[Advances in the application of dynamic virtual patients in prosthodontics].

With the development and application of technologies such as facial scanning, intraoral scanning, virtual facebow and mandibular movement tracking in prosthodontics, dynamic virtual patients are gradually applied to preoperative analysis, esthetic diagnosis, treatment planning, and restorative implementation, becoming a research hotspot in recent years. This review focuses on data acquisition, construction of dynamic virtual patients and their application advantages, aiming to provide a reference for the clinical application of related digital technologies.

Effects of two in-office bleaching agents with different pH on the structure of human enamel: an in situ and in vitro study.

This study evaluated the effects of two in-office bleaching agents (Beyond and Opalescence Boost) with different pH on the structure and mechanical properties of human enamel in vitro and in situ. One hundred and eight enamel slabs were obtained from freshly extracted premolars. The specimens were randomly distributed into nine groups (n=12), and the human saliva (HS) in the volunteers' oral cavities was used to simulate the in situ condition: Beyond + HS, Opalescence Boost (O-Boost) + HS, Control + HS, Beyond + artificial saliva (AS), O-Boost + AS, Control + AS, Beyond + distilled water (DW), O-Boost + DW, and Control + DW. The bleaching treatments were performed on the first and eighth day, and the total bleaching time was 90 minutes. Baseline and final surface roughness (RMS), surface morphology, microhardness, and fracture toughness (FT) were measured before the treatment and on the fifteenth day, respectively. Compared with control groups, surface alterations on enamel were found in the Beyond + AS and Beyond + DW groups under atomic force microscopy evaluation. Two-way analysis of variance and Tukey test revealed that the RMS showed significant intergroup differences for both storage condition and bleaching agent, whereas microhardness and FT revealed no significant alteration. The results indicated that in-office bleaching agents with low pH values could induce enamel morphology alterations under in vitro conditions. The presence of natural HS could eliminate the demineralization effect caused by low pH.

Enhanced Thermo-Mechanical Reliability of Ultralow-K Dielectrics with Self-Organized Molecular Pores.

This paper reported the enhancement in thermo-mechanical properties and chemical stability of porous SiCOH dielectric thin films fabricated with molecularly scaled pores of uniform size and distribution. The resulting porous dielectric thin films were found to exhibit far stronger resistance to thermo-mechanical instability mechanisms common to conventional SiCOH dielectric thin films without forgoing an ultralow dielectric constant (i.e., ultralow-k). Specifically, the elastic modulus measured by nano-indentation was 13 GPa, which was substantially higher than the value of 6 GPa for a porous low-k film deposited by a conventional method, while dielectric constant exhibited an identical value of 2.1. They also showed excellent resistance against viscoplastic deformation, as measured by the ball indentation method, which represented the degree of chemical degradation of the internal bonds. Indentation depth was measured at 5 nm after a 4-h indentation test at 400 °C, which indicated an ~89% decrease compared with conventional SiCOH film. Evolution of film shrinkage and dielectric constant after annealing and plasma exposure were reduced in the low-k film with a self-organized molecular film. Analysis of the film structure via Fourier-transform infrared (FTIR) spectroscopy and X-ray photoelectron spectroscopy (XPS) indicated an increase in symmetric linear Si-O-Si molecular chains with terminal -CH3 bonds that were believed to be responsible for both the decrease in dipole moment/dielectric constant and the formation of molecular scaled pores. The observed enhanced mechanical and chemical properties were also attributed to this unique nano-porous structure.

Hydrogen Peroxide Might Bleach Natural Dentin by Oxidizing Phosphoprotein.

Recent studies suggested that bleaching agents may whiten teeth by oxidizing the fluorescent materials, which are the proteins located in the organic-inorganic interface. Therefore, we postulated that fluorescence of dentin came from dentin phosphoprotein (DPP) and that bleaching agents might bleach dentin by oxidizing DPP. Fifty-six specimens were randomly divided into 4 groups and exposed to distilled water, hydrogen peroxide (HP), ethylenediamine tetraacetic acid disodium salt (EDTA), and acetic acid for 24 h. After measuring the organic and inorganic components, fluorescence, and color characteristics of dentin before and after exposure, we found that when DPP was removed from dentin by EDTA, fluorescent intensity declined proportionally with the reduction in Raman relative intensity, and dentin was whitened considerably, with an Δ E value 6 times higher than that of the distilled water group. On the contrary, due to the incapability of acetic acid to dissolve DPP during decalcification, fluorescent intensity values and tooth color remained nearly unchanged after exposure to acetic acid. Dentin exposed to neutral HP showed no obvious morphologic and organic/inorganic component changes except for the destruction of DPP. Similarly, dramatically decreased fluorescent intensity and lightened color were found in the HP group. Moreover, DPP solution of the HP group exhibited decreased ultraviolet absorbance, especially between 250 and 300 nm, which arose from aromatic amino acids. The results indicated that DPP was responsible for the fluorescent properties of dentin and that HP might bleach dentin by the oxidization of aromatic amino acids in DPP. These findings are of great significance in promoting our further understanding of the mechanism of tooth bleaching and the fluorescent property of normal dentin.

