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Artículo

Cardiopatía isquémica

REC Interv Cardiol. 2023;5:270-278

Estudio de la vasorreactividad y la función microvascular por termodilución en ausencia de enfermedad coronaria obstructiva

Thermodilution assessment of vasoreactivity and microvascular function in the absence of obstructive coronary artery disease

Pau Federico Zaragoza. , Teresa Castelló Viguer, Luis Martínez Ortiz de Urbina, Ana Planas del Viejo, Enrique Peris Domingo y Francisco Pomar Domingo

Servicio de Cardiología, Hospital Universitario La Ribera, Alzira, Valencia, España

RESUMEN

Introducción y objetivos: El diagnóstico invasivo de la vasorreactividad y la función microvascular puede resultar de utilidad para optimizar el manejo de los pacientes con signos o síntomas de isquemia miocárdica en ausencia de estenosis coronarias significativas (INOCA). Se analizó la prevalencia de los distintos endotipos y la concordancia entre 2 métodos diagnósticos basados en la termodilución.

Métodos: Se incluyeron de forma prospectiva 60 pacientes con INOCA a quienes se realizó un test de vasorreactividad con acetilcolina intracoronaria, medida del flujo absoluto (Q) y la resistencia microvascular mínima (R) por termodilución continua y, por último, se calcularon la reserva de flujo coronario (RFC) y el índice de resistencia microvascular (IRM) por termodilución con bolos. Se consideraron como patológicos los puntos de corte establecidos de RFC < 2 e IRM ≥ 25.

Resultados: El procedimiento diagnóstico funcional invasivo permitió clasificar a los pacientes en 4 subgrupos: disfunción microvascular (40%), vasoespasmo epicárdico (17%), trastorno mixto (20%) y estudio normal (23%). No se observó correlación entre Q y RFC. Mediante curvas ROC se estimó una R > 435 UW como el punto de corte óptimo para identificar pacientes con IRM ≥ 25, con un área bajo la curva de 0,67 (IC95%, 0,51-0,82; p = 0,04).

Conclusiones: El estudio invasivo de la vasorreactividad y la microcirculación fue factible y seguro. La prevalencia de vasoespasmo y de disfunción microvascular en pacientes con INOCA fue elevada. El análisis conjunto de RFC, IRM y Q permitió desenmascarar un subtipo de disfunción microvascular caracterizado por un flujo coronario basal anormalmente elevado. La concordancia entre la resistencia microvascular obtenida por termodilución continua respecto al método de referencia fue baja, por lo que se requieren futuros estudios para determinar la utilidad de esta técnica.

Palabras clave: Disfunción microvascular. Vasoespasmo. Acetilcolina. Termodilución continua. Resistencia microvascular. INOCA.

ABSTRACT

Introduction and objectives: Invasive diagnosis of vasoreactivity and microvascular function may be useful to optimize the management of patients with signs and/or symptoms of myocardial ischemia in the absence of significant coronary stenosis (INOCA). We analyzed the prevalence of the different endotypes, as well as the concordance between 2 diagnostic methods based on thermodilution assessment.

Methods: We prospectively included 60 patients with INOCA who underwent a vasoreactivity test with intracoronary acetylcholine, and measurement of absolute coronary blood flow (Q) and minimum microvascular resistance (R) using continuous thermodilution assessment. Finally, calculations of the coronary flow reserve (CFR) and index of microcirculatory resistance index (IMR) were made using the bolus thermodilution method considering CFR < 2 and MRI ≥ 25 as established pathological cut-off values.

Results: The invasive functional diagnostic procedure allowed patients to be categorized into 4 subgroups: microvascular dysfunction (40%), epicardial vasospasm (17%), mixed disorder (20%), and normal study (23%). No correlation was seen between the Q and the CFR. Using ROC curves, an R > 435 UW was estimated as the optimal cut-off value to identify patients with IMR ≥ 25 with an area under the curve of 0.67 (95%CI, 0.51-0.82; P = .04).

Conclusions: The invasive study of vasoreactivity and microcirculation was feasible and safe. Prevalence of vasospasm and microvascular dysfunction in patients with INOCA was high. The CFR/MRI/Q combined study allowed us to unmask a subtype of microvascular dysfunction characterized by an abnormally high coronary flow at baseline. The concordance seen between the microvascular resistance obtained by continuous thermodilution measurements and the reference method was low so future studies are justified to determine the usefulness of this technique.

