Area Representative: María Luaces Méndez
Cardiovascular diseases are the leading cause of death in developed countries, including Spain. For this reason, an important part of health policies and available care resources work to prevent these diseases, and to address their significant social-health burden. Biomedical research has also particularly focused in cardiovascular diseases. Indeed, cardiology is the medical specialty generating a greater number of randomized clinical trials. This dynamic has enabled constant generation of new scientific findings, and the transfer of new insights onto clinical practice, in order to improve patient care.
RESEARCH GROUPS
Technology Assessment and Therapeutic Strategies in Coronary Arteriosclerosis
Principal investigator:
Escaned Barbosa, Javier
Address:
Servicio de Cardiología.
Hospital Clínico San Carlos
Telephone: 91 330 32 89
> GROUP DETAILS:
Percutaneous coronary intervention (PCI) has radically changed the handling of acute coronary syndromes and stable angina associated with coronary atherosclerosis. Such change has occurred in just a few decades as a result of incessant progress in PCI technologies, and their continuous evaluation in cardiovascular patients. Thus, in the coming years, technologies such as new and biodegradable drug-eluting stents, as well as farmacoactive balloons currently being introduced in clinical practice, will need to be thoroughly assessed in order to determine their safety, effectiveness and applicability in different subgroups of patients. On top of this, the assessment of the application of such technologies to specific strategies (complete versus the culprit artery revascularization) will be necessary. The Interventional Cardiology Unit of HUSC has played a key role in the evaluation of these technologies, being internationally renowned not only as a participant in major clinical trials within the field of coronary revascularization, but also as a promoter of its own research lines.
> STRATEGIC GOALS:
- Placing HUSC as the center of national reference in the performance of valuation studies of different technologies and therapeutic strategies in patients with coronary arteriosclerosis.
- Initiating lines of translational research in ischemic heart disease patients for the evaluation of the results obtained upon usage of new revascularization or percutaneous diagnostic technologies, previously tested in animal models.
- Performing an investigation of excellence that will result in the publication, in scientific journals that rank on the third tertile impact factor, in the field of cardiovascular diseases.
> RESEARCH LINES LINKED TO STRATEGIC GOALS:
- Survey of the influence of local (e.g., atheromatous plaque composition) and systemic factors (e.g., diabetes, cardiovascular risk factors, coronary syndrome, etc.) on the vascular response and on the long-term outcome of coronary revascularization.
- Valuation of the immediate and long-term vascular response to interventions, taking into account the vascular damage degree associated to the revascularization technique (evaluated by intracoronary imaging tools).
- Assessment of the coronary microcirculation integrity upon usage of revascularization technologies (distal protection, preserved endothelial function, etc.).
- Evaluation of the applicability of coronary revascularization techniques in specific subgroups of patients and coronary lesions. A few examples of such subgroups: patients with diabetes or renal failure, acute coronary syndrome, thrombus stenosis, chronic occlusions, saphenous vein grafts, diffuse coronary involvement, restenotic lesions, calcified stenosis.
- Comparison of mechanical behavior between in vitro and in vivo intracoronary prosthesis (elastic recoil after stent implantation, etc.).
- Evaluation of biodegradable endo-coronary prosthesis.
- Assessment of intracoronary drug dispensing systems (antiproliferative or antithrombotic drug-eluting balloons, proteolytic agents in chronic occlusions, etc.).
- Evaluation of the required type of revascularization, supported by intracoronary diagnostic tools (pressure guide, ultrasound or intravascular optical coherence tomography): selection of candidates for a specific revascularization technique, result optimization of the technique, etc.
> OTHER GROUP MEMBERS
Espejo Paeres, Carolina
Gonzalo Lopez, María Nieves
Macaya Miguel, Carlos
Macaya Ten, Fernando
Mejía Rentería, Hernán David
Rodríguez García- Abad, Vera
Salinas Sanguino, Pablo
Cardiovascular Imaging
Principal investigator:
Pérez de Isla, Leopoldo
Address:
Cardiología. Hospital Clínico San Carlos.
