Nuestros investigadores

Jesús Pueyo Villoslada

Publicaciones científicas más recientes (desde 2010)

Autores: García, Alejandra; et al.
ISSN 1569-5794  Vol. 35  Nº 4  2019  págs. 675 - 682
Abstract To evaluate the vasodilator effect of adenosine triphosphate (ATP) compared with adenosine in stress perfusion cardiac magnetic resonance (CMR) examinations. A total of thirty-three patients underwent clinically indicated stress/rest perfusion CMR examination following intravenous injection of a total dose of 0.2 mmol/kg of gadobutrol. Individuals were randomly assigned to ATP (160 mcg/kg/min) or adenosine (140 mcg/kg/min). The vasodilator effect of both drugs was analyzed by comparing differences in heart rate, symptoms during stress, and semiquantitative myocardial and splenic perfusion parameters, including time, time to peak, upslope, myocardial perfusion reserve index, tissue perfusion values, splenic and myocardial signal intensity ratios, and splenic-to-myocardial signal intensity ratios. No significant difference was found in heart rate variation between the stressors (26.1¿±¿19.1 bpm for ATP vs. 21.7¿±¿17.3 bpm for adenosine, p¿=¿0.52). Patients receiving ATP referred less pronounced clinical symptoms. Semiquantitative myocardial perfusion parameters were comparable, and patients in the adenosine and ATP groups showed similar myocardial perfusion reserve index values (2.34 [1.62-2.73] vs 1.63 [1.29-2.10], p¿=¿0.07). Splenic switch off was visually confirmed in all patients and estimated spleen to myocardium ratio was similar (0.92 [0.53-1.09] vs 0.81 [0.53-0.86] with ATP and adenosine, respectively, p¿=¿0.12). Both ATP and adenosine are potent coronary vasodilators that can be safely employed in stress-CMR. Both stressor cause similar hyperemic response. Splenic switch-off can be used to assess stress adequacy in patients undergoing stress-CMR with either adenosine or ATP.
Autores: González, Jéssica; Henschke, C. I.; Yankelevitz, D. F. ; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 14  Nº 7  2019 
Background To assess the relationship between lung cancer and emphysema subtypes. Objective Airflow obstruction and emphysema predispose to lung cancer. Little is known, however, about the lung cancer risk associated with different emphysema phenotypes. We assessed the risk of lung cancer based on the presence, type and severity of emphysema, using visual assessment. Methods Seventy-two consecutive lung cancer cases were selected from a prospective cohort of 3,477 participants enrolled in the Clinica Universidad de Navarra's lung cancer screening program. Each case was matched to three control subjects using age, sex, smoking history and body mass index as key variables. Visual assessment of emphysema and spirometry were performed. Logistic regression and interaction model analysis were used in order to investigate associations between lung cancer and emphysema subtypes. Results Airflow obstruction and visual emphysema were significantly associated with lung cancer (OR = 2.8, 95%CI: 1.6 to 5.2; OR = 5.9, 95%CI: 2.9 to 12.2; respectively). Emphysema severity and centrilobular subtype were associated with greater risk when adjusted for confounders (OR = 12.6, 95%CI: 1.6 to 99.9; OR = 34.3, 95%CI: 25.5 to 99.3, respectively). The risk of lung cancer decreases with the added presence of paraseptal emphysema (OR = 4.0, 95%CI: 3.6 to 34.9), losing this increased risk of lung cancer when it occurs alone (OR = 0.7, 95%CI: 0.5 to 2.6). Conclusions Visual scoring of emphysema predicts lung cancer risk. The centrilobular phenotype is associated with the greatest risk.
Autores: Font, C.; Carmona Bayonas, A.; Beato, C.; et al.
ISSN 0903-1936  Vol. 49  Nº 1  2017  págs.  1600282
The study aimed to identify predictors of overall 30-day mortality in cancer patients with pulmonary embolism including suspected pulmonary embolism (SPE) and unsuspected pulmonary embolism (UPE) events. Secondary outcomes included 30- and 90-day major bleeding and venous thromboembolism (VTE) recurrence.The study cohort included 1033 consecutive patients with pulmonary embolism from the multicentre observational ambispective EPIPHANY study (March 2006-October 2014). A subgroup of 497 patients prospectively assessed for the study were subclassified into three work-up scenarios (SPE, truly asymptomatic UPE and UPE with symptoms) to assess outcomes.The overall 30-day mortality rate was 14%. The following variables were associated with the overall 30-day mortality on multivariate analysis: VTE history, upper gastrointestinal cancers, metastatic disease, cancer progression, performance status, arterial hypotension <100¿mmHg, heart rate >110¿beats·min-1, basal oxygen saturation <90% and SPE (versus overall UPE).The overall 30-day mortality was significantly lower in patients with truly asymptomatic UPE events (3%) compared with those with UPE-S (20%) and SPE (21%) (p<0.0001). Thirty- and 90-day VTE recurrence and major bleeding rates were similar in all the groups.In conclusion, variables associated with the severity of cancer and pulmonary embolism were associated with short-term mortality. Our findings may help to develop pulmonary embolism risk-assessment models in this setting
Autores: Caballeros, Fanny Meylin; Gonzalez, O. F.; et al.
ISSN 0284-1851  Vol. 58  Nº 7  2017  págs. 809 - 815
