Qué es la vertiente investigadora?


Una unidad asistencial sin vocación investigadora no puede llegar a la excelencia clínica deseada. Por este motivo, la investigación clínica es también nuestra prioridad. El uso de una misma base de datos y la creación de bancos de imágenes y muestras biológicas facilitará la realización de estudios pioneros en el campo cardiovascular y, a la vez, permitirá cuantificar el impacto de esta iniciativa en la salud cardiovascular de la población del entorno.

Los proyectos de investigación que se realizan en la UDETMA están orientados principalmente a:

  1. La mejora de la prevención primaria de las enfermedades cardiovasculares.
  2. La mejora en la detección y tratamiento de las calcificaciones vasculares en enfermos con enfermedad renal. 

Publicaciones


Association of the rs495392 Klotho polymorphism with atheromatosis progression in patients with chronic kidney disease

The presence of the allele T of the SNP rs495392 of the Klotho gene is associated with a decrease in the odds of progression of atheromatosis in CKD patients.

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Preclinical carotid atherosclerosis in patients with latent autoimmune diabetes in adults (LADA), type 2 diabetes and classical type 1 diabetes

LADA is probably the most prevalent form of autoimmune diabetes. Nevertheless, there are few data about cardiovascular disease in this group of patients. The aim of this study was to investigate the frequency of carotid atherosclerotic plaques in patients with LADA as compared with patients with classic type 1 diabetes and type 2 diabetes.

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Low Serum Levels of Vitamin D are Associated with Progression of Subclinical Atherosclerotic Vascular Disease in Peritoneal Dialysis Patients: A Prospective, Multicenter Study

The prevalence of subclinical atherosclerosis and the main predictors of progression of this condition in patients undergoing peritoneal dialysis (PD) have been insufficiently investigated.

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Skin Autofluorescence and Subclinical Atherosclerosis in Mild to Moderate Chronic Kidney Disease: A Case-Control Study

Advanced glycation end-products (AGEs) are increased and predict mortality in patients with chronic kidney disease (CKD) who are undergoing hemodialysis, irrespective of the presence of type 2 diabetes.

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High Levels of Hemoglobin Promote Carotid Adventitial Vasa Vasorum Neoangiogenesis in Chronic Kidney Disease

The association of hemoglobin with higher Adventitial Vasa Vasorum could suggest the role of high hemoglobin in the higher incidence of adverse cardiovascular outcomes in Chronic Kidney Disease patients.

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A New Gender-Specific Formula to Estimate 24-Hour Urine Protein from Protein to Creatinine Ratio.

The quantification of proteinuria with the protein to creatinine ratio (PCR) is influenced by the excretion of creatinine, which, in turn, varies according to muscle mass and hence, to gender.

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Randomised intervention study to assess the prevalence of subclinical vascular disease and hidden kidney disease and its impact on morbidity and mortality: The ILERVAS project

The objectives of the ILERVAS project are: (1) to determine the prevalence of subclinical arterial disease and hidden kidney disease; (2) to assess the impact of early diagnosis of both diseases on cardiovascular morbidity and mortality and also on the progression of CKD; (3) to have a platform of data and biological samples.

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Factors influencing pathological ankle-brachial index values along the chronic kidney disease spectrum: the NEFRONA study

The aim of this study is to evaluate the prevalence and associated factors of pathological ABI values in CKD patients.

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Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain

Diabetic patients receiving dialysis therapy are at high risk of foot complications and should receive appropriate and intensive foot care.

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Randomised intervention study to assess the prevalence of subclinical vascular disease and hidden kidney disease and its impact on morbidity and mortality: The ILERVAS project

The ILERVAS project will reveal the prevalence of subclinical vascular disease and hidden kidney disease, determine whether or not their early diagnosis brings health benefits and will also allow investigation of new risk factors.

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Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD

Ultrasonographic detection of subclinical atheromatosis is a noninvasive method predicting cardiovascular events. Risk factors predicting atheromatosis progression in CKD are unknown. Predictors of atheromatosis progression were evaluated in patients with CKD.

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Soluble TWEAK and Major Adverse Cardiovascular Events in Patients with CKD

Soluble TNF–like weak inducer of apoptosis (sTWEAK) is a proinflammatory cytokine belonging to the TNF superfamily. sTWEAK concentrations have been associated with the presence of CKD and cardiovascular disease (CVD).