New Insights into Effects of Aromatic Amino Acids on Hydroxyapatite.

Biomimetics inspired by superstructures and extraordinary properties of teeth have resulted in tooth repair and the generation of novel materials. However, little attention has been paid to tooth color, whose origin remains unknown. Based on recent studies, fluorophores-mainly aromatic amino acids (AAAs) in proteins-might be responsible for tooth color. We synthesized carbonated hydroxyapatite (HA; the mineral phase of teeth) in the presence of different amino acids (AAs; the basic units of protein matrix of teeth) as a simplified model of teeth to explore the color source at the AA level. After measuring the fluorescence and color characteristics of HA-AAs before and after bleaching treatment, we found that only HA, synthesized in the presence of AAAs, exhibited remarkable fluorescence and color property. Furthermore, linearly increased fluorescence intensity and deeper color were observed with an increase in AAA content in HA-AAAs. Similarly, significantly decreased absorbance of HA-AAAs between 250 and 300 nm in ultraviolet spectra, declined fluorescence intensity, and decolored performance of HA-AAAs were observed after bleaching treatment. The results showed that AAAs contributed to the fluorescence and color properties of HA and that hydrogen peroxide might whiten HA-AAAs by oxidizing the benzene ring in AAAs. These findings are of great significance in promoting the synthesis of advanced tooth-colored materials and furthering our understanding of the possible mechanisms of hydrogen peroxide. Moreover, our study shed light on the importance of AAAs and might provide new ideas for investigations of biomineralization and biomimetics.

Reduced semen quality in chronic prostatitis patients that induce the release of apoptotic protein Omi/HtrA2 from spermatozoa.

The relationship between chronic prostatitis and fertility has been disputed for many years. Several groups have shown infection and autoimmune response against prostate antigens could have a deleterious effect on semen quality and fertility. This study was conducted to test the hypothesis that Omi/HtrA2-induced apoptosis in chronic prostatitis could be a mechanism underlying the observed clinical benefit. The Omi/HtrA2 serine protease is a nuclear-encoded mitochondrial protein, which can be released from mitochondria into the cytosol after apoptosis stimuli, inducing apoptosis in caspase-dependent and independent manners. Forty-one patients diagnosed as suffering from chronic prostatitis were included. Healthy normal individuals were included as controls. Human spermatozoa in the semen were purified by Percoll-gradient technique to separate the seminal plasma and other round cells. Measurements for sperm concentration, motility, morphology, proinflammatory cytokines, Omi/HtrA2 mRNA and protein levels in spermatozoa of chronic protatitis patients, were performed accordingly. Significantly increased levels of proinflammatory cytokines were detected in seminal plasma from these prostatitis patients. Omi/HtrA2 mRNA and protein levels were significantly higher in prostatitis men than in normal men. This study shows that chronic prostatitis patients present important alterations in their semen quality parameters, Omi/HtrA2 mRNA and protein levels of spermatozoa. We speculate that the inflammatory process involved may affect male fertility by release of proapoptotic protein Omi/HtrA2.

[Saliva, serum estriol, randomized urinary estriol/creatine in prenatal monitoring].

