Introduction: Cases of acute myocarditis have been after administration of the BNT162b2 and Ad26.COV2.S vaccine.Objective: Describe another possible mechanism of myocarditis after COVID-19 vaccination.Case presentation: We describe the clinical case of a 72-year-old female with pleuritic chest pain one week after the third of the BNT162b2 mRNA vaccine. Serological tests for cardiotropic pathogens were negative, and autoimmunity screening was positive with anti-nuclear antibody (ANA) in 1:160 dilu-tion, Anti-double-stranded DNA (anti-dsDNA), and anti-histone antibodies. 18F-fluoro-deoxy-glucose (FDG) positron emission tomography/computed tomography (PET/CT) showed a focal myocardial and pericardial inflammatory process in the cardiac apex.Results and discussion: Systemic lupus erythematosus (SLE) diagnosis was made with myocardial affec-tion. As far as we know, this is the first report of a case of lupus myocarditis after the COVID-19 vaccine.Conclusion: Given the pathogenic rationales, the association between SLE and myocarditis should be considered.(c) 2022 Elsevier Espana, S.L.U. and Sociedad Espanola de Reumatologi acute accent a y Colegio Mexicano de Reumatologi acute accent a. All rights reserved.

Introduction and objectives: Heart retransplantation (ReHT) is controversial in the current era. The aim of this study was to describe and analyze the results of ReHT in Spain. Methods: We performed a retrospective cohort analysis from the Spanish Heart Transplant Registry from 1984 to 2018. Data were collected on donors, recipients, surgical procedure characteristics, immunosuppression, and survival. The main outcome was posttransplant all-cause mortality or need for ReHT. We studied differences in survival according to indication for ReHT, the time interval between transplants and era of ReHT. Results: A total of 7592 heart transplants (HT) and 173 (2.3%) ReHT were studied (median age, 52.0 and 55.0 years, respectively). Cardiac allograft vasculopathy was the most frequent indication for ReHT (42.2%) and 59 patients (80.8%) received ReHT > 5 years after the initial transplant. Acute rejection and primary graft failure decreased as indications over the study period. Renal dysfunction, hypertension, need for mechanical ventilation or intra-aortic balloon pump and longer cold ischemia time were more frequent in ReHT. Median follow-up for ReHT was 5.8 years. ReHT had worse survival than HT (weighted HR, 1.43; 95%CI, 1.17-1.44; P < .001). The indication of acute rejection (HR, 2.49; 95%CI, 1.45-4.27; P < .001) was related to the worst outcome. ReHT beyond 5 years after initial HT portended similar results as primary HT (weighted HR, 1.14; 95%CI, 0.86-1.50; P < .001). Conclusions: ReHT was associated with higher mortality than HT, especially when indicated for acute rejection. ReHT beyond 5 years had a similar prognosis to primary HT.

BACKGROUND Myocarditis is a potentially fatal complication of immune checkpoint inhibitor (ICI) therapy. Data on the utility of cardiovascular magnetic resonance (CMR) T1 and T2 mapping in ICI myocarditis are limited. OBJECTIVES This study sought to assess the value of CMR T1 and T2 mapping in patients with ICI myocarditis. METHODS In this retrospective study from an international registry of patients with ICI myocarditis, clinical and CMR findings (including T1 and T2 maps) were collected. Abnormal T1 and T2 were defined as 2 SD above site (vendor/field strength specific) reference values and a z-score was calculated for each patient. Major adverse cardiovascular events (MACE) were a composite of cardiovascular death, cardiogenic shock, cardiac arrest, and complete heart block. RESULTS Of 136 patients with ICI myocarditis with a CMR, 86 (63%) had T1 maps and 79 (58%) also had T2 maps. Among the 86 patients (66.3 +/- 13.1 years of age), 36 (41.9%) had a left ventricular ejection fraction <55%. Across alt patients, mean z-scores for T1 and T2 values were 2.9 +/- 1.9 (p < 0.001) and 2.2 +/- 2.1 (p < 0.001), respectively. On Siemens 1.5-T scanner (n = 67), native T1(1,079.0 +/- 55.5 ms vs. 1,000.3 +/- 221 ms; p < 0.001) and 12 (56.2 +/- 4.9 ms vs. 49.8 +/- 2.2 ms; p < 0.001) values were elevated compared with reference values. Abnormal T1 and T2 values were seen in 78% and 43% of the patients, respectively. Applying the modified Lake Louise Criteria, 95% met the nonischemic myocardial injury criteria and 53% met the myocardial edema criteria. Native T1 values had excellent discriminatory value for subsequent MACE, with an area under the curve of 0.91(95% confidence interval: 0.84 to 0.98). Native T1 values (for every 1-unit increase in z-score, hazard ratio: 1.44; 95% confidence interval: 1.12 to 1.84; p = 0.004) but not T2 values were independently associated with subsequent MACE. CONCLUSIONS The use of T1 mapping and application of the modified Lake Louise Criteria provides important diagnostic value, and T1 mapping provides prognostic value in patients with ICI myocarditis. (C) 2021 by the American College of Cardiology Foundation.

El tratamiento percutáneo de la estenosis aórtica severa es una opción terapéutica para paciente inoperables y para aquellos de moderado o elevado riesgo quirúrgico. Presentamos el caso de un paciente joven inicialmente considerado inoperable, sometido a una implantación transcatéter de válvula aórtica, que comenzó a mostrar signos de degeneración tras seis años, que evolucionaron hasta requerir tratamiento quirúrgico a los ocho años del implante. Durante este tiempo, su estado de salud mejoró, por lo que fue presentado en sesión médico quirúrgica para la resección de la válvula previamente implantada y sustitución por otra bioprótesis. El procedimiento transcurrió sin complicaciones. No obstante, la resección de estas válvulas no es un procedimiento exento de riesgo, por las densas adherencias del marco a la raíz aórtica. Por este motivo, la expansión de esta tecnología a pacientes jóvenes y de bajo riesgo, no estaría justificada.

Aunque el alto volumen intervencionista ha demostrado ser importante para tener una baja tasa de complicaciones y una buena evolución a largo plazo, hay centros con bajo volumen intervencionista que por sus características pueden obtener resultados equiparables a los de alto volumen

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

The conjoint consumption of food with beer has an interactive influence on metabolic oxidative fates and may have impact on alcoholaemia. The objective of this is study is to characterize the impact of alcohol in macronutrient oxidation and blood alcohol oncentrations in healthy people, depending on sex, age, body mass and ¿tapas¿ different nutrient composition, as well as the relationship with alcohol in breath test and respiratory quotient. The trial included seventy-one people who drank a beer jointly with some food (bread, nuts or ham) in controlled conditions, where macronutrients oxidation during 3 hours and the behavior of other parameters such as glucose and lipids, blood pressure and heart rate were assessed. The analysis of the experimental groups concluded that there are not differences in blood alcohol levels according to the food consumed with beer, but there are depending on sex and body composition (p<0.05). Also, there are differences in blood glucose levels at 120 minutes in bread group compared with the rest of the groups (p<0.01). Finally, there is a strong correlation between respiratory quotient and alcohol in breath test which may be useful for practical purposes.

nuestros resultados demuestran efectos similares en pacientes con y sin disfunción ventricular, hecho importante teniendo en cuenta que la prevalencia de hiponatremia es similar en ambos grupos. Por lo tanto, la administración de tolvaptán a pacientes no seleccionados con IC descompensada e hiponatremia refractaria sintomática aumenta significativamente las cifras de sodio y el ritmo de diuresis sin afectar significativamente a la función renal