Josep Comín Colet

Classification and Quality Standards of Heart Failure Units: Scientific Consensus of the Spanish Society of Cardiology

The prevalence of heart failure remains high and represents the highest disease burden in Spain. Heart failure units have been developed to systematize the diagnosis, treatment, and clinical follow-up of heart failure patients, provide a structure to coordinate the actions of various entities and personnel involved in patient care, and improve prognosis and quality of life. There is ample evidence on the benefits of heart failure units or programs, which have become widespread in Spain. One of the challenges to the analysis of heart failure units is standardization of their classification, by determining which programs can be identified as heart failure units and by characterizing their complexity level. The aim of this article was to present the standards developed by the Spanish Society of Cardiology to classify and establish the requirements for heart failure units within the SEC-Excellence project.

Insuficiencia cardiaca y trasplante

The mission of the Heart Failure and Heart Transplantation Section of the Spanish Society of Cardiology is to study, promote interest in, and disseminate information about all aspects of myocardial dysfunction and heart transplantation. Heart failure is a highly prevalent disorder that consumes a substantial proportion of healthcare resources. Consequently, there is a very high level of interest in the condition and a wide range of preclinical and clinical research is being carried out, including research into new ways of looking at the disease that will increase our understanding. The aim of this article was to describe current developments concerning this disease and its treatment. Firstly, the latest publications on heart failure are summarized. Then, the most recent studies on advanced heart failure and ventricular assist devices are reviewed. Finally, the latest findings on heart transplantation are reported.

Temas de actualidad en insuficiencia cardiaca

En el presente articulo se presentan los avances mas destacados en el campo de la insuficiencia cardiaca en el ultimo ano. Se exponen las principales novedades en el manejo de la insuficiencia cardiaca cronica tanto en los aspectos mas relevantes de los nuevos modelos de gestion del paciente con insuficiencia cardiaca cronica como en los avances farmacologicos y en el uso y la indicacion de dispositivos en estos pacientes. Tambien se revisan los nuevos adelantos en el abordaje de la insuficiencia cardiaca en su fase mas avanzada, con especial enfasis en la fase aguda. Los nuevos enfoques del manejo quirurgico de la insuficiencia cardiaca, incluyendo en este apartado las nuevas aportaciones en el campo de las asistencias circulatorias, merecen un papel destacado en esta actualizacion.

Prevalence and Clinical Course of Patients in Spain With Acute Myocardial Infarction and Severely Depressed Ejection Fraction Who Meet the Criteria for Automatic Defibrillator Implantation

The Multicenter Automatic Defibrillator Implantation Trial (MADIT)-II has broadened the indications for cardioverter defibrillator implantation. We present a retrospective study designed to estimate the number of patients in Spain eligible for an implantable defibrillator according to the MADIT-II criteria. From January 1999 to October 2002, 758 consecutive patients were admitted to our center with the diagnosis of acute myocardial infarction. Sixty-seven had a left ventricular ejection fraction ≤30% (mean, 23[5]) and were not eligible for revascularization. Excluding patients older than 80 years and patients with marked co-morbidity, 47 patients met the MADIT-II criteria for an implantable defibrillator. After a mean follow-up of 18 months, there were 20 deaths, 6 of which were considered sudden. In conclusion, application of the MADIT-II criteria for defibrillator implantation may benefit 6% of the patients with myocardial infarction in Spain. This proportion translates as 4110 defibrillator implantations.