ABSTRACT
Resumen Este artículo de revisión pretende resumir el papel de la imagen cardiaca en cuanto a los avances técnicos y de conocimiento más relevantes publicados en el último año. Aunque la imagen cardiaca sigue ocupando un lugar destacado en el diagnóstico y en la detección de complicaciones de la afectación cardiaca por la infección por coronavirus, otros temas candentes están claramente de actualidad. Entre lo más relevante cabe destacar la confirmación de la utilidad pronóstica de parámetros obtenidos mediante técnicas de imagen avanzada en el campo de las valvulopatías, prevención cardiovascular o cardio-oncología, el papel destacado de la imagen en el primer escalón diagnóstico de las nuevas guías de dolor torácico o el crecimiento exponencial del intervencionismo estructural percutáneo, donde se hace necesario un mayor conocimiento en la selección de pacientes, el timing del procedimiento o los predictores de éxito. Por último, la inteligencia artificial es un aliado que ha llegado para quedarse, y esperemos que la precisión y la rentabilidad diagnósticas, así como los tiempos dedicados a la interpretación, mejoren gracias a este avance tecnológico. This review article aims to summarize the role of cardiac imaging regarding the most relevant technical and knowledge advances published within the last year. Although diagnosis and detection of cardiac involvement due to coronavirus disease maintain a prominent place, other interesting hot topics have been raised. Among the most relevant, it is noteworthy to highlight the prognostic utility of different parameters obtained by advanced imaging techniques in the field of valvular heart disease, cardiovascular prevention or cardio-oncology, the prominent role of imaging in the first diagnostic step of the new Chest Pain guidelines or the exponential growth of percutaneous structural interventionism, where further knowledge is demanded in terms of patient selection, procedure timing or predictors of success. Finally, artificial intelligence is a promising tool already in our hands, we hope that diagnostic precision and interpretation time will improve thanks to these technological advances.
ABSTRACT
Some patients with COVID-19 pneumonia develop an associated cytokine storm syndrome that aggravates the pulmonary disease. These patients may benefit of anti-inflammatory treatment. The role of colchicine in hospitalized patients with COVID-19 pneumonia and established hyperinflammation remains unexplored. In a prospective, randomized controlled, observer-blinded endpoint, investigator-initiated trial, 240 hospitalized patients with COVID-19 pneumonia and established hyperinflammation were randomly allocated to receive oral colchicine or not. The primary efficacy outcome measure was a composite of non-invasive mechanical ventilation (CPAP or BiPAP), admission to the intensive care unit, invasive mechanical ventilation requirement or death. The composite primary outcome occurred in 19.3% of the total study population. The composite primary outcome was similar in the two arms (17% in colchicine group vs. 20.8% in the control group; p = 0.533) and the same applied to each of its individual components. Most patients received steroids (98%) and heparin (99%), with similar doses in both groups. In this trial, including adult patients with COVID-19 pneumonia and associated hyperinflammation, no clinical benefit was observed with short-course colchicine treatment beyond standard care regarding the combined outcome measurement of CPAP/BiPAP use, ICU admission, invasive mechanical ventilation or death (Funded by the Community of Madrid, EudraCT Number: 2020-001841-38; 26/04/2020).