C/ Profesor Martín Lagos s/n. 28040 Madrid
Telephone: 91 330 32 90
> GROUP DETAILS:
This research group is one of the most dynamic and productive within the cardiovascular imaging field in our country. Due to a strong welfare activity encompassing different fields of cardiovascular imaging, such as echocardiography and cardiac magnetic resonance, the group displays a pronounced teaching and research projection. Proof of this are the numerous publications in national and international scientific journals and books, work presentations in the most important national and international conferences, and the participation of the group members as moderators, speakers and organizers. The research work conducted by the group stands out for the development of the clinical application of novel imaging tools to improve the diagnosis, management and treatment of both cardiac and extra-cardiac patients, upon exploration of the technique’s advantages and limitations. The group outstands for the collaboration with other research groups related with cardiology and other fields within IdISSC.
> STRATEGIC GOALS:
- Development and validation of new imaging diagnostic tools.
- Automated study of cardiac output in non-invasive methods.
- Use of imaging for the study of myocardial deformation.
- Use of imaging in new procedures of invasive cardiology.
> RESEARCH LINES LINKED TO STRATEGIC GOALS:
- Three-dimensional echocardiography in valvular studies.
- Cardiac Resonance.
- Cardiac TAC.
- Early detection of cardiac abnormalities using imaging tools.
> OTHER GROUP MEMBERS
de Agustín Loeches, José Alberto
Gómez de Diego, José Juan
Luaces Méndez, María
Mahia Casado, Patricia
Marcos Alberca-Moreno, Pedro
Pozo Osinalde, Eduardo
Translational Research in Acute Myocardial Syndromes (INTEGRA)
Principal investigator:
Fernández Ortiz, Antonio Ignacio
Address:
Unidad Coronaria.
Hospital Clínico San Carlos.
C/Prof. Martin lagos s/n.
28040, Madrid
Telephone: 91 330 32 20
> GROUP DETAILS:
The group is formed by cardiologists (Antonio Fernández-Ortiz, IvánNúñez-Gil, David Vivas, Ana Viana, Javier Nogueiraand Javier Higueras) and biologists (Esther Bernardo). Health care work is integrated into the Coronary Care Unit, the hospital facility and the hemodynamic rooms. The group has common research facilities at the Cardiovascular Institute. Over the last years, the group has focused on the study of platelet/leucocyte reactivity inpatients with ischemic heart disease. Clinical aspects of transient apical dyskinesia have also been studied, and a research line on the ischemia-reperfusion myocardial injury has been opened in close collaboration with CNIC. Relevant publications in the last 5 years include 3 articles in JACC, 2 in Diabetes, 2 in Heart, 3 in the AJC, and 5 in REC. The group is involved in numerous multicenter clinical trials and has competitive funding from official calls (HORIZON 2020, ISCIII, FICI, CNIC, SEC,MM).
> STRATEGIC GOALS:
- Advancing in the study of platelet/leukocyte reactivity and the response to inhibitory drugs in patients with ischemic heart disease.
- Strengthening the research on pathophysiology and prevention of myocardial ischemia/reperfusion.
- Strengthening the research on pathophysiology of transient apical dyskinesia.
- Promotingnew translational research projects in collaboration with CNIC.
- Promoting the development of joint projects with other hospital groups working on similar research lines.
> RESEARCH LINES LINKED TO STRATEGIC GOALS:
- Platelet/leukocyte reactivity in patients with ischemic heart disease.
- Pathophysiological bases in transient apical dyskinesia syndromes.
