Julián Roldán

Hospital Universitario San Juan De Alicante, Alicante, Valencia, Spain

Are you Julián Roldán?

Claim your profile

Publications (9)14.78 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Aim. The resistive index (RI) is a hemodynamic parameter that reflects local wall extensibility and related vascular resistance. We analyze the relationship between common carotid RI and target organ damage in treated hypertensive patients. Methods. We analyzed 265 consecutive hypertensive patients. Risk factors, cardiovascular history and treatments were collected; blood test, urinary albumin excretion (UAE), echocardiography to determine left ventricular mass index (LVMI), ankle-brachial index (ABI) and carotid echo-Doppler ultrasound to calculate the carotid intima-media thickness (IMT) and RI of both common carotids arteries were performed. Results. A positive correlation was found between carotid RI and age, systolic blood pressure, heart rate, carotid IMT, LVMI, UAE and a negative correlation was found with diastolic blood pressure and ABI. Subjects at the top quartile of carotid RI showed a higher prevalence of left ventricular hypertrophy and peripheral artery disease (increased IMT, carotid plaques and lower ABI) compared with those with low RI (p < 0.05). Multiple regression analysis demonstrated that age, systolic and diastolic blood pressure and LVMI independently influence carotid RI. Conclusion. Carotid RI is related with age, systolic-diastolic blood pressure and LVMI in hypertensive patient. This evaluation could predict the presence of early cardiovascular damage and provide an accurate estimation of overall risk in this population.
    Blood pressure 07/2012; · 1.26 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background and objectiveThe guidelines for arterial hypertension recommend a systematic determination of ankle-brachial index (ABI) in the initial risk stratification in hypertensive patients, while not indicating whether controls should be evolutionary. Our aim was to analyze the evolution of the ABI value in hypertensive patients in terms of control of blood pressure (BP) after one year follow-up.Patients and methodsWe included 209 hypertensive patients, in whom ABI was determined at baseline and after one year of antihypertensive treatment. Patients were divided into 2 groups in terms of good/poor clinical control of BP (< 140/90 mmHg).ResultsA total of 82.8% of the population showed a good control of the BP after one year of treatment and it was associated with significant increase in the ABI value (1.081 versus 1.046 at baseline, P = .002). By contrast, there was no difference of ABI value in patients with poor BP control (1.054 versus 1.093 at baseline).ConclusionsA good clinical control of BP is associated with an increase in the value of the ABI.
    Medicina Clínica. 06/2012; 139(2):61–64.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The guidelines for arterial hypertension recommend a systematic determination of ankle-brachial index (ABI) in the initial risk stratification in hypertensive patients, while not indicating whether controls should be evolutionary. Our aim was to analyze the evolution of the ABI value in hypertensive patients in terms of control of blood pressure (BP) after one year follow-up. We included 209 hypertensive patients, in whom ABI was determined at baseline and after one year of antihypertensive treatment. Patients were divided into 2 groups in terms of good/poor clinical control of BP (<140/90 mmHg). A total of 82.8% of the population showed a good control of the BP after one year of treatment and it was associated with significant increase in the ABI value (1.081 versus 1.046 at baseline, P=.002). By contrast, there was no difference of ABI value in patients with poor BP control (1.054 versus 1.093 at baseline). A good clinical control of BP is associated with an increase in the value of the ABI.
    Medicina Clínica 04/2012; 139(2):61-4. · 1.40 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: to assess the relationship between lesion length and other angiographic parameters on the functional significance of long coronary lesions with moderate stenosis. BACKGROUND-: Coronary revascularization is usually based on angiographic percent stenosis. Coronary stenosis length is not usually considered in daily clinical practice for revascularization decision making. The relevance of lesion length might be greater in longer lesions with intermediate stenosis. METHODS.: All coronary lesions >20 mm and of 40-70% percent stenosis assessed by intracoronary pressure wire between 2007 and 2009 were included. Interventionists performing digital quantification of lesion stenosis were blinded to the result of fractional flow reserve (FFR). Correlations between angiographic data and FFR were analyzed. RESULTS.: One hundred and six lesions from 103 patients were included. Reference diameter: 2.9±0.56 mm; maximal stenosis: 49.0±8.7%; minimal luminal diameter (MinimalLD): 1.48±0.4 mm; mean luminal diameter (MeanLD): 2.3±0.5 mm; mean lesion length: 28.7±10.6 mm. Lesions with FFR <0.75 accounted for 33% (n=35). Weak correlations were obtained between FFR and MinimalLD(r=0.36;p<0,0005), MeanLD(r=0.24;p=0,014), maximal(r=0,31;p=0,001) and mean stenosis(r=0,018;p=0,85); strong correlations were observed between FFR and lesion length(r=0,63;p<0,0005), lesion length/MinimalLD(r=0,67;p<0,0005) and lesion length/MeanLD(0,72;p<0,0005). The predictive values of lesion length, lesion length/MinimalLD and lesion length/MeanLD for FFR <0.75 were 0.86, 0.91 and 0.92, respectively. CONCLUSIONS-: In long lesions (>20 mm) with moderate angiographic stenosis, lesion length might be the strongest determinant of functional repercussion. Lesion