Author-level metrics are usually employed for academic promotion and research funding. The h-index is a way of measuring scientists' productivity and impact on their field, determined by the number of publications and the number of times those publications have been cited. However, the h-index calculation does not capture the influence of factors such as research topics, article types, highly cited items, self-citations, number and position of authors, and academic career length. Nonetheless, variants of h-index that address some of these limitations correlate widely with their original metric, are not available in bibliographic databases and, overall, add little for measuring research productivity.

Cardiorenal syndrome (CRS) includes a spectrum of disorders affecting both the heart and the kidneys in which acute or chronic dysfunction in one organ leads to acute or chronic dysfunction in the other. The use of Point-of-Care ultrasound (POCUS) and specifically the VExUS score seems to play an important role in the detection of venous congestion, being a useful tool to complement the physical examination of the patient, allowing the establishment of a targeted therapeutic approach. CRS is a entity that presents a challenge for the clinician, from the difficulty in establishing the etiology to the need to monitoring and follow-up of the chosen treatment. Point-of-Care ultrasound and specifically the VExUS Score emerged promisingly for the evaluation of patients with kidney injury and congestion. In this context, it makes sense to find the evidence that can guide us towards the integrated use of VExUs in such a complex pathology and common as CRS. A article review was made for systematic reviews, meta-analyses, observational studies, original studies, articles on evidence-based medicine sites published in the last 10 years, in English and Spanish. 43 results were obtained, of which 13 met the inclusion criteria. In conclusion, most of the studies carried out correspond to post-surgical patients, and despite the fact that VExUS is increasingly present in the literature, it is necessary to generate evidence to know if it could be useful to manage, assess and adjust the treatment of our main cohort of patients.

Introduction: Patients with cardiovascular disease require continuous monitoring throughout their lives. Studies have shown that remote monitoring improves assessments of these patients, leading to more accurate prevention and lower hospitalization rates. The aim of this study is to evaluate the impact of monitoring patients with heart failure (HF) using different devices and to make a comparison with standard clinical practice, mainly based on hospital readmissions and patients’ quality of life by improving their self-care strategy. Methods: The study involved 32 patients previously discharged from hospital, divided into two groups: a study group underwent telemonitoring for 3 months using their mobile phone and various portable devices, and a control group followed standard clinical practice for the same period. The physiological variables analyzed were heart rate, blood oxygen saturation, blood pressure, physical activity, sleep patterns, weight, height, and fluid intake. To assess the impact of monitoring on HF patients, the number of outpatient visits, emergency room visits, and hospital readmissions were taken into account. The impact on quality of life, self-care, and patient satisfaction was also assessed by analyzing patient reported outcomes measures and patient reported experience measures. Results: The results showed that the study group had a lower readmission rate than the control group (40% vs 60%) and fewer visits to the Emergency Department (relative risk 0.667). On the other hand, it is important to note that in the control group, 60% of patients were readmitted during the follow-up period, while in the experimental group, this percentage was reduced to 40%. At the same time, the telemonitored patients have improved their self-care, have greater adherence to the taking of constants, and feel more confident and calmer. In addition, professionals have been able to take different actions proactively, due to the possibility of obtaining information in real time. Conclusions: Telemonitoring patients have achieved a better quality of life and improved health status through continuous, real-time monitoring.

La hipertensión arterial pulmonar (HAP) es una enfermedad rara caracterizada por vasoconstricción y remodelado adverso de la circulación pulmonar con aumento de la resistencia vascular pulmonar, que causa disnea de esfuerzo y fatiga. En caso de no ser tratada, provoca una progresiva sobrecarga y disfunción del ventrículo derecho (VD), y en etapas finales insuficiencia cardiaca y la muerte prematura. Los antagonistas de los receptores de la endotelina 1 (ARE) son potentes vasodilatadores que en combinación con inhibidores de la fosfodiesterasa 5 (iPDE5) constituyen la estrategia de tratamiento inicial en los pacientes con HAP sin comorbilidad cardiopulmonar con un riesgo de mortalidad al año bajo o intermedio, mientras que los ARE o los iPDE5 en monoterapia se recomiendan en aquellos pacientes con comorbilidad cardiopulmonar asociada independientemente de su categoría de riesgo. Los ARE, como el bosentán y el ambrisentán, en monoterapia o con un iPDE5, han demostrado enlentecer la progresión de la enfermedad, con beneficios a corto plazo en la capacidad de ejercicio y la hemodinámica cardiopulmonar, y mejoras en la calidad de vida de los pacientes. Sin embargo, el macitentán, el ARE más recientemente aprobado y con mayor tiempo de seguimiento, ha sido el primero en demostrar, tanto en monoterapia como combinado con un iPDE5, beneficios a largo plazo en la morbilidad y la mortalidad, así como mejoras a corto plazo en la hemodinámica, la capacidad de ejercicio y la clase funcional. Además, es el único que ha demostrado un remodelado inverso del VD, lo que indica que contribuye a mejorar la función y la estructura del VD de manera sostenida. La farmacocinética favorable del macitentán, su mejor penetración tisular y su mayor afinidad por el receptor, en comparación con otros ARE, hacen que los pacientes tratados con bosentán o ambrisentán que lo requieran puedan beneficiarse de cambiar a macitentán. Presentamos una revisión de los datos clínicos del uso de macitentán en la HAP.