Keywords: Microvascular dysfunction. Vasospasm. Acetylcholine. Continuous thermodilution measurements. Microvascular resistance. INOCA.

Abreviaturas INOCA: isquemia sin enfermedad coronaria obstructiva. IRM: índice de resistencia microvascular. Q: flujo coronario absoluto. R: resistencia coronaria microvascular. RFC: reserva de flujo coronario.

INTRODUCCIóN

En los últimos años se ha establecido el término INOCA (Ischemia with Non-Obstructive Coronary Arteries) para definir a los pacientes que presentan signos o síntomas de isquemia cardiaca sin enfermedad obstructiva coronaria significativa en la angiografía1. En estos pacientes, la disfunción microvascular coronaria o de los vasos epicárdicos podría ser el mecanismo fisiopatológico causante de los síntomas y de las alteraciones isquémicas2.

En la actualidad, el estudio invasivo de la función microvascular en pacientes con INOCA es una recomendación IIa en las guías de la Sociedad Europea de Cardiología3. Se basa en la medida de parámetros que reflejen su estado funcional o estructural, como la reserva de flujo coronario (RFC) miocárdico o el índice de resistencia microvascular (IRM)4.

Recientemente se ha descrito la posibilidad de medir el flujo absoluto coronario (Q) y la resistencia microvascular (R) mediante termodilución continua con infusión de solución salina fisiológica a través de un microcatéter coronario específico; una técnica con potenciales ventajas, como su independencia del operador y no requerir la inducción farmacológica de hiperemia5.

Con el presente trabajo se pretende estimar la prevalencia de los distintos endotipos de pacientes con INOCA y analizar la correlación entre las medidas obtenidas por termodilución continua y con el método clásico de termodilución con bolos intracoronarios de solución salina fisiológica.

MéTODOS

Se estudió de manera prospectiva y consecutiva a 60 pacientes remitidos por síntomas o signos de isquemia miocárdica que no presentaban estenosis coronarias significativas en la angiografía, bien por estimación visual (< 50%) o tras valoración funcional (índice de reposo de ciclo cardiaco completo [RFR] > 0,89 o reserva fraccional de flujo [RFF] > 0,80). Se excluyeron las valvulopatías graves, los síndromes coronarios agudos, la insuficiencia cardiaca descompensada y cualquier condición clínica o anatómica en la que no se considerara apropiado el estudio de la microcirculación y de la vasorreactividad.

Todos los estudios de vasorreactividad y microcirculación se realizaron de forma programada en un segundo tiempo, y se retiraron los nitratos y los antagonistas del calcio antes de la prueba.

La coronariografía se realizó de acuerdo con la práctica habitual, con acceso radial. Se administró un cóctel espasmolítico con 200 µg de nitroglicerina y la arteria objeto de evaluación fue la coronaria izquierda.

El estudio fue aprobado por el comité de ética institucional y se obtuvo el consentimiento informado de todos los pacientes.

Test de vasorreactividad

En primer lugar, se realizó el test de vasorreactividad. La monitorización de los pacientes incluyó derivaciones precordiales y los angiogramas basales se realizaron en 2 proyecciones. Seguidamente se procedió a la administración secuencial de acetilcolina a dosis crecientes de 2, 20 y 100 µg en bolo intracoronario durante 2 minutos. En caso de bradicardia significativa se interrumpió la inyección y si se consideró apropiado se volvió a inyectar más lentamente. Se efectuó angiograma de control tras cada dosis. Si los pacientes presentaron síntomas graves, cambios electrocardiográficos o espasmo epicárdico, se administraron 200 µg de nitroglicerina intracoronaria.

La prueba se consideró positiva según los criterios del grupo COVADIS (Coronary Vasomotor Disorders International Study Group): espasmo epicárdico en caso de dolor torácico, cambios electrocardiográficos y constricción ≥ 90%, y espasmo microvascular en caso de dolor torácico y cambios electrocardiográficos sin espasmo epicárdico ≥ 90%6.

Índices obtenidos con termodilución continua

Tras la administración de heparina no fraccionada (70 UI/kg) se introdujo una guía con sensor de presión-temperatura Pressure Wire X (Abbott, Estados Unidos), ecualizando las presiones a nivel del extremo distal del catéter y avanzando hasta posicionarla en el segmento distal de la arteria descendente anterior.