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Impaired Vitamin D Signaling in Endothelial Cell Leads to an Enhanced Leukocyte-Endothelium Interplay: Implications for Atherosclerosis Development

Endothelial cell activation leading to leukocyte recruitment and adhesion plays an essential role in the initiation and progression of atherosclerosis.

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Fracaso renal agudo secundario a crisis de hipercalcemia muy severa por hiperparatiroidismo primario

La crisis hipercalcémica es una forma de presentación poco frecuente del hiperparatiroidismo primario. Solo existen pequeñas series de casos reportadas en la literatura. Se caracteriza por hipercalcemia severa, insuficiencia renal y alteración del estado de conciencia. 

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Differential Effects of Dabigatran and Warfarin on Bone Volume and Structure in Rats with Normal Renal Function

Warfarin, a widely used anticoagulant, is a vitamin K antagonist impairing the activity of vitamin K-dependent Bone Gla Protein (BGP or Osteocalcin) and Matrix Gla Protein (MGP). 

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Nuevo artículo sobre ecografia de carótidas en pacientes con diabetes mellitus 2

The current nurse-led study shows that subjects with type 2 diabetes mellitus have a high prevalence of subclinical atherosclerosis that is associated with cardiovascular risk factors.

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Type 2 diabetes-associated carotid plaque burden is increased in patients with retinopathy compared to those without retinopathy

Cardiovascular disease (CVD) is the leading cause of mortality among subjects with type 2 diabetes (T2D), and diabetic retinopathy (DR) has been associated with an increased risk for CVD.

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Left carotid adventitial vasa vasorum signal correlates directly with age and with left carotid intima-media thickness in individuals without atheromatous risk factors

The early identification of the onset of subclinical atheromatosis is essential in reducing the high mortality risk from cardiovascular disease (CVD) worldwide.

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The active form of vitamin D, calcitriol, induces a complex dual up-regulation of endothelin and nitric oxide in cultured endothelial cells

Despite the presence of vitamin D receptor (VDR) in endothelial cells, the effect of vitamin D on endothelial function is unknown.

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High phosphate diet increases arterial blood pressure via a parathyroid hormone mediated increase of renin.

There is growing evidence suggesting that phosphate intake is associated with blood pressure levels. However, data from epidemiological studies show inconsistent results.

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Lack of vitamin D receptor causes stress-induced premature senescence in vascular smooth muscle cells through enhanced local angiotensin-II signals

The inhibition of the renal renin-angiotensin system by the active form of vitamin D contributes to the cardiovascular health benefits of a normal vitamin D status

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Sprouty1 induces a senescence-associated secretory phenotype by regulating NFκB activity: implications for tumorigenesis

Genes of the Sprouty family (Spry1-4) are feedback inhibitors of receptor tyrosine kinase (RTK) signaling. As such, they restrain proliferation of many cell types and have been proposed as tumorsuppressor genes.

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A low fractional excretion of Phosphate/Fgf23 ratio is associated with severe abdominal Aortic calcification in stage 3 and 4 kidney disease patients

Vascular calcification (VC) contributes to high mortality rates in chronic kidney disease (CKD). High serum phosphate and FGF23 levels and impaired phosphaturic response to FGF23 may affect VC. 

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Vitamin D receptor activation, left ventricular hypertrophy and myocardial fibrosis

Left ventricular hypertrophy (LVH), a common complication in chronic kidney disease (CKD), is associated with high cardiovascular mortality.

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Soluble TWEAK is associated with atherosclerotic burden in patients with chronic kidney disease

Chronic kidney disease (CKD) is characterized by a high mortality rate, primarily due to cardiovascular disease. 

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Calcium signaling in renal tubular cells

The kidney handles calcium by filtration and reabsorption. About 60% of the plasma calcium is filterable, and 99% is reabsorbed in the tubule. In the proximal tubule, the reabsorption is passive and paracellular, but in the distal tubule is active and transcellular. 

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Assessment of the potential role of active vitamin D treatment in telomere length: a case-control study in hemodialysis patients

Telomeres are special chromatin sequences located at the end of eukaryotic chromosomes, protecting these regions from recombination and degradation.

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Beyond proteinuria: VDR activation reduces renal inflammation in experimental diabetic nephropathy

Local inflammation is thought to contribute to the progression of diabetic nephropathy. The vitamin D receptor (VDR) activator paricalcitol has an antiproteinuric effect in human diabetic nephropathy at high doses.

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Observational multicenter study to evaluate the prevalence and prognosis of subclinical atheromatosis in a Spanish chronic kidney disease cohort: baseline data from the NEFRONA study

Cardiovascular events (CVE) are more prevalent in chronic kidney disease (CKD) than in general population, being the main cause of morbimortality.