- Pathophysiological bases of myocardial damage in acute coronary syndromes
> OTHER GROUP MEMBERS
Álvarez Morales, María Verónica
Bernardo García, Esther
Higueras Nafria, Javier
Maldonado Castillo, María Concepción
Mera González, Silvia
Nogueira Sánchez, Francisco Javier
Núñez Gil, Iván Javier
Viana Tejedor, Ana
Vivas Balcones, David
Myocardial Regeneration Therapy
Principal investigator:
Pilar Jiménez Quevedo
Address:
Unidad de hemodinámica. Servicio de Cardiología. Hospital Clínico San Carlos. C/Prof. Martin lagos s/n. 28040, Madrid
Telephone: 91 330 32 83
> GROUP DETAILS:
The cardiovascular cell therapy group of the Hospital San Carlos consists of clinical and interventional cardiologists, cardiac surgeons, hematologists, cell biologists and heart image experts (5 professional in total). The team aims to accomplish translational research in cell therapy in order to demonstrate the safety, feasibility and efficacy of this new therapeutic alternative in patients with advanced cardiovascular disease without anyother therapeutic options. The ultimate goal is to improve the symptoms and the prognosis in patients presenting high morbidity and mortality. The group members are experts on the procurement, isolation and administration of stem cells into the heart, and have broad experience in the development of randomized clinical trials.
The team is currently working on a phase I-II clinical trial, evaluating the safety and feasibility of the transendocardial injection of autologous circulating endothelial progenitor CD 133+ cells. Once an electromechanical mapping (NOGA XP platform) of the left ventricular is performed, the injected cells are aimed to induce angiogenesis in refractory angina patients lacking other revascularization options. The trial also includes a molecular biology analysis on the functionality of the administered stem cells with the aim of evaluating the capacity of individual regeneration, and correlating these results with the therapeutic response.
Additional research lines include the study of cardiovascular cell therapy in the subgroup of diabetic patients, the study of endothelial stem cell kinetics after percutaneous coronary intervention and its implications in the repair process of the arterial wall upon stent implantation. These research lines have already been published and are being part of two doctoral theses.
> STRATEGIC GOALS:
- The main goal is the study of the safety, feasibility and effectiveness of cell therapy in cardiovascular diseases, particularly in advanced chronic ischemic heart disease and in diabetic patients, and the study of the vessel wall repair processcoronary stent implantation.
- Other objectives include the optimization of stem cell isolation, the refinement of the percutaneous cell administration techniques, the development of new cell therapy protocols, and the completion of a current doctoral thesis.
- The final goal is the strengthening of the group, and the expansion of their research to other specific cardiovascular diseases, and other fields of regenerative medicine.
> RESEARCH LINES LINKED TO STRATEGIC GOALS:
- Using endothelial stem cells for the induction of angiogenesis in patients with chronic myocardial ischemia and refractory angina.
- The study of the in vitro functionality and regenerative capacity of autologous endothelial stem cells.
- The study of the implications of circulating endothelial stem cells in the repairing process of the coronary artery wall, after stent implantation.
- The differential characterization of cardiovascular cell therapy in the diabetic population.
- The study of Ischemic heart disease in diabetic patients.
> OTHER GROUP MEMBERS
Del Trigo Espinosa, María
Nombela Franco, Luis
Ortega Pozzi, Arancha
Arrhythmia
Principal investigator:
Julián Pérez-Villacastín
Address:
Unidad de Arritmias. Hospital Clínico San Carlos. C/ Profesor Martín Lagos s/n, 28040 Madrid
Telephones: 91 330 30 00 Ext 7045 / 7510/ 7266
> GROUP DETAILS:
The Arrhythmia Unit of the HospitalClínico San Carlos, established in December 2000, belongs to the Cardiovascular Institute of the hospital. The cardiologists within the group are accredited in Interventional Cardiac Electrophysiology by the Spanish and European Society, and they are members of the Spanish and European Society of Cardiology.
Among them, three are members of the Selection Committee of Communications for the SEC (Spanish Society of Cardiology) and ESC (European Society of Cardiology) conferences, and referees for the following journals: RevEspCardiol, MedicinaClínica, Europace, J CardiovascElectrophysiol, HeartRhythm, EurHeart J and JACC.
In addition, Dr. Pérez-Villacastín is referee for the “Guías de ablación AF” guidelines from the HeartRhythm journal.
The scientific activity of the group has been reflected in more than 100 publications in national and international journals and books (as first authors in published articlesin journals such as Circulation, Journal of the American College of Cardiology, Journal of Cardiovascular Electrophysiology); more than 200 publications in the form of abstracts at national, European and American conferences, and more than 200 national and international cardiology conferences, mainly focused on the treatment of cardiac arrhythmias.