Saliva, randomized urine and blood samples were collected simultaneously from 461 cases of late pregnancies, and saliva, serum estriol(SaE3, SeE3) and randomized urinary estriol/creatinine (RUE3/C) were measured by radioimmunoassay and biochemical method. The coefficient of correlation among SaE3,SeE3 and RUE3/C level was close in either normal or high-risk pregnancies (r = 0.4990-0.7266, P < 0.01). The coefficient of correlation between SaE3 and SeE3 was closest in normal and high-risk pregnancies (r = 0.7266 and r = 0.6901, respectively). The deviation of false negative rate(FN) among these three indexes was not significant. However, the false positive rate (FP) of SaE3 and SeE3 in antenatal monitoring was lower significantly than that of RUE3/C, 91.1% FP RUE3/C cases were corrected by SaE3 or SeE3 test. The correction rate of RUE3/C test (84.6%) in prenatal monitoring was notably lower than that of SaE3 and SeE3 tests (95.7% and 95.4%, respectively, p < 0.01). The results suggest that SaE3 is more valuable than SeE3 fetal monitoring. Combined RUE3/C and SaE3 should replace combined RUE3/C and SeE3 in prenatal monitoring.

[Enhanced continent mechanism of the tapered ileum in continent urinary reservoir].

OBJECTIVE: To construct a reliable continent tube that is easy to catheterize and is surgically simple. METHODS: From October 1999 through March 2001, 20 patients underwent a procedure in which ileal segment was tapered as an efferent tube and the partial efferent tube was placed between the back surface of the rectus muscle and the wall of the ileal pouch. The internal orifice of the tapered ileum was anastomosed to the ileal pouch and its external orifice of the tapered ileum was anastomosed to the umbilicus. Urodynamic study of the efferent tubes and pouch was done 1.5 to 3 months and 6 to 17 months after operation. RESULTS: The stoma was easily catheterized with a 16 F catheter in all patients. One patient died of heart disease 55 days after the operation, while 18 of the remaining 19 were completely continent day and night. At 1.5 to 3 months, the urodynamic study of the efferent tubes showed the maximum close pressure with a full pouch of 46-124 cmH2O(91.53 +/- 17.21), and when the pouch was empty it was 34-84 cmH2O(66.68 +/- 11.60). The difference in the mean maximum closure pressure in full and empty pouches was statistically significant (t = 10.59, P < 0.01). At 6 to 17 months, urodynamic study was performed in 12 patients, the maximum closure pressure in the efferent tube was 77 to 154 cmH2O (100.92 +/- 20.88) when the pouch was filled with saline. When the pouch was empty, it was 56 to 115 cmH2O (74.08 +/- 14.59). The difference in the mean maximum closure pressure in full and empty pouches was statistically significant (t = 8.54, P < 0.01). Reservoir capacity was 360 to 750 ml (455 +/- 110.74). When it was filled to the maximum, the reservoir pressure was 16 to 35 cmH2O (23.17 +/- 5.82). There was no contractive wave in filling in any patient. CONCLUSIONS: This study indicates that the continent mechanism of the tapered ileum can be greatly enhanced by fixing it between the abdominal and pouch walls. This maneuver also provides easy catheterization and surgical simplicity.

Minimally invasive treatment for esthetic management of severe dental fluorosis: a case report.

Dental fluorosis is a developmental disturbance of enamel caused by excessive fluoride on ameloblasts during enamel formation. Patients often present to the dentist with a main goal of improving their esthetic appearance. This case report describes a minimally invasive technique for treating a severe case of enamel fluorosis with brown surface aspect and small defects. A selective mega-abrasion and microabrasion were used to recreate macro- and micro- surface morphology, followed by power bleaching, home bleaching, and resin infiltration to improve the esthetic appearance.

WE-C-217BCD-05: A Novel Interpolation Method for the 3D Reconstruction of Cell Structures.

PURPOSE: To develop a new interpolation method for accurate 3D reconstruction of cell morphology from laser scanning confocal microscope (LSCM) image data. METHODS: Current techniques are based on the assumption that pixel intensity or contour shapes of images change linearly in the interpolation direction. Gray-value and position of the pixel in interpolated image slice are obtained through weighted average calculation with gray-values and distances of corresponding pixels in two adjacent original image slices, only information from adjacent image slices is considered, often fail to meet the need of 3D reconstruction for cells because of the complex cell morphology. The new method interpolates cellular organelle contours in polar coordinate system. Coordinate system origin is chosen to be the mass center weighted by pixel intensity instead of conventional geometric center, contour points of the organelle is sampled by their angles first and fitted with uniform cubic B-spline to perform interpolation. For complex organelle structures such as branched nuclei, a special method combining morphological information and corner detection technique based on curvature scale space has been developed to solve the contour division and related problems. New method was applied to confocal images of 130 different cells acquired with an LSCM system (LSM510, Zeiss), sampling step was set as 0.5 µm in longitudinal direction, pixel size in horizontal plane was 0.07 µm and the resolution was 512×512. Marching cubes algorithm was used for 3D reconstruction. RESULTS: Experiments showed that reconstructed 3D images with new method have much smoother and more valid organelle surfaces for both cytoplasm and nucleus than those from conventional methods. CONCLUSIONS: The new interpolation method can significantly improve the quality of 3D reconstruction and serve as a valid and effective tool for quantitative study of 3D cell morphology in radiation biology and other areas of life science.*support by NSFC- 81171342. Supported by the National Science Foundation of China (NSFC- 81171342).