Se registró el índice de reposo del ciclo cardiaco completo para confirmar la ausencia de estenosis epicárdicas hemodinámicamente significativas (RFR > 0,89).

A continuación, se posicionó en el segmento proximal de la descendente anterior un microcatéter específico para infusión intracoronaria Rayflow (Hexacath, Francia). Una vez confirmado que el sensor de la guía se encontraba al menos 3 cm distal a la punta del microcatéter, mediante una bomba inyectora se inició la infusión de solución salina fisiológica intracoronaria a temperatura ambiente a dosis de 20 ml/min para inducir la hiperemia.

Se registraron las curvas de presión-temperatura con el software Coroventis (Abbott, Estados Unidos). Cuando se observó una estabilización de la caída de temperatura distal, se retiró el sensor hasta la punta del microcatéter para determinar la temperatura de infusión.

Seguidamente se detuvo la inyección de solución salina fisiológica y se obtuvieron de forma automatizada (figura 1) los valores de Q (l/min) y R (Unidades Wood).


Figura 1. Medidas por termodilución continua. Pd: presión distal; Q: flujo absoluto; Qi: flujo de infusión (ml/min); R: resistencia microvascular; T: temperatura distal; Ti: temperatura de infusión.

 

Índices obtenidos con termodilución con bolos de solución salina fisiológica

Una vez finalizado el estudio con termodilución continua y retirado el microcatéter Rayflow, se reubicó la guía de presión-temperatura en la posición previa y se procedió al registro de las curvas de termodilución con el software Coroventis, tras la inyección manual vigorosa de 3 bolos intracoronarios de 3 ml de solución salina fisiológica. Las medidas se efectuaron en reposo y tras la inducción de hiperemia con un bolo de regadenosón intravenoso por vía periférica (400 µg), con lo que se obtuvieron la RFC y el IRM.

Análisis estadístico

Las variables continuas se presentan como media ± desviación estándar o como mediana [rango intercuartílico], y las categóricas como valor absoluto o porcentaje. Se estimaron mediante curvas ROC (Receiver Operating Characteristic) los puntos de corte óptimos para las variables continuas Q y R. Se tomaron como referencia los puntos de corte establecidos como patológicos para RFC < 2 e IRM ≥ 25. Una vez dicotomizadas las variables Q y R, se contrastaron con los valores de RFC e IRM mediante pruebas de χ2. La comparación entre las diferentes variables cuantitativas se realizó empleando la prueba ANOVA de 1 vía. El análisis estadístico se efectuó con el programa SPSS v20 (IBM, Estados Unidos) y los resultados se consideraron significativos con valores de p < 0,05.

RESULTADOS

Pacientes en estudio

En la tabla 1 se describen las características basales de los 60 pacientes incluidos en el estudio, en quienes destacan un predominio de mujeres (55%) y una alta prevalencia de factores de riesgo cardiovascular. La mayoría presentaban clínica anginosa típica (76%) y tenían un test de isquemia positivo previo a la coronariografía (60%).

 

Tabla 1. Características clínicas y angiográficas (n = 60)

Edad (años) 63 ± 10
Mujeres 33 (55%)
Hipertensión 39 (65%)
Diabetes 21 (35%)
Dislipemia 35 (58%)
Tabaquismo (actual o pasado) 28 (47%)
Revascularización percutánea previa 4 (7%)
Infarto de miocardio previo 3 (5%)
Disfunción sistólica ventricular izquierda 4 (7%)
Fracción de eyección (%) 63 ± 8
Presentación clínica  
   Angina de esfuerzo 19 (32%)
   Angina de reposo 13 (22%)
   Angina mixta 14 (23%)
   Otras 14 (24%)
Test de isquemia  
   Ergometría 19 (32%)
   Gammagrafía isotópica 18 (30%)
   Eco-dobutamina 3 (5%)
   Ninguno 20 (33%)
Coronariografía  
   Ateromatosis 22 (37%)
   Flujo lento 13 (22%)

Los datos expresan n (%) o media ± desviación estándar.

 

En la angiografía coronaria basal, un 37% mostraban irregularidades parietales compatibles con ateromatosis y un 22% flujo coronario lentificado. Se confirmó que los valores de RFF y RFR eran normales en todos los casos.