On the other hand, the group has participated in more than 25 multicenter studies, and in more than 30 privately funded projects.
Today, five competitively funded projects are being developed, among which two are from the Health Research Fund of the InstitutoCarlos III and three additional privately funded projects are also elaborated by the team itself. The group is also involved in seven competitive multicenter clinical trials, being Dr. Perez-Villacastín the national coordinator in two of them. In addition, the group contributes to the record of arrhythmia ablations at a national and international level, to the research in implantable devices and to the EURObservational Research Program from the European Cardiology Society.
> STRATEGIC GOALS:
- The accomplishment and the publication, in international journals,of at least two randomized studies providing scientifically relevant developments in arrythmology.
- Trainingof at least three cardiologists in arrythmology.
- Completion of five doctoral thesis and the publication of results.
> RESEARCH LINES LINKED TO STRATEGIC GOALS:
- Atrial fibrillation.
- Ablation of arrhythmias.
- Ablation of atrial fibrillation.
- Ablation of difficult accessory pathways.
- Ablation of atrial flutter.
- Supraventricular arrhythmias.
- Treatment and prevention of heart failure by “smart clothes” and telemonitoring.
- Implantable defibrillators.
- Electrical conductivityof muscle stem cell implants.
- Advice on the design of special pacemakers.
- Dynamic of the ventricular fibrillation propagation.
- Dynamic of the atrial fibrillation.
- Sudden cardiac death.
- Cardiac repolarization.
- Interventional cardiology.
- Ablation with the Sterotaxis remote navigation system.
- Syncope study.
- Heart failure.
- Pacemakers.
- Ventricular arrhythmias.
- Electrophysiological properties of the atria and ventricles and their link to fibrillatory mechanisms in normal isolated, and perfused with blood, human heart.
- Echocardiographic characterization of electrical and mechanical activity in patients with paroxysmal and persistent atrial fibrillation, and its predictive value in pharmacological cardioversion.
- 3 dimensional ventricular modeling, based on fibrosis determination, using Nuclear Magnetic Resonance and functional incorporation as a guide for the virtual simulation of clinical tachycardia.
- Predictive R wave value in sinus rhythm and its equivalent during spontaneous ventricular fibrillation.
- In vitro analysis of the optical mapping for the study of the mechanistic and predictive value upon ion current blockage presenting atrial selectivity on the completion of paroxysmal atrial fibrillation.
- Translational research on cardiac arrhythmias due to channelopathies.
- Panoramic endocardial mapping as a new tool for the understanding and effective completion of the activation of complex patterns during atrial fibrillation.
> OTHER GROUP MEMBERS
Borrego Bernabé, Luis
Bover Freire, Ramón
Cañadas Godoy, María Victoria
Casas de la Cal, Marta Lourdes
Cerrón Rodriguez, Virginia Beatriz
Filgueiras Rama, David
García Torrent, Maria Jesús
Goirigolzarri Artaza, Josebe
González Ferrer, Juan José
Herreros Gil, María
Lamuedra del Olmo, Mónica
Martinez Rodríguez, Ana
Núñez Chavarry, Jennifer
Pérez Castellano, Nicasio
Salgado Aranda, Ricardo
Sánchez Sánchez, María
Group on Predictive Biomedicine and Translational Research of Respiratory, Cardiovascular and Metabolic Diseases
Principal investigator:
López Farré, Antonio
Address:
Facultad de Medicina,
Universidad Complutense de Madrid Pabellon 3
Madrid
Telephone: 91 394 15 91
> GROUP DETAILS:
The Group on Predictive Biomedicine and Translational Research of Respiratory, Cardiovascular and Metabolic Diseases is a multidisciplinary group of researchers from different health sciences areas and from different institutions, mainly from the Faculty of Medicine of the Complutense University of Madrid and the San Carlos Clinical Hospital.The Complutense University group has been positively evaluated by the National Research Agency (AEI).