Bulk properties and bioactivity assessment of porous polymethylmethacrylate cement loaded with calcium phosphates under simulated physiological conditions.

Polymethylmethacrylate (PMMA) cements are widely used in spinal surgery. Nevertheless, these types of cements present some documented drawbacks. Therefore, efforts have been made to improve the properties and biological performance of solid PMMA. A porous structure would seem to be advantageous for anchoring purposes. This work studied the bulk physicochemical, mechanical and interconnectivity properties of porous PMMA cements loaded with various amounts of calcium phosphate (CaP). As a measure of bioactivity, changes of PMMA cements under simulated physiological conditions were studied in a calcium phosphate solution for 0, 3, 7, 14, 21 and 28 days. Scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), micro-computed tomography (µ-CT) and mechanical compression tests were performed to characterize the morphology, crystallographic and chemical composition, interconnectivity and mechanical properties, respectively. SEM allowed observing the result of loading CaP into the porous PMMA, which was corroborated by XRD, FTIR and µ-CT. No interference of the CaP with the PMMA was detected. µ-CT described similar interconnectivity and pore distribution for all CaP percentages. Mechanical properties were not significantly altered by the CaP percentages or the immersion time. Hence, porous PMMA was effectively loaded with CaP, which provided the material with properties for potential osteoconductivity.

Effect of halogen light irradiation on hydrogen peroxide bleaching: an in vitro study.

BACKGROUND: The aim of this study was to evaluate the effect of halogen light irradiation on hydrogen peroxide (HP) bleaching by assessing HP concentrations, tooth whitening efficacy, and temperature variations in bleaching agents and pulp chambers. METHODS: Sixteen premolars were randomly divided into two groups: Group BL (bleaching agent with halogen light irradiation for 3 × 10 minutes) and Group B (bleaching agent alone). HP concentrations were tested before and after treatment. CIE L*a*b* values of specimens were obtained using a spectrophotometer. Temperatures of bleaching gels and pulpal chambers were recorded by a digital multimeter with K-type thermocouple. Data were analysed using ANOVA and paired t-test. RESULTS: After treatment, HP concentration in group BL was slightly higher than that in group B. Paired t-tests revealed significant differences of ΔE between groups BL and B in all time intervals except at day 35. The temperature rise of bleaching gels and pulpal chambers in group BL was significantly higher than that in group B. CONCLUSIONS: In-office bleaching was effective for tooth whitening. The involvement of halogen light was beneficial for the immediate whitening effect but had little impact on the long-term whitening effect.

The dentine remineralization activity of a desensitizing bioactive glass-containing toothpaste: an in vitro study.

BACKGROUND: Dentine hypersensitivity occurs easily on exposed dentine. This study aimed to evaluate the effectiveness of a novel bioactive glass-containing toothpaste on dentine permeability and remineralization. METHODS: Thirty dentine discs were divided into three groups of 10 specimens each. The groups corresponded to the following brushing treatments: no brush, distilled water, and bioactive glass-containing toothpaste (Novamin). The toothpaste was applied twice a day for 7 days. Dentine permeability was measured after ethylene-diamine-tetraacetic acid (EDTA) etching, initial application, 3-day application, 7-day application and citric acid challenge, respectively. The dentine morphology was investigated using scanning electron microscopy (SEM). Attenuated total reflection Fourier transform infrared (ATR/FTIR) spectroscopy was performed to monitor the mineral variation on demineralized dentine. Qualitative information of elemental variation before and after treatments on completely demineralized dentine was detected by energy dispersive X-ray (EDX) analysis. RESULTS: The bioactive glass-containing toothpaste significantly reduced dentine permeability after the 7-day treatment and showed, under SEM, excellent resistance to acid challenge compared to the other groups. ATR/FTIR and EDX revealed increased mineral content after treatment with Novamin. CONCLUSIONS: As the innovative bioactive glass-containing toothpaste occlude dentinal tubules and resist acid challenge, it may be useful for the treatment of dentine hypersensitivity and dentine remineralization.