Vasorreactividad coronaria

Tal como se muestra en la tabla 2, un 60% de los casos (36/60) tuvieron respuesta positiva a la acetilcolina en el test de vasorreactividad. Un 32% (19/60) mostraron vasoconstricción epicárdica grave y un 23% (14/60) tuvieron criterios de espasmo microvascular. En 3 pacientes (5%) se observó de forma concomitante espasmo microvascular con la dosis media (20 µg) y espasmo epicárdico con la dosis alta (100 µg), lo que unido a las alteraciones de los índices de función microvascular resultó compatible con un endotipo mixto.

 

Tabla 2. Datos del procedimiento

Test de vasorreactividad patológico 36 (60%)
   Vasoespasmo epicárdico 19 (32%)
   Vasoespasmo microvascular 14 (23%)
   Vasoespasmo combinado 3 (5%)
Disfunción microvascular estructural (IRM ≥ 25) 20 (33%)
   Aislada 5 (8%)
   Asociada a espasmo epicárdico 8 (13%)
   Asociada a espasmo microvascular 4 (7%)
   Asociada a espasmo combinado 3 (5%)
RFC < 2 11 (18%)
RFC < 2,5 17 (28%)
RFR 0,93 [0,91-0,94]
RFF 0,90 [0,87-0,93]
Q (ml/min) 170 [138-219]
R (UW) 496 [381-654]
RFC 3,0 [2,3-4,2]
IRM 20 [12-28]

Los datos expresan n (%) o mediana [rango intercuartílico].
IRM: índice de resistencia microvascular; Q: flujo absoluto; R: resistencia microvascu­lar; RFC: reserva de flujo coronario; RFF: reserva fraccional de flujo; RFR: índice de reposo de ciclo cardiaco completo.

 

Índices de función microvascular

Ambos estudios, termodilución con bolos y termodilución con infusión continua, pudieron realizarse sin incidencias en todos los pacientes. En la tabla 2 se muestran los valores de las medidas de función microvascular obtenidas con ambas técnicas.

En el estudio con infusión continua se registró una mediana de flujo absoluto en la descendente anterior de 170 ml/min [138-219 ml/min], mientras que la mediana de resistencia microvascular fue de 496 UW [381-654 UW].

Un 18% de los pacientes (11/60) tenían una RFC reducida (RFC < 2) y un 33% (20/60) mostraron resistencias elevadas (IRM ≥ 25).

El grupo de pacientes con disfunción microvascular por RFC baja con IRM normal (7/60, 12%), respecto a los casos con disfunción microvascular por IRM alto con RFC normal (16/60, 27%), presentaba un perfil clínico con menor edad media (61 ± 11 frente a 66 ± 8 años) y mayor predominio de mujeres (86 frente a 58%), si bien esta tendencia no alcanzó significación estadística.

En la tabla 3 se muestran los tiempos medios de tránsito (Tmn) de las pruebas de termodilución con bolos. Los casos con RFC baja mostraron un Tmn basal significativamente reducido (0,48 ± 0,45 frente a 1,13 ± 0,70 s), especialmente el subgrupo de pacientes con RFC baja y Q alto (0,31 ± 0,15 frente a 0,77 ± 0,68 s).

 

Tabla 3. Tiempos de tránsito medios obtenidos por termodilución con bolos

  Global
(n = 60)
RFC < 2
(n = 11)
RFC < 2
Q > 170
(n = 7)
RFC < 2
Q < 170
(n = 4)
Tmn basal 1,13 ± 0,70 0,48 ± 0,45* 0,31 ± 0,15* 0,77 ± 0,68
Tmn hiperémico 0,36 ± 0,25 0,35 ± 0,28 0,25 ± 0,14 0,51 ± 0,41

Valores (en segundos) expresados como media ± desviación estándar.
RFC: reserva de flujo coronario; Q: flujo absoluto; Tmn: tiempo medio de tránsito.
* p < 0,05 para la comparación con el resto de la muestra.

 

En la figura 2 se presentan los datos de flujo coronario estimado por la medida del Tmn, divididos en 3 grupos en función de los resultados de RFC e IRM. Es interesante observar que los pacientes con RFC baja sin resistencias elevadas presentaron flujos en reposo significativamente altos y flujos hiperémicos sin diferencias significativas respecto al resto, mientras que en los pacientes con RFC baja y resistencias elevadas se observó el fenómeno contrario.


