> 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:

1. 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.
2. 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.
3. 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:

1. 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.
2. 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).
3. Assessment of the coronary microcirculation integrity upon usage of revascularization technologies (distal protection, preserved endothelial function, etc.).
4. 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.
5. Comparison of mechanical behavior between in vitro and in vivo intracoronary prosthesis (elastic recoil after stent implantation, etc.).
6. Evaluation of biodegradable endo-coronary prosthesis.
7. Assessment of intracoronary drug dispensing systems (antiproliferative or antithrombotic drug-eluting balloons, proteolytic agents in chronic occlusions, etc.).
8. 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

Gonzalo Lopez, María Nieves
Guerra Casañas, Reddy
Lauri, Francesco María
Macaya Miguel, Carlos
Mejía Rentería, Hernán David
Rodríguez García- Abad, Vera
Rodríguez Trigo, Gema
Salinas Sanguino, Pablo

> 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:

1. Development and validation of new imaging diagnostic tools.
2. Automated study of cardiac output in non-invasive methods.
3. Use of imaging for the study of myocardial deformation.
4. Use of imaging in new procedures of invasive cardiology.

> RESEARCH LINES LINKED TO STRATEGIC GOALS:

1. Three-dimensional echocardiography in valvular studies.
2. Cardiac Resonance.
3. Cardiac TAC.
4. Early detection of cardiac abnormalities using imaging tools.

> OTHER GROUP MEMBERS

de Agustín Loeches, José Alberto
Gómez de Diego, José Juan
Islas Ramirez, Fabián O´nore
Luaces Méndez, María
Mahia Casado, Patricia
Marcos Alberca-Moreno, Pedro

> 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:

1. Advancing in the study of platelet/leukocyte reactivity and the response to inhibitory drugs in patients with ischemic heart disease.
2. Strengthening the research on pathophysiology and prevention of myocardial ischemia/reperfusion.
3. Strengthening the research on pathophysiology of transient apical dyskinesia.
4. Promotingnew translational research projects in collaboration with CNIC.
5. Promoting the development of joint projects with other hospital groups working on similar research lines.

> RESEARCH LINES LINKED TO STRATEGIC GOALS:

1. Platelet/leukocyte reactivity in patients with ischemic heart disease.
2. Pathophysiological bases in transient apical dyskinesia syndromes.
3. Pathophysiological bases of myocardial damage in acute coronary syndromes

> OTHER GROUP MEMBERS

Álvarez Morales, María Verónica
Bernardo García, Esther
Fernández Salvador, Gracia
Higueras Nafria, Javier 
Maldonado Castillo, María Concepción
Mera González, Silvia
Nogueira Sánchez, Francisco Javier
Núñez Gil, Iván Javier
Viana Tejedor, Ana
Vivas Balcones, David 

> 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:

1. 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.
2. 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.
3. 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:

1. Using endothelial stem cells for the induction of angiogenesis in patients with chronic myocardial ischemia and refractory angina.
2. The study of the in vitro functionality and regenerative capacity of autologous endothelial stem cells.
3. The study of the implications of circulating endothelial stem cells in the repairing process of the coronary artery wall, after stent implantation.
4. The differential characterization of cardiovascular cell therapy in the diabetic population.
5. The study of Ischemic heart disease in diabetic patients.

> OTHER GROUP MEMBERS

Del Trigo Espinosa, María
Nombela Franco, Luis
Ortega Pozzi, Arancha

> 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:

1. The accomplishment and the publication, in international journals,of at least two randomized studies providing scientifically relevant developments in arrythmology.
2. Trainingof at least three cardiologists in arrythmology.
3. 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
González Ferrer, Juan José
Herrero Calvo, José Antonio
Herreros Gil, María
Lamuedra del Olmo, Mónica
Núñez Chavarry, Jennifer
Pérez Castellano, Nicasio
Sánchez Sánchez, María

> GROUP DETAILS:

The Cardiovascular Research Unit focuses on two main translational research lines: On one hand, on the research of biomarkers of prognosis / diagnosis and drug response, on the signaling pathways associated with cardiovascular pathophysiology, and on the action of drugs used in the treatment of cardiovascular diseases. For this purpose, classical molecular biology techniques (Western blot, ELISA etc.,), and 2DE proteomics and mass spectrometry are performed. The second research line focuses on the study of genetic alterations associated with sudden death in sports, primarily using genetic and epigenetic studies.