Heat-shock protein 70 expression in the seminal plasma of patients with chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome.

The purpose of this study was to assess the diagnostic value and potentially protective capacity of heat-shock protein 70 (HSP70) in chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In this study, seminal plasma levels of cytokines (tumor necrosis factor-α (TNF-α) and interleukin 1ß (IL-1ß)) and HSP70 were evaluated by enzyme-linked immunosorbent assay in 80 men: 15 healthy controls, 16 men with chronic bacterial prostatitis, 23 men with CP/CPPS IIIA and 26 with CP/CPPS IIIB. The HSP70 levels in chronic bacterial prostatitis and CP/CPPS patients were correlated with chronic prostatitis symptom index (CPSI). Significantly increased levels of cytokines (TNF-α and IL-1ß) and HSP70 were observed in seminal plasmas from patients with chronic bacterial prostatitis compared with CP/CPPS patients and controls. However, only IL-1ß was significantly elevated compared with CP/CPPS IIIB and controls in patients with CP/CPPS IIIA. HSP70 levels in CP/CPPS patients were significantly lower than that in controls. HSP70 concentration in seminal plasma was negatively correlated with CPSI in chronic bacterial prostatitis. The results indicated that HSP70 and IL-1ß appear to be the most reliable and predictive surrogate markers to diagnose chronic bacterial prostatitis and CP/CPPS, respectively. HSP70 has an important protective role in the regulation of cell functions in chronic bacterial prostatitis. CP/CPPS would probably be detrimental to the ability of T cells and consequently suppress the expression of HSP70.

Infective endocarditis of unusual location following surgical correction of a complex congenital heart disease.

A 40-year-old woman from Ecuador diagnosed with a complex congenital heart disease was admitted complaining of fever chills, night sweats, and productive cough 6 months after surgical correction of the anomalies. An echocardiography showed vegetations located on the interatrial pericardium patch. To the best of our knowledge, this is the first reported case of postoperative infective endocarditis on this location.

Cardiovascular scientific production in Spain and in the European and global context (2003-2007).

INTRODUCTION AND OBJECTIVES: The publication of research articles has increased considerably in recent years in all biomedical fields. The present study examines the position of Spanish quality research in cardiology in the European and world context, and its evolution during the 5-year period 2003-2007. METHODS: Using the Science Citation Index Expanded of Thomson Reuters as data source, we compared Spanish cardiovascular scientific production with that of the rest of countries in the European Union and of the most important countries worldwide, along with relative productivity as per number of inhabitants and Gross Domestic Product, and the number of citations in the journals of the <> area of the Journal Citation Reports (CCS-JCR). RESULTS: Spain ranks sixth in the European Union and ninth worldwide in scientific production (tenth worldwide if only the journals of the first quartile of the CCS-JCR area are considered). As regards the number of citations received, Spain ranks seventh in the European Union and eleventh worldwide. In terms of relative productivity as per number of inhabitants and Gross Domestic Product, the Spanish ranking is less favorable (positions 15 and 18, respectively). CONCLUSIONS: The ranking of Spanish cardiovascular research is similar to that of other biomedical fields, though its position is less favorable in relation to certain demographic and economical indicators. In order to maintain adequate investigational levels, it is necessary for the European governments and scientific societies to regard the promotion of high-quality cardiological research as a priority concern.

Fibrinolytic and antithrombotic protease from Spirodela polyrhiza.

A fibrinolytic protease was purified from a Chinese herb (Spirodela polyrhiza). The protease has a molecular mass of 145 kDa and 70 kDa in gel filtration and SDS-polyacrlamide gel electrophoresis (PAGE), respectively, implying it is a dimer. Its optimum pH was 4.5-5.0. The enzyme was stable below 42 degrees C and after lyophilization. The enzyme activity was inhibited significantly by leupeptin and aprotinin. The protease hydrolyzed not only fibrin but also fibrinogen, cleaving Aalpha and Bbeta without affecting the gamma chain of fibrinogen. It preferentially cleaved the peptide bond of Arg or Lys of synthetic substrates (P1 position). The enzyme had an anticoagulating activity measured with activated partial thromboplastin time (APTT), thrombin time (TT), and prothrombin time (PT) tests. It delayed APTT, TT, and PT two times at the concentration of 36, 39, and 128 nM, respectively and this was drastically reduced after heat treatment.