length should be considered when judging the benefit of revascularization and when seeking functional measures that overcome the limitations of simple stenosis quantification. © 2012 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 04/2012; · 2.51 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Electrocardiography (ECG) is the most widely used method for diagnosing left ventricular hypertrophy (LVH) in hypertensive patients. We assessed the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) determination compared with ECG for detecting LVH in 336 consecutive hypertensive patients with preserved systolic function. We found a significant correlation between NT-proBNP levels and left ventricular mass adjusted for body surface area (r=.41; P<.001). The area under the receiver operating characteristic curve was 0.75 (95% CI, 0.7-0.8). A cut-off of 74.2 pg/mL had a greater sensitivity than ECG (76.6% vs 25.5%; P<.001) and a higher negative predictive value (87.8% vs 76.6%; P<.001) in the identification of LVH. NT-proBNP determination may be a useful tool for LVH screening in hypertensive patients.
    Revista Espa de Cardiologia 06/2011; 64(10):939-41. · 3.20 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Recent guidelines on arterial hypertension regard increased carotid intima-media thickness (IMT) as a marker of end-organ damage. However, these guidelines do not specify whether the maximum or mean IMT should be used as an indicator. The aim of this study was to compare these two measures and their relationship to atherosclerotic burden. The study involved 215 consecutive hypertensive patients who were divided into three groups according to their IMT: maximum IMT>0.9mm (with mean IMT<0.9mm); mean IMT>0.9mm (i.e. mean and maximum IMT>0.9mm); and normal IMT. Patients with a pathologically raised IMT (whether maximum or mean value) were more likely to be dyslipidemic, were older, had a longer history of hypertension, and had a poorer glomerular filtration rate and ankle-brachial index. Patients with a mean IMT>0.9mm were more likely to have carotid plaque, carotid stenosis and a low ankle-brachial index than those with a maximum IMT>0.9mm. The mean IMT provided a better indication of atherosclerotic burden in patients with hypertension.
    Revista Espa de Cardiologia 03/2011; 64(5):417-20. · 3.20 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recent guidelines on arterial hypertension regard increased carotid intima–media thickness (IMT) as a marker of end-organ damage. However, these guidelines do not specify whether the maximum or mean IMT should be used as an indicator. The aim of this study was to compare these two measures and their relationship to atherosclerotic burden. The study involved 215 consecutive hypertensive patients who were divided into three groups according to their IMT: maximum IMT>0.9mm (with mean IMT0.9mm (i.e. mean and maximum IMT>0.9mm); and normal IMT. Patients with a pathologically raised IMT (whether maximum or mean value) were more likely to be dyslipidemic, were older, had a longer history of hypertension, and had a poorer glomerular filtration rate and ankle–brachial index. Patients with a mean IMT>0.9mm were more likely to have carotid plaque, carotid stenosis and a low ankle–brachial index than those with a maximum IMT>0.9mm. The mean IMT provided a better indication of atherosclerotic burden in patients with hypertension.Full English text available from: www.revespcardiol.org
    Revista Espanola De Cardiologia - REV ESPAN CARDIOL. 01/2011; 64(5):417-420.
  • [Show abstract] [Hide abstract]
    ABSTRACT: There is increasing interest in the role of aldosterone in the pathophysiology of hypertension, cardiovascular disease and deteriorating renal function. The aim of this study was to investigate the relationship between aldosterone and the glomerular filtration rate (GFR) in hypertensive patients with preserved renal function. The study involved 186 consecutive hypertensive patients with a GFR >60 mL/min. The GFR was determined using the Modification of Diet in Renal Disease (MDRD) equation and the patients’ plasma aldosterone levels were measured. Patients with a GFR between 60–89 mL/min had a significantly higher plasma aldosterone level than those with a GFR >90 mL/min (20.02 ng/dL vs. 15.3 ng/ dL; P<.05). Multivariate analysis showed that the plasma aldosterone level was independently associated with the GFR (B=-7.36; P<.001). In hypertensive patients with preserved kidney function, the plasma aldosterone level was observed to increase as the GFR decreased.
    Revista Espanola De Cardiologia - REV ESPAN CARDIOL. 01/2010; 63(1):103-106.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There is increasing interest in the role of aldosterone in the pathophysiology of hypertension, cardiovascular disease and deteriorating renal function. The aim of this study was to investigate the relationship between aldosterone and the glomerular filtration rate (GFR) in hypertensive patients with preserved renal function. The study involved 186 consecutive hypertensive patients with a GFR >60 mL/min. The GFR was determined using the Modification of Diet in Renal Disease (MDRD) equation and the patients' plasma aldosterone levels were measured. Patients with a GFR between 60-89 mL/min had a significantly higher plasma aldosterone level than those with a GFR >90 mL/min (20.02 ng/dL vs. 15.3 ng/dL; P< .05). Multivariate analysis showed that the plasma aldosterone level was independently associated with the GFR (B=-7.36; P< .001). In hypertensive patients with preserved kidney function, the plasma aldosterone level was observed to increase as the GFR decreased.
    Revista Espa de Cardiologia 01/2010; 63(1):103-6. · 3.20 Impact Factor