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Prevalence of subclinical atheromatosis and associated risk factors in chronic kidney disease: the NEFRONA study.

The causes of the high cardiovascular mortality observed in chronic kidney disease (CKD) are unknown. Here, we report data on prevalence of subclinical atherosclerosis in the NEFRONA population and...

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Large Artery Calcification on Dialysis Patients Is Located in the Intima and Related to Atherosclerosis

Background and objectives: Vascular calcification (VC) has a significant effect in cardiovascular diseases on dialysis patients.However, VC is assessed with x-ray-based techniques, which do not inform about calcium localization (intima, media, atherosclerosis-related). 

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Carotid Intima-Media Thickness Measurements: Techniques and Clinical Relevance

The measurement of carotid intima-media thickness (c-IMT) is an accepted surrogate marker of atherosclerosis. 

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Noninvasive Imaging of the Vulnerable Atherosclerotic Plaque

Atherosclerosis is a progressive inflammatory disease of the arterial wall and the main cause of cardiovascular disease. Despite advances in both primary and secondary prevention...

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Early Detection of Atherosclerosis: a Randomized Clinica Trial to assess a novel strategy in the Primary Prevention of Cardiovascular Diseases. Rationale and Design.

Primary prevention in cardiovascular diseases is based on risk scoring. However, the use of validated...

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New Advances in Noninvasive Imaging of the Carotid Artery: CIMT, Contrast-Enhanced Ultrasound, and Vasa Vasorum

Carotid ultrasound measurement of carotid intima-media thickness (C-IMT) and detection of plaques is an useful method to better assess...

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Carotid atherosclerotic lesion echogenicity and severity on standard ultrasound is correlated with intraplaque neovascularization detected by contrast-enhanced ultrasound imaging

Current risk stratification of carotid atherosclerotic lesions is based on the...

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Contrast-enhanced ultrasound for imaging vasa vasorum: comparison with histopathology in a swine model of atherosclerosis

To evaluate the agreement between contrast-enhanced ultrasound imaging and histopathology in an animal model of atherosclerosis.

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Contrast-Enhanced Ultrasound Imaging of the Vasa Vasorum From Early Atherosclerosis to the Identification of Unstable Plaques

Proliferation of the adventitial vasa vasorum (VV) is inherently linked with early atherosclerotic plaque development and vulnerability.

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Vascular and metabolic effects of 12 days intensive walking to Santiago de Compostela

Physical exercise has multiple beneficial health effects. Yearly, over five million persons walk a pilgrimage in various parts of the World, and this number is increasing.

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Cardiovascular risk factors underestimate atherosclerotic burden in chronic kidney disease: usefulness of non-invasive tests in cardiovascular assessment

Cardiovascular risk scoring (Score) does not specifically address chronic kidney disease (CKD) patients.

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N-methyl-D-aspartate receptors are expressed in rat parathyroid gland and regulate PTH secretion

The presence of the receptor has been detected in the principal organs responsible for calcium homeostasis (kidney and bone), pointing to a possible role in mineral metabolism.

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Predicting cardiovascular disease morbidity and mortality in chronic kidney disease in Spain. The rationale and design of NEFRONA: a prospective, multicenter, observational cohort study.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients...

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Vasa Vasorum and Plaque Neovascularization on Contrast-Enhanced Carotid Ultrasound Imaging Correlates With Cardiovascular Disease and Past Cardiovascular Events

Histological data associate proliferation of adventitial vasa vasorum and intraplaque neovascularization with...

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Contrast enhanced ultrasound imaging

The origins of contrast enhanced ultrasound imag-ing (CEUS) date to the earliest observations of Claude Joyner and publications of Gramiak and Shah in 1968.1 Interest in the development of ultrasound contrast agents and clinical applications continues today, nearly 40 years later the first reports.

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Predictive value of ankle brachial index in patients with acute ischaemic stroke

The ankle brachial index (ABI) is a known measure of lower-limb peripheral artery disease (PAD), as well as a marker for other cardiovascular disease events.

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Vasa Vasorum and Plaque Neovascularization on Contrast-Enhanced Carotid Ultrasound Imaging Correlates With Cardiovascular Disease and Past Cardiovascular Events

Histological data associate proliferation of adventitial vasa vasorum and intraplaque neovascularization with vulnerable...