Predictive biomedicine is the group’s main core research, understanding by means of genetic and peptide or protein biomarkers, how we metabolize the different nutrients of our diet, the risk of suffering a disease, what type of exercise is best, how cells age or the molecular and cellular mechanisms that explain how drugs work, etc.
The members of the research group have published more than 250 high impact scientific papers in the main related scientific journals. The group manager, Professor LópezFarré, was awarded the National Prize on Research as young researcher of the decade in 2001.
The group includes researchers from the Vascular Surgery Department (Dr. Javier Serrano Hernando, Dr. Guillermo MoñuxDucajú, Dr. Antonio Martín Conejero), the Otorhinolaryngology Department (Dr.JoaquínPochBroto, Dr.María Cruz Iglesias Moreno, Dr. Manuel Gómez Serrano), of the Military Emergency Unit, UME (Dr.Jesús Manuel Peraza Casajús), of the Faculty of Sports Science of the University of Castilla La Mancha (Dr. José Manuel GarcíaGarcía), of the Public Health Service of Talavera de la Reina Hospital of the University of Castilla La Mancha (Dr. Antonio Segura Fragoso), of the Faculty of Medicine of the Complutense University (Dr. José Javier Zamorano León, Dr. Vicente LaheraJuliá, Dr. Natalia de las Heras, Dr.MeritxellLópez Gallardo).
The Main Researcher of the group is also general coordinator of the GenObIA project, set under one of the research networks of the Community of Madrid of the Biomedicine Programme 2017, where researchers from this Group also participate. The objective of this research network is to develop predictive algorithms using artificial intelligence, based on the genetic polymorphisms of nutrigeneticsand physical exercise, as well as on the questionnaires of life habits, that predict the risk of overweight/obesity and their comorbidities.
> STRATEGIC GOALS:
- Study genes and genetic polymorphisms relatedto nutrition and physical exercise.
- Identify biomarkers related to disease prediction.
- Study mechanisms associated with cellular senescence.
- Identify biomarkers and molecular signalling pathways related to the pharmacological response in cells.
- Training and teaching viathe completion of doctoral theses and the publication of scientific and informative books.
> RESEARCH LINES LINKED TO STRATEGIC GOALS:
- Development of algorithms using artificial intelligence and big-data based on genetic and protein biomarkers that predict overweight/obesity and their comorbidities.
- Search for biomarkers and their interaction that predicts the progress of diseases.
- Study of molecular mechanisms associated with the development and progression of abdominal aortic aneurysm and the effect of new drugs in their treatment.
- Study of the senescence of cells mainly of the aorta and inner ear.
- Analysis of the mechanisms associated with the response of related platelets and cells to acetylsalicylic acid. .
> OTHER GROUP MEMBERS
Álvarez-Sala Walther, José Luis
Ballesteros Rodrigálvarez, Sandra
De las Heras Jiménez, Natalia
Galiana Rodríguez-Barbero, Adrián
Gómez Serrano, Manuel
Herrero Calvo, José Antonio
Iglesias Moreno, María Cruz
Klett Mingo, Mercedes
Lahera Juliá, Vicente
López Gallardo, Meritxell
Martín Conejero, Antonio
Moñux Ducajú, Guillermo
Poch Broto, Joaquín
Serrano Hernando, Francisco Javier
Zamorano León, José Javier
Cardiovascular Risk
Principal investigator:
Martell Claros, Nieves
Principal Co-investigator:
Maria Dulce Nombre Gomez Garre
Address:
Planta 4ª-sur. Hospital Clínico San Carlos. C/ Profesor Martín Lagos s/n, 28040 Madrid
Telephone: 91 330 33 95
> GROUP DETAILS:
The group has always focused on clinical and experimental research in the area of Cardiovascular Prevention, it started off using health care techniques for the evaluation, diagnosis and monitoring of major risk factors, such as hypertension, diabetes, dyslipidemia and obesity. A large number of researchers have been trained in our laboratory, and 30 doctoral theses have been concluded. Today, some of the doctorates occupy important positions in hospitals, universities and private companies.