Figura 2. Flujo medio basal e hiperémico calculado a partir del Tmn (1 / Tmn) y agrupado según el resultado de RFC e IRM. Valores expresados como s−1. IRM: índice de resistencia microvascular; RFC: reserva de flujo coronario; Tmn: tiempo medio de tránsito.
* p < 0,05.

 

Endotipos

En la figura 3A se muestran los porcentajes de endotipos en función del resultado del test de acetilcolina y las medidas de RFC e IRM. El patrón más frecuente fue el de disfunción microvascular (24/60, 40%), seguido del estudio normal (14/60, 23%). En un 20% de los pacientes (12/60) se solapaba la disfunción microvascular con el vasoespasmo epicárdico, mientras que un 17% (10/60) presentaron vasoespasmo epicárdico aislado.


Figura 3. A: clasificación por endotipos. Valores expresados como número absoluto y porcentaje. B: valores medios de flujo absoluto y resistencia microvascular agrupados por endotipos. Q: flujo absoluto; R: resistencia microvascular.
* p < 0,05 respecto a estudio normal.

 

En la tabla 4 se puede observar que los mecanismos de disfunción vasomotora y microvascular se superponen en muchos casos.

 

Tabla 4. Resultados del test de acetilcolina y del estudio por termodilución con bolos (n = 60)

Espasmo epicárdico Espasmo microvascular IRM ≥ 25 RFC < 2 Endotipo Casos
Normal 14 (23,3%)
+ Vasoespasmo epicárdico 10 (16,7%)
+ Disfunción microvascular 9 (15,0%)
+ Disfunción microvascular 5 (8,3%)
+ Disfunción microvascular 5 (8,3%)
+ + Disfunción microvascular 3 (5,0%)
+ + Disfunción microvascular 1 (1,6%)
+ + + Disfunción microvascular 1 (1,6%)
+ + Trastorno mixto 6 (10,0%)
+ + + Trastorno mixto 2 (3,3%)
+ + + Trastorno mixto 2 (3,3%)
+ + Trastorno mixto 1 (1,6%)
+ + + + Trastorno mixto 1 (1,6%)

Los datos expresan n (%).
RFC: reserva de flujo coronario; IRM: índice de resistencia microvascular.

 

La asociación de vasoespasmo epicárdico con disfunción microvascular estructural (IRM ≥ 25) fue la combinación más prevalente en los casos de trastorno mixto (11/12). Este endotipo, a su vez, en las medidas por termodilución continua presentaba diferencias significativas respecto al patrón normal, con valores de flujo absoluto reducidos y resistencias elevadas (figura 3B) que sugieren un daño estructural y funcional más grave.

Concordancia entre los diferentes índices de función microvascular

El análisis mediante curva ROC del flujo absoluto Q respecto a la RFC < 2 determinó un punto de corte óptimo de 170 ml/min (sensibilidad del 64% y especificidad del 53%), con un área bajo la curva de 0,50 (intervalo de confianza del 95% [IC95%], 0,33-0,66; p = 0,97), por lo que no mostraba utilidad diagnóstica.

Dada la propuesta reciente de considerar el punto de corte de RFC < 2,57, se realizó el análisis tomando como referencia este umbral e igualmente no se halló una concordancia significativa (área bajo la curva de 0,45 [IC95%, 0,30-0,61; p = 0,56]).

En cuanto a la R respecto al IRM, se obtuvo un área bajo la curva de 0,67 (IC95%, 0,51-0,82; p = 0,04), con lo que presentaba una concordancia diagnóstica débil, aunque significativa (figura 4). El valor de corte óptimo estimado fue de 435 UW, con una sensibilidad del 81% y una especificidad del 57%. El 66% de los casos con IRM ≥ 25 se clasificaban correctamente con este índice.


Figura 4. Análisis del punto de corte R > 435 UW para predecir IRM ≥ 25 y gráfico de dispersión que muestra la correlación entre IRM y R. IRM: índice de resistencia microvascular; R: resistencia microvascular.

 

En las pruebas de correlación se confirmó la ausencia de asociación entre Q y RFC (rho de Spearman = −0,02; IC95%, −0,24-0,25; p = 0,99). En cambio, sí se observó una correlación débil, pero significativa, entre Q y Tmn hiperémico (rho de Spearman = −0,28; IC95%, −0,01-0,51; p = 0,04), al igual que entre R e IRM (rho de Spearman = 0,28; IC95%, 0,04-0,51; p = 0,03).