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A new role for vitamin d receptor activation in chronic kidney disease

Vitamin D has proven to be much more than a simple ‘calcium hormone’. The fact that the vitamin D receptor has been found in cells not related to mineral metabolism supports that statement.

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Vitamin D and the vasculature: can we teach an old drug new tricks?

Background: Vitamin D is a steroid hormone known for its role in regulating levels of calcium and phosphorus. Vitamin D has important autocrinelparacrine roles and it is involved in vascular biology. 

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Arterial microvessels an early or late sign of atherosclerosis?

Hypoxia is a strong stimulus for the induction of angiogenesis. In an elegant series of experiments including in vivo labeling of hypoxic tissues, Sluimer et al have demonstrated that hypoxia in advanced atherosclerotic plaques colocalized with the expression of...

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RANKL Increases Vascular Smooth Muscle Cell Calcification Through a RANK-BMP4 Dependent Pathway

Vascular calcification commonly associated with several pathologies and it has been suggested to be similar to bone mineralization.

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Should doctors screen asymptomatic patients for subclinical disease?

Should doctors screen asymptomatic individuals for subclinical disease? That's the question posed and debated in the July 6, 2010 issue of the Journal of the American College of Cardiology, with one expert arguing that noninvasive screening tests...

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The association between fatal vascular events and risk factors for carotid atherosclerosis in patients on maintenance hemodialysis: Plaque number of dialytic atherosclerosis study

Atherosclerotic vascular diseases are a major cause of morbidity and mortality for end-stage renal disease patients.

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Efficacy of Rosuvastatin Among Men and Women With Moderate Chronic Kidney Disease and Elevated High-Sensitivity C-Reactive Protein

We evaluated the efficacy of statin therapy in primary prevention among individuals with moderate chronic kidney disease (CKD).

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Highlight dementia risk to reduce CVD

Convincing patients to substantially change their lifestyle and, thus, reduce their risk of cardiovascular disease is often challenging. Although they understand the cardiovascular benefits of life-style change, they just can’t bring themselves to give up some of the creature comforts they have become...

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Inflammation within Carotid Atherosclerotic Plaque: Assessment with Late-Phase Contrast-enhanced US

By quantifying microbubble retention within the carotid plaque, LP contrast-enhanced US depicts clear differences between groups of subjects with plaque ipsilateral to symptoms and asymptomatic plaques. 

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Europe's politicians put women on 'red alert' for their risks of cardiovascular disease

Although cardiovascular disease (CVD) is the leading cause of death for women in Europe, and more women die from CVD than from all cancers combined, women - and many of their physicians - remain largely unaware of their risk of developing CVD.

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Carotid Intima-Media Thickness and Presence or Absence of Plaque Improves Prediction of Coronary Heart Disease Risk

We evaluated whether carotid intima-media thickness (CIMT) and the presence or absence of plaque improved coronary heart disease (CHD) risk prediction when added to traditional risk factors (TRF).

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Contrast-enhanced ultrasound for imaging vasa vasorum: comparison with histopathology in a swine model of atherosclerosis

To evaluate the agreement between contrast-enhanced ultrasound imaging and histopathology in an animal model of atherosclerosis

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Parathyroid hormone level is associated with mortality and cardiovascular events in patients undergoing coronary angiography

Elevated parathyroid hormone (PTH) levels have been associated with increased cardiovascular risk in the general population.

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Use of Carotid Ultrasound to Identify Subclinical Vascular Disease and Evaluate Cardiovascular Disease Risk

A Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force Endorsed by the Society for Vascular Medicine

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Imaging of atherosclerosis: carotid intima–media thickness

Carotid ultrasound provides quantitative measurements of carotid intima–media thickness (CIMT) that can be used to assess cardiovascular disease (CVD) risk in individuals and monitor ongoing disease progression and regression in clinical trials.

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La ecografía carotídea es útil para predecir enfermedad coronaria y mortalidad en pacientes en hemodiálisis

Cardiovascular disease and other complications of atherosclerosis are the most common cause of death in patients with chronic renal failure in maintenance hemodialysis (MHD). Carotid ultrasonography is a simple non-invasive tool to investigate the vascular system, by means of intima media thickness (IMT) measurement and carotid wall calcifications.

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Is carotid intima media thickness useful for individual prediction of cardiovascular risk? Ten-year results from the Carotid Atherosclerosis Progression Study (CAPS)

Carotid intima media thickness (cIMT) is an intermediate phenotype of early atherosclerosis that independently predicts vascular events.

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