To date, 200 articles in major scientific journals have been published by the group, and in 2001, the group leader was awarded as the researcher of the Decade, with the National Award for Research.

The Unit works in close collaboration with the Vascular Surgery Service (Dr. Javier Serrano and Dr. Guillermo Moñux), the Cardiac Surgery (Dr. Luis Maroto, Dr. Silva, Dr. Cobiella) and the Cardiology Department (Dr. Carlos Macaya, Dr. Luis Azcona, etc ...), conforming a multidisciplinary group, interested in the study of cardiovascular diseases. The unit also closely cooperates with other groups from the Center, including the Nephrology Service, Emergency Department, Otorhinolaryngology, Oncology and other national and international high prestige researchers. In addition, several members of the group belong to the Heracles Network of the FIS Retics Networks.

At an educational level, it is worth noting the direction of more than 33 doctoral theses in the ​​cardiovascular biomedicine area, proving broad training activity among the research personnel. Within the activities, an annual refresher course in Cardiology is organized in Madrid, in collaboration with the BBVA Foundation, for which 25 scholarships are annually granted to Latin American researchers. In addition, an international symposium attended by prestigious international researchers in the cardiovascular field is annually organized during 3 days, in collaboration with the BBVA Foundation in Madrid.

The unit is one of the few research laboratories in Spain to have recently obtained the ISO 9001: 2008 for the “activities developed in the fields of research, biobank genetic and proteomic analysis, mass spectrometry, biochemistry and molecular biology”.

> STRATEGIC GOALS:

1. Studying proteins and intracellular signals associated with the genesis and progression of cardiovascular diseases.
2. Identifying new protein biomarkers associated with drug response in patients with cardiovascular disease.
3. Studying new protein biomarkers and mediators involved in platelet activity and their pharmacological response.
4. Identifying new genetic and epigenetic alterations linked to sudden cardiac death in sports.
5. The completion of at least one doctoral thesis.

> RESEARCH LINES LINKED TO STRATEGIC GOALS:

1. Analyzing cellular and molecular mechanisms involved in the development of cardiovascular diseases.
2. Searching protein biomarkers associated with the diagnosis, prognosis and drug response in cardiovascular diseases.
3. Studying genetics in pathologies associated with sudden cardiac death, due to ventricular arrhythmia, in populations of athletes and non-athletes.
4. Research of the molecular mechanisms involved in the development and progression of abdominal aneurysms, and the action of new drugs for its treatment.
5. Studying the molecular mechanisms associated with the failure of the saphenous vein.

> OTHER GROUP MEMBERS

Ballesteros Rodrigálvarez, Sandra
De las Heras Jiménez, Natalia
Galiana Rodríguez-Barbero, Adrián
Gómez Serrano, Manuel
Iglesias Moreno, María Cruz
Klett Mingo, Mercedes
Lahera Juliá, Vicente
Martín Conejero, Antonio
Moñux Ducajú, Guillermo
Poch Broto, Joaquín
Serrano Hernando, Francisco Javier
Zamorano León, José Javier

> 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:

1. Maintaining a research line that demonstrates leadership.
2. Maintaining the clinical trial platform.
3. Developing a research line for its clinical application ("translational research")

> RESEARCH LINES LINKED TO STRATEGIC GOALS:

1. Studying the molecular mechanisms and biomarkers of hypertension and diabetes.New therapeutic approaches.
2. Insulin Resistance Syndrome and its relation with hypertension and dyslipidemia.
3. Cardiovascular risk, metabolic syndrome and HIV infection.
4. Complications of internal medicine patients.
5. Studying the prevention of preeclampsia.
6. Noninvasive hemodynamics.