Complicaciones

Durante el test de vasorreactividad se registraron 3 casos (5%) de bradicardia transitoria sin repercusión clínica y 2 episodios (4%) de fibrilación auricular, uno de ellos autolimitado y el otro precisó sedación y cardioversión eléctrica. Tras la administración de regadenosón, la mayoría de los pacientes experimentaron algún grado de malestar, bien tolerado y revertido con la administración de 100 mg de teofilina por vía intravenosa. No se observaron otras complicaciones ni efectos adversos.

DISCUSIóN

El presente estudio confirma que un elevado porcentaje de pacientes con síntomas o signos de INOCA tiene disfunción microvascular o vasoespasmo en el estudio funcional invasivo, y que la realización de este es factible y segura (figura 5).


Figura 5. Diseño del estudio, clasificación por endotipos y análisis mediante curva ROC. AUC: área bajo la curva; INOCA: isquemia sin enfermedad coronaria obstructiva; IRM: índice de resistencia microvascular; Q: flujo absoluto; R: resistencia microvascular; RFC: reserva de flujo coronario.
* p < 0,05.

 

La proporción de pacientes con alteraciones de la microcirculación o de la vasomotilidad en nuestro trabajo (77%) se encuentra en la línea de lo observado en estudios previos de pacientes con angina sin enfermedad coronaria obstructiva (64-89%)8-11.

Test de vasorreactividad

Algunos grupos emplean de forma sistemática en el test de vasorreactividad la dosis de 200 µg de acetilcolina intracoronaria; en nuestro estudio se estableció la dosis alta en 100 µg de acuerdo con el grupo COVADIS, el protocolo del CorMicA y el documento técnico de la Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología, en el que se destacan sus altas sensibilidad y especificidad (90 y 99%, respectivamente)12. De hecho, la alta prevalencia de positivos en el test de acetilcolina (60%) encontrada en nuestro estudio es similar a la de otras series (57-71%)13-15. Feenstra et al.11, en un estudio con 110 pacientes, muestran que un 62% tuvieron test de acetilcolina patológico, con un 36% de vasoespasmo epicárdico y un 26% de espasmo microvascular.

Las complicaciones del test de vasorreactividad en nuestro estudio han sido pocas, 2 casos de fibrilación auricular (4%), lo que se corresponde con la incidencia comunicada en el estudio CorMicA (5%)9.

Prevalencia de endotipos

La disfunción microvascular aislada fue el endotipo más frecuente en nuestros pacientes (40%), pero en proporción menor que la observada en el estudio CorMicA, en el que fue del 52%. Estas diferencias podrían explicarse por la discrepancia en el porcentaje de angiografías totalmente normales (22% en CorMicA y 63% en nuestro estudio), debido a la posible asociación entre ateromatosis no obstructiva y disfunción microvascular16,17.

La prevalencia del resto de los endotipos es similar a la comunicada en CorMicA: vasoespasmo epicárdico aislado 17 frente a 17% y trastorno mixto 20 frente a 21%. Un metanálisis que incluyó 14.427 pacientes con INOCA muestra también porcentajes similares18.

Índices de función microvascular obtenidos por termodilución con bolos

El análisis del Tmn obtenido con esta técnica (figura 2), un parámetro que se correlaciona de forma inversa con la medida directa del flujo coronario19, pone de manifiesto un aspecto interesante que resulta concordante con los datos publicados por Nardone et al.20: los pacientes con RFC baja presentan 2 fenotipos diferenciados en función del IRM. Por una parte, los casos con RFC reducida y resistencias elevadas presentan flujo basal normal y flujo hiperémico bajo, lo que reflejaría una insuficiente respuesta vasodilatadora. Sin embargo, en los pacientes con resistencias normales, la RFC reducida se debe a un flujo en reposo anormalmente elevado, con flujo hiperémico en rango normal. Este fenómeno se observa también en el análisis de los pacientes con Q alto (tabla 3), en quienes la RFC reducida es atribuible a un flujo basal elevado en lugar de a una insuficiente respuesta hiperémica.

Por tanto, probablemente este subgrupo presenta una ineficiencia o disregulación del flujo miocárdico basal. Esta característica, de causa indeterminada, podría tener importantes implicaciones terapéuticas, como la falta de respuesta a fármacos vasodilatadores.

