Introduction and objectives: Several trials have tested the diagnostic and prognostic value of stress cardiac magnetic resonance (CMR) in ischemic heart disease. However, scientific evidence is lacking in the older population, and the available techniques have limitations in this population. The aim of this study was to evaluate the usefulness of stress CMR in the elderly. Methods: We prospectively studied consecutive patients referred for stress CMR to rule out myocardial ischemia. The cutoff age for the elderly population was 70 years. Stress CMR study was performed according to standardized international protocols. Hypoperfusion severity was classified according to the number of affected segments: mild (1-2 segments), moderate (3-4 segments), or severe (> 4 segments). We analyzed the occurrence of major events during follow-up (death, acute coronary syndrome, or revascularization). Survival was studied with the Kaplan-Meier method and multivariate Cox regression models. Results: Of an initial cohort of 333 patients, 110 were older than 70 years. In 40.9% patients, stress CMR was positive for ischemia. The median follow-up was 26 [18-37] months. In elderly patients there were 35 events (15 deaths, 10 acute coronary syndromes, and 10 revascularizations). Patients with moderate or severe ischemia were at a higher risk of events, adjusted for age, sex, and cardiovascular risk (HR, 3.53 [95%CI, 1.41-8.79]; P=.01). Conclusions: Moderate to severe perfusion defects in stress CMR strongly predict cardiovascular events in people older than 70 years, without relevant adverse effects.

Objective: To assess the usefulness of cardiac stress magnetic resonance imaging (MRI) with adenosine in the detection of ischemic heart disease in patients with a low pretest probability of disease. Material and methods: We used the probability ratio to analyze the usefulness of cardiac stress MRI in a selection of patients with a low pretest probability of ischemic heart disease (low or moderate cardiovascular risk, atypical chest pain, or absence of prior ischemic heart disease). Results: We included 295 patients followed up for a median of 28 (19-36) months. A total de 60 patients had an event. Cardiac stress MRI was more useful in patients with a low pretest probability: atypical chest pain (probability ratio [PR] positive 8.56), absence of prior ischemic heart disease (PR positive 4.85), and low or moderate cardiovascular risk (PR positive 3.87). Conclusions: Cardiac stress MRI can be useful in the diagnosis of ischemic heart disease in patients with a low pretest probability. (C) 2018 SERAM. Published by Elsevier Espana, S.L.U. All rights reserved.

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