Enhanced continent mechanism of tapered ileum by extramural support from the pouch and abdominal walls: a preliminary report of a clinical study.

PURPOSE: We constructed a reliable continent tube that is easy to catheterize and surgically simple. MATERIALS AND METHODS: Eight patients with bladder cancer underwent a procedure in which ileal segment was tapered as an efferent tube, of which a part was placed between the back surface of the rectus muscle and the ileal pouch wall. The internal orifice of the tapered ileum was anastomosed to the ileal pouch and its external orifice was anastomosed to the umbilicus. Urodynamic and radiological studies were done postoperatively in 7 cases. RESULTS: The stoma was easily catheterized with a 16Fr catheter in all cases. One patient died of heart disease 55 days postoperatively, while 6 of the remaining 7 were completely continent day and night. Urodynamic study of the efferent tubes showed that maximum close pressure with the pouch full was significantly higher than with the pouch empty (p <0.001). Retrograde radiography of the efferent tubes demonstrated perfect canalization without stenosis. CONCLUSIONS: This study indicates that the continent mechanism of tapered ileum may be greatly enhanced by fixing it between the abdominal and pouch walls. This maneuver also provides easy catheterization and surgical simplicity.

La producción científica cardiovascular en España y en el contexto europeo y mundial (2003-2007) / Cardiovascular Scientific Production in Spain and in the European and Global Context (2003-2007)

Introducción y objetivos. La publicación de artículos de investigación ha aumentado de manera considerable en los últimos años en todas las áreas biomédicas. El objetivo de este trabajo es determinar el lugar que ocupa la investigación cardiológica española de calidad en el contexto europeo y mundial y su evolución durante el quinquenio 2003-2007. Métodos. Utilizando como fuente de datos la base de datos Science Citation Index Expanded de Thomson Reuters, se comparó la producción científica cardiovascular española con la de los países de la Unión Europea y los más destacados del mundo, así como la productividad relativa respecto al número de habitantes y producto interior bruto y el número de citas recibidas en las revistas del área «Cardiac & Cardiovascular Systems» del Journal Citation Reports (CCS-JCR). Resultados. España ocupa el sexto puesto en el ranking europeo y el noveno en el mundial de la producción científica, pasando al décimo mundial si se consideran únicamente las revistas del primer cuartil del área CCS-JCR. En número de citas recibidas, España ocupa el séptimo lugar europeo y undécimo mundial. En la productividad relativa respecto al número de habitantes y el producto interior bruto, la posición española es menos favorable, ocupando la decimoquinta y la decimoctava posición, respectivamente. Conclusiones. En investigación cardiovascular, España ocupa posiciones similares a otras áreas biomédicas, si bien su situación es menos ventajosa respecto a algunos indicadores demográficos y económicos. Para que se mantengan los niveles adecuados de investigación, es necesario que los gobiernos y las sociedades científicas europeas consideren el fomento de la investigación cardiológica de alta calidad como un objetivo primordial (AU)

Introduction and objectives. The publication of research articles has increased considerably in recent years in all biomedical fields. The present study examines the position of Spanish quality research in cardiology in the European and world context, and its evolution during the 5-year period 2003-2007. Methods. Using the Science Citation Index Expanded of Thomson Reuters as data source, we compared Spanish cardiovascular scientific production with that of the rest of countries in the European Union and of the most important countries worldwide, along with relative productivity as per number of inhabitants and Gross Domestic Product, and the number of citations in the journals of the «Cardiac & Cardiovascular Systems» area of the Journal Citation Reports (CCS-JCR). Results. Spain ranks sixth in the European Union and ninth worldwide in scientific production (tenth worldwide if only the journals of the first quartile of the CCS-JCR area are considered). As regards the number of citations received, Spain ranks seventh in the European Union and eleventh worldwide. In terms of relative productivity as per number of inhabitants and Gross Domestic Product, the Spanish ranking is less favorable (positions 15 and 18, respectively). Conclusions. The ranking of Spanish cardiovascular research is similar to that of other biomedical fields, though its position is less favorable in relation to certain demographic and economical indicators. In order to maintain adequate investigational levels, it is necessary for the European governments and scientific societies to regard the promotion of high-quality cardiological research as a priority concern (AU)