Índices de función microvascular obtenidos por termodilución continua

La evolución de la técnica de termodilución continua ha permitido que mediante un microcatéter y un software específico se puedan cuantificar Q y R de una manera simple y precisa. Las principales ventajas de este método son su independencia del operador, su reproducibilidad y la inducción de hiperemia con solución salina fisiológica sin necesidad de agentes farmacológicos21-24. Sin embargo, su principal limitación es la ausencia de unos valores normales de referencia.

En nuestro estudio, la falta de correlación entre Q y RFC se podría justificar por las variaciones descritas del flujo miocárdico basal. Para el cálculo de la RFC se requiere la estimación del flujo coronario basal, mientras que Q es una medida representativa del flujo hiperémico.

La débil concordancia entre Q y Tmn hiperémico y entre R e IRM que se observó en nuestro trabajo pone de manifiesto la dificultad de establecer unos puntos de corte válidos para la comparación entre pacientes con estos índices.

Con un valor de corte óptimo de R en nuestro estudio de 435 UW (sensibilidad del 81% y especificidad del 57%), el 66% de los casos con IRM ≥ 25 se clasificaban correctamente con este índice. Este valor es algo menor que el indicado por Rivero et al.25, quienes analizaron 120 pacientes y encontraron que una R > 500 UW clasificaba correctamente el 80% de los casos con IRM ≥ 25. Konst et al.26 evaluaron 84 pacientes con INOCA mediante las 2 técnicas de termodilución y no encontraron correlación entre Q y R con el IRM.

Las diferencias observadas podrían explicarse porque los valores cuantitativos de Q y R presentan una gran variabilidad entre individuos, en principio atribuible a su dependencia de la masa miocárdica. No obstante, en estudios con tomografía de emisión de positrones, incluso ajustando los valores de flujo y resistencia a la masa miocárdica, se observaron igualmente rangos considerables. Por tanto, se ha especulado con que la hipótesis más plausible es la variación natural de la perfusión miocárdica hiperémica entre individuos27.

En este sentido, se están desarrollando indicadores, como la RFC estimada por termodilución continua y la reserva de resistencia microvascular, que relacionan los valores absolutos de flujo y resistencia registrados en hiperemia con los obtenidos en reposo. Estos nuevos parámetros necesitarán ser validados en futuros estudios28,29.

Limitaciones

Los datos presentados deberían ser interpretados teniendo en cuenta que se trata de un análisis observacional, unicéntrico y con una muestra pequeña, por lo que los resultados pueden estar afectados por factores de confusión propios de este tipo de estudios.

La arteria descendente anterior se consideró el vaso diana preespecificado, pero en la práctica habitual podría resultar apropiado valorar otras arterias en caso de pruebas negativas y alta sospecha clínica1.

No está establecida la secuencia idónea en el estudio funcional invasivo1. En nuestro caso se optó por realizar el test de acetilcolina en primer lugar, con la idea de minimizar la instrumentalización de la arteria y que la guía no indujera una mayor vasorreactividad. Como contrapartida, el espasmo y los síntomas durante el test de provocación, aunque transitorios, podrían interferir con las posteriores medidas de función microvascular. La posibilidad de determinar la RFC por termodilución continua se estableció con posterioridad al inicio de nuestro estudio, y se asumió que la comparación entre la RFC obtenida con ambas técnicas hubiera resultado más apropiada.

En la mayoría de los estudios de termodilución con bolos se usa adenosina intravenosa para inducir la hiperemia. Nosotros optamos por el regadenosón por su facilidad de uso, nuestra experiencia previa y la evidencia que avala su equivalencia respecto a la adenosina30,31.

Por último, no se puede obviar que se trata de un estudio invasivo, por lo que deben sopesarse los riesgos de la exploración y no se ha demostrado hasta la fecha que su realización tenga impacto pronóstico.

CONCLUSIONES

El estudio invasivo de la vasorreactividad y la microcirculación coronaria es factible y seguro. Estos estudios permiten reconocer fácilmente los diferentes endotipos de pacientes con INOCA y ayudan a optimizar su tratamiento.

El análisis conjunto de RFC, IRM y Q puede desenmascarar un subtipo de disfunción microvascular caracterizado por un flujo coronario basal anormalmente elevado.

Los nuevos índices obtenidos por termodilución continua muestran una baja concordancia con los índices de referencia y se requerirán futuros estudios para determinar la utilidad de esta técnica.