The group is nationally and internationally known, and it is recognized at the Universidad Complutense. Many of the major clinical trials performed for the control of cardiovascular diseases with new drugs are led by several researchers who are often invited to national and international meetings. The Cardiovascular Prevention Area is part of the REDINSCOR heart failure thematic research network of ISCIII.
Our group has been pioneer in the identification of natriuretic peptides, as markers of cardiovascular and ophthalmological disease associated with diabetes. In the area of hypertension, an inverse relationship between the well-known ANP natriuretic substance, and the left ventricular mass itself has been shown to be a predictive value of the blood pressure readings in the upper multivariate analysis. The Society of Pediatrics uses our results on childhood and adolescence hypertension as a reference table for the Spanish population. In the cardiac transplantation area, several humoral rejection markers (endothelins and natriuretic peptides: ANP, BNP, CNP) have been identified by the group. The presence of endothelin receptor-1 and BNP in the atrium and ventricle of hearts from potential donors, and in heart failure due to ischemic heart disease have also been demonstrated. The group created a primary care communication program (UCAP) and works in programs of therapeutic compliance of risk factors. A hospitalization program established by the group has modified the paradigms of diseases that are considered severe.
> STRATEGIC GOALS:
- Maintaining a research line that demonstrates leadership.
- Maintaining the clinical trial platform.
- Developing a research line for its clinical application ("translational research")
> RESEARCH LINES LINKED TO STRATEGIC GOALS:
- Studying the molecular mechanisms and biomarkers of hypertension and diabetes.New therapeutic approaches.
- Insulin Resistance Syndrome and its relation with hypertension and dyslipidemia.
- Cardiovascular risk, metabolic syndrome and HIV infection.
- Complications of internal medicine patients.
- Studying the prevention of preeclampsia.
- Noninvasive hemodynamics.
> OTHER GROUP MEMBERS
Abad Cardiel, María
Álvarez-Arcaya Vicente, Arántzazu
Barbero Pedraz, Aránzazu
Corbatón Anchuelo, Arturo
Gómez-Gordo Díaz, Rubén
Laguna Calle, Maria Victoria
Marco Martínez, Javier
Méndez Bailón, Manuel
Modrego Martín, Javier
Molino González, Ángel Manuel
Nieto Sánchez, Angel
Ortega Hernández, Adriana
Pedrajas Navas, Jose María
Reinares García, Leonardo
ValvularPathology and Large Vessels
Principal investigator:
Vila Costa, Isidre
Address:
Cardiología. Hospital Clínico San Carlos.
C/ Profesor Martín Lagos s/n, 28040 Madrid
Telephone: 91 330 30 00 (2712 extensión)
> GROUP DETAILS:
In 1996, a multicenter group (H. Clinical, H. H. U. of Valladolid and Princess) for the study of endocarditis was created. Since then, the group, together with the important contribution of the Clinical Microbiology Service and Cardiac Surgery, manages a database including 900 patients suffering from this serious infectious valvular disease. Numerous publications in national and international journals, as well as a FIS grant to further study this disease, have resulted from this collaboration and hard work: The ENDOVAL project. In this area we are specifically investigating the following aspects: the diagnostic yield of echocardiography, factors of poor prognosis of the disease, and the adequacy of surgery among others.
The group also works together with the Cardiac Surgery Service, and is pioneer on the acute aortic syndrome and the ascending aortic aneurysms. Upon definition of these features by the group in 2001, the different elements that conform the acute aortic pathology are known as the acute aortic syndrome (AAS).
The group regularly works with: ICICOR (Universitary Hospital of Valladolid; IP: Dr. J. A. San Roman) and the Hospital Princesa (S. Internal Medicine; IP: Dra. C. Sarriá). Together, a great experience in this type of valve disease and in large vessels has been achieved. Despite of their lower prevalence, these pathologies are the most seriouscomparing to other cardiovascular diseases.
> RESEARCH LINES LINKED TO STRATEGIC GOALS:
- Infectious endocarditis.
- Acute aortic syndrome and ascending aortic aneurysms.
> OTHER GROUP MEMBERS
Maroto Castellanos, Luis Carlos
Pérez- Cecilia Carrera, Elisa
Olmos Blanco, Carmen