
Revista: JOURNAL OF HYPERTENSION
ISSN 0263-6352  Vol. 29  Nº 5  2011  págs. 876 - 883
Objective: To analyze whether genetic variants of PPARA are associated with the development of stage C heart failure. Methods: We analyzed the distribution of the rs1800206, rs4253778 and rs135551 polymorphisms in genomic DNA extracted from peripheral blood cells of 534 patients in different heart failure stages and 63 healthy individuals. The mRNA expression of the peroxisome proliferator-activated receptor (PPAR)¿ target genes long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) and medium-chain acyl-CoA dehydrogenase (MCAD) was measured in myocardial biopsies of a subgroup of stage B and C patients. Functional studies were performed in HL-1 cardiomyocytes. Results: The V162 allele of the rs1800206 polymorphism was more frequent in stage C patients than in stage A and B patients and healthy individuals. Patients with the V162 allele exhibited decreased myocardial LCHAD and MCAD mRNA expression as compared to L162 homozygote patients. In addition, stage C patients exhibited lower myocardial LCHAD and MCAD mRNA expression than stage B patients. Cardiomyocytes transfected with the V162 allele presented decreased PPAR¿ transcriptional activity, LCHAD mRNA expression and ATP production compared to cardiomyocytes transfected with the L162 variant. Conclusions: These findings suggest that the V162 allele of the human PPARA gene can be a new risk factor in the development of stage C heart failure, likely via depressed cardiac PPARalfa activity.
Autores: Rodríguez, Amaia; Gómez-Ambrosi, J; Catalán, V; et al.
Revista: Journal of hypertension
ISSN 0263-6352  Vol. 28  Nº 3  2010  págs. 560 - 567
Objective The gut-derived hormone, ghrelin, improves cardiac function in healthy individuals and patients with chronic heart failure. The aim of this study was to investigate whether the major isoforms of the hormone, acylated and desacyl ghrelin, are related to inappropriate left ventricular mass in patients with the metabolic syndrome (MetS). Methods and results Plasma concentrations of ghrelin forms were measured in 180 white participants (65 normal weight, 60 obese without MetS and 55 obese with MetS; 56% men). MetS was defined according to Adult Treatment Panel III criteria. The presence of left ventricular hypertrophy (LVH) was diagnosed by sex-specific left ventricular mass/height(2.7) cut-off values (> 49.2 g/m(2.7) for men and > 46.7 g/m(2.7) for women). Circulating concentrations of acylated ghrelin were increased in obesity and MetS, whereas desacyl ghrelin levels were decreased. Compared with participants in the lowest tertiles, the age-adjusted and sex-adjusted odds of having MetS were lower in the highest category of desacyl ghrelin (odds ratio 0.1, 95% confidence interval 0.1-0.4, P < 0.001). The prevalence of LVH was increased in the highest tertile of acylated ghrelin (odds ratio 3.4, 95% confidence interval 1.7-5.6, P < 0.05). Plasma acylated ghrelin was increased (P < 0.05) in patients with MetS exhibiting LVH compared with those with appropriate left ventricular mass, whereas plasma desacyl ghrelin was not changed (P = 0.490). Conclusion Acylated ghrelin was positively associated with SBP and left ventricular mass indices, even after correction for BMI. These results suggest that the increased acylated ghrelin concentrations may represent a compensatory mechanism to overcome the development of hypertension and LVH in patients with MetS.
Autores: Coma, María Isabel; Artaiz, Miguel; et al.
Revista: HEART INTERNATIONAL
ISSN 1826-1868  Vol. 5  Nº 2  2010  págs. 58 - 63
Autores: Guembe, M. J.; Toledo, Estefanía Ainhoa; Barba, Joaquín; et al.
Revista: ATHEROSCLEROSIS
ISSN 0021-9150  Vol. 211  Nº 2  2010  págs. 612 - 617
OBJECTIVE: To assess the association between the metabolic syndrome (MetSd) and asymptomatic cardiovascular disease and determine if the MetSd or its single risk factors perform better in discriminating prevalent asymptomatic cardiovascular disease. METHODS: A total of 880 community-dwelling subjects (423 with and 457 without MetSd according to ATPIII) underwent a physical examination, an echocardiography and an ultrasound examination of carotid arteries and blood and urine samples were collected. Associations between the subclinical organ damage markers and the MetSd were addressed with non-conditional logistic regression. AUCs of ROCs were used to compare the models' ability to discriminate asymptomatic cardiovascular disease. RESULTS: The MetSd was independently associated with carotid subclinical atherosclerosis, increased left ventricular mass index and cardiac dysfunction. The MetSd did not discriminate prevalent increased carotid intima-media thickness better than abdominal obesity and impaired fasting glucose [AUC=0.75 (95% CI: 0.71-0.78) and 0.75 (0.71-0.79), respectively; p=0.55]. The MetSd performed worse than abdominal obesity in discriminating increased left ventricular mass index among males younger than 65 years [AUC=0.66 (95% CI: 0.62-0.69) and 0.69 (0.66-0.73), respectively; p=0.02]. No differences between the ability of MetSd or its components in discriminating increased left ventricular mass index were observed among older men or women. The discrimination ability for microalbuminuria for the MetSd or impaired fasting glucose was not statistically different [AUC=0.67 (95% CI: 0.60-0.74) and 0.69 (0.62-0.76), respectively; p=0.18]. CONCLUSION: This study supports the association between the MetSd and asymptomatic cardiovascular disease. The construct of the MetSd might not be better than its single components in addressing cardiovascular risk.