FINANCIACIóN

El presente trabajo no ha recibido ningún tipo de financiación.

CONTRIBUCIóN DE LOS AUTORES

Todos los autores han contribuido sustancialmente en la concepción, el diseño y la adquisición de datos del estudio, y han dado su aprobación a la versión final del artículo.

CONFLICTO DE INTERESES

Ninguno.

¿QUé SE SABE DEL TEMA?

  • El diagnóstico invasivo de la disfunción microvascular y el vasoespasmo coronario ha mostrado su utilidad para mejorar la calidad de vida de los pacientes sin enfermedad obstructiva en la coronariografía.
  • Los índices de disfunción microvascular obtenidos por termodilución continua ofrecen potenciales ventajas por ser independientes del operador, reproducibles y no requerir la inducción farmacológica de hiperemia.

¿QUé APORTA DE NUEVO?

  • El diagnóstico funcional invasivo coronario es factible y seguro, y demuestra la elevada prevalencia de alteraciones de la microcirculación y de la vasomotilidad en los pacientes sin enfermedad coronaria obstructiva.
  • El análisis conjunto de los distintos índices puede resultar de utilidad para caracterizar los casos con RFC disminuida.
  • Son necesarios futuros estudios para establecer la utilidad de las medidas de función microvascular obtenidas por termodilución continua.

BIBLIOGRAFíA

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* Autor para correspondencia.

Correo electrónico: pau@comv.es (P. Federico Zaragoza).

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  • afterRenderModule mod_custom (Article Herramientas Compartir) (258.3KB) (7.1ms)
  • beforeRenderRawModule mod_custom (Innovacion Herramientas Compartir) (6.36KB) (30μs)
  • afterRenderRawModule mod_custom (Innovacion Herramientas Compartir) (928B) (91μs)
  • beforeRenderModule mod_custom (Innovacion Herramientas Compartir) (736B) (3μs)
  • afterRenderModule mod_custom (Innovacion Herramientas Compartir) (204.58KB) (5.25ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Estadísticas) (3.52KB) (30μs)
  • afterRenderRawModule mod_custom (Article Herramientas Estadísticas) (928B) (88μs)
  • beforeRenderModule mod_custom (Article Herramientas Estadísticas) (736B) (2μs)
  • afterRenderModule mod_custom (Article Herramientas Estadísticas) (685.49KB) (22.68ms)
  • beforeRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (5.47KB) (32μs)
  • afterRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (928B) (91μs)
  • beforeRenderModule mod_custom (Innovacion Herramientas Estadísticas) (736B) (3μs)
  • afterRenderModule mod_custom (Innovacion Herramientas Estadísticas) (128.25KB) (4.32ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Material Adicional) (3.53KB) (28μs)
  • afterRenderRawModule mod_custom (Article Herramientas Material Adicional) (944B) (88μs)
  • beforeRenderModule mod_custom (Article Herramientas Material Adicional) (736B) (3μs)
  • afterRenderModule mod_custom (Article Herramientas Material Adicional) (169.11KB) (5.09ms)
  • beforeRenderRawModule mod_menu (Contenido) (4.88KB) (737μs)
  • afterRenderRawModule mod_menu (Contenido) (18.41KB) (745μs)
  • beforeRenderModule mod_menu (Contenido) (704B) (4μs)
  • afterRenderModule mod_menu (Contenido) (3.3KB) (155μs)
  • beforeRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (2.36KB) (44μs)
  • afterRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (6.73KB) (450μs)
  • beforeRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (752B) (4μs)
  • afterRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (5.39KB) (145μs)
  • beforeRenderRawModule mod_menu (Publicar) (1.38KB) (131μs)
  • afterRenderRawModule mod_menu (Publicar) (29.62KB) (832μs)
  • beforeRenderModule mod_menu (Publicar) (704B) (3μs)
  • afterRenderModule mod_menu (Publicar) (3.55KB) (124μs)
  • beforeRenderRawModule mod_menu (Sobre nosotros) (400B) (113μs)
  • afterRenderRawModule mod_menu (Sobre nosotros) (22.12KB) (737μs)
  • beforeRenderModule mod_menu (Sobre nosotros) (720B) (4μs)
  • afterRenderModule mod_menu (Sobre nosotros) (3.42KB) (128μs)
  • beforeRenderRawModule