Background: Diffuse myocardial fibrosis can be quantified by calculating extra-cellular volume (ECV) from native and post-contrast T1 values using dedicated single bolus contrast medium injection protocols. Purpose: To evaluate differences in T1 maps and myocardial ECV measurements in routine stress/rest perfusion cardiovascular magnetic resonance (CMR) examinations after injection of single and double dose of contrast medium. Material and Methods: Thirty-seven consecutive patients (30 men; mean age, 62 +/- 13 years) underwent clinically indicated adenosine stress/rest perfusion CMR examination to rule out myocardial ischemia following a conventional split-dose contrast medium injection strategy. Native and post-contrast T1 mapping was performed 15 min after the first (0.1 mmol/kg) and second (0.1 mmol/kg) dose of contrast medium using a breath-held Modified Look-Locker Inversion recovery (MOLLI) sequence. Student's t-test for paired samples, Bland-Altman plots, and concordance-correlation coefficients (CCC) for agreement between T1 and ECV calculations after single and double dose of contrast medium were calculated. Intra- and inter-observer agreement for measurements was also analyzed. Results: Myocardial T1 values after single and double dose of contrast medium significantly differed (mean difference of 114.1 +/- 19.9 ms, P< 0.01). A single dose of contrast agent provided slightly higher ECV values (mean difference of 2.3 +/- 1.1%). CCC for ECV calculations was 0.66. Intra- and inter-observer agreement for all measurements was excellent (CCC >= 0.83). Conclusion: Quantification of myocardial ECV on conventional stress/rest perfusion CMR examination is feasible. T1 maps obtained 15 min after 0.1 mmol/kg of contrast medium provide slightly higher myocardial T1 measurements and ECV values compared with T1 maps obtained after a total dose of 0.2 mmol/kg.
Autores: González, A; Pueyo, Jesús Ciro; et al.
ISSN 1388-9842  Vol. 19  Nº Supl. 1  2017  págs. 123
Autores: González, Jéssica; Henschke, C. ; Yankelevitz, D. ; et al.
ISSN 1073-449X  Vol. 195  2017  págs. A7682
Autores: Wilson, D. O.; de Torres, Juan Pablo; et al.
ISSN 1073-449X  Vol. 191  Nº 8  2015  págs. 924 - 931
Rationale: Lung cancer (LC) screening using low-dose chest computed tomography is now recommended in several guidelines using the National Lung Screening Trial (NLST) entry criteria (age, 55-74; ¿30 pack-years; tobacco cessation within the previous 15 yr for former smokers). Concerns exist about their lack of sensitivity. Objectives: To evaluate the performance of NLST criteria in two different LC screening studies from Europe and the United States, and to explore the effect of using emphysema as a complementary criterion. Methods: Participants from the Pamplona International Early Lung Action Detection Program (P-IELCAP; n = 3,061) and the Pittsburgh Lung Screening Study (PLuSS; n = 3,638) were considered. LC cumulative frequencies, incidence densities, and annual detection rates were calculated in three hypothetical cohorts, including subjects whometNLST criteria alone, those withcomputed tomography-detected emphysema, and those who met NLST criteria and/or had emphysema. Measurements and Main Results: Thirty-six percent and 59% of P-IELCAP and PLuSS participants, respectively, met NLST criteria. Among these, higher LC incidence densities and detection rates were observed. However, applying NLST criteria to our original cohorts would miss asmany as 39% of all LC. Annual screening of subjects meeting either NLST criteria or having emphysema detected most cancers (88% and 95% of incident LC of P-IELCAP and PLuSS, respectively) despite reducing the number of screened participants by as much as 52%. Conclusions: LC screening based solely on NLST criteria could miss a significant number of LC cases. Combining NLST criteria and emphysema to select screening candidates results in higher LC detection rates and a lower number of cancers missed.
Autores: de Torres, Juan Pablo; et al.
ISSN 0300-2896  Vol. 51  Nº 4  2015  págs. 169 - 176
The experience in Spain's longest lung cancer screening program is comparable to what has been described in the rest of Europe, and confirms the feasibility and efficacy of lung cancer screening using LDCT.
Autores: de Torres, Juan Pablo; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 8  Nº 4  2013  págs. e60260
Current or former smokers expressing a well-defined disease characteristic such as emphysema, has a specific plasma cytokine profile. This includes a decrease of cytokines mainly implicated in activation of apoptosis or decrease of immunosurveillance. This information should be taken into account when evaluated patients with tobacco respiratory diseases
Autores: Herrero, José Ignacio; Bastarrika, Gorka; D'Avola, Delia; et al.
ISSN 1425-9524  Vol. 18  2013  págs. 587 - 592
Background: The prognosis of non-cutaneous malignancies after liver transplantation is dismal, mainly because most cases are diagnosed at advanced stages. In the last decade, studies have shown the potential role of screening for lung cancer with low-radiation dose computed tomography. Material/Methods: Fifty-nine liver transplant recipients with a cumulative dose of smoking greater than 10 pack-years were enrolled in a lung cancer screening program using yearly low-radiation dose computed tomography. Results: Lung cancer was diagnosed in 7 patients (11.8%), 5 of which were in stage Ia at diagnosis. Patients with lung cancer were significantly older (median age 66 vs. 58 years), had a higher cumulative history of smoking, and had emphysema more frequently than patients without cancer. Conclusions: Screening for lung cancer with low-radiation dose computed tomography in liver transplant recipients results in the diagnosis of lung cancer in early stages.
Autores: Arraiza, María; Arias, Javier; et al.
ISSN 0033-8419  Vol. 54  Nº 5  2012  págs. 432-441
Autores: Bastarrika, Gorka; Arraiza, María; et al.
Revista: European Radiology
ISSN 0938-7994  Vol. 21  Nº 9  2011  págs. 1887 - 1894
Autores: Mastrobuoni, S.; Dell'aquila, A.M.; Arraiza, María; et al.
ISSN 1873-734X  Vol. 40  Nº 1  2011  págs. 62 - 66
Autores: García, Loreto; Pueyo, Jesús Ciro;
Revista: Radiologia
ISSN 0033-8338  Vol. 53  Nº 2  2011  págs. 102 - 107