> OTHER GROUP MEMBERS

Abad Cardiel, María
Barbero Pedraz, Aránzazu
Fernández-Cruz Pérez, Arturo
Laguna Calle, Maria Victoria
Marco Martínez, Javier
Méndez Bailón, Manuel
Molino González, Ángel Manuel
Nieto Sánchez, Angel

> GROUP DETAILS:

Dr. Gomez Garre joined the Cardiovascular Prevention Area in 2001 on a FIS contract, with the aim of initiating a new research line focused on the study of genetic, molecular and cellular basis of the mechanisms of vascular damage and repair, and their impact on cardiovascular disease. He then obtained a SNS stabilization contract in 2007.

The group has a great expertise in the study of the molecular basis of the mechanisms of tissue injury and repair in cardiovascular disease, mainly atherosclerosis and heart failure (HF), as well as the study of new therapeutic approaches. In the last years, we have demonstrated that some proinflammatory cytokines may improve the diagnosis of HF and even that could serve as surrogate markers of disease progression. In addition, our group has described new mechanisms of action of some drugs and have identified potential new therapies for HF patients with preserved cardiac function; a group of patients with a high morbidity and mortality and for whom there is no specific therapy. Recently, we have reported the role of endothelial progenitor cells (EPCs) as a new strategy for tissue repair. Using an experimental model of hypertensive rats with spontaneous development of HF (SHHF), we have identified new pathways implicated in the development of fibrosis, inflammation and apoptosis signalling and, finally, of cardiac and renal damage. Since one of the most advanced and appealing hypothesis is that gut microbiota may contribute to cardiovascular diseases by creating a chronically inflamed milieu, our group initiated the study of the composition and functionality of microbiota several months ago.

To date, about 60 published papers and seven co-directed doctoral thesis have been completed. The group is well known both nationally and internationally, having received grants from several national research agencies, most notably ISCIII, MINECO and the Community of Madrid. The group has also an extensive experience in research projects developed in collaboration with pharmaceutical industries. Group members are part of the CIBERCV.

> STRATEGIC GOALS:

1. Studying new molecular mechanisms and prognostic markers in heart failure syndrome in order to identify new therapeutic approaches.
2. Deepening into the molecular mechanisms of the inflammatory reaction in arteriosclerosis.
3. Studying the association between gut microbiota profile and the development of cardiovascular disease
4. The ultimate goal is the consolidation of the group, and the development of a research line on its own that will be of interest in the IdISSC Strategic Plan, increasing the funding and the number of publications.

> RESEARCH LINES LINKED TO STRATEGIC GOALS:

1. The study of the molecular mechanisms of the inflammatory reaction in atherosclerosis: 
   Studying the ezetimibe anti-inflammatory mechanisms. 
   Identification of the ezemibe role on plaque stabilization.
2. Studying new molecular mechanisms and prognostic markers in heart failure syndrome in order to identify new therapeutic approaches. Studyingproinflammatory factors as biomarkers of heart failure. 
   Role of the circulating progenitor endothelial cells on vascular endothelium regeneration.
   Studying the possible role of ezetimibe as a potential marker and a possible therapeutic approach of the disease.
   Therapeutic management of heart failure.
3. Studying the association between gut microbiota profile and the development of cardiovascular disease. Study of the relationship between inflammation, nutritional status and gut microbiota in the development and progression of chronic heart failure. Identification of a gut microbiota profile associated to the development of coronary atherosclerosis in subjects without evidence of cardiovascular disease.

> OTHER GROUP MEMBERS

Álvarez-Arcaya Vicente, Arántzazu
Berastegui Cabrera, Judith
Modrego Martín, Javier
Ortega Hernández, Adriana
Reinares García, Leonardo

> 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:

1. Infectious endocarditis.
2. Acute aortic syndrome and ascending aortic aneurysms.

> OTHER GROUP MEMBERS

Maroto Castellanos, Luis Carlos
Pérez- Cecilia Carrera, Elisa
Olmos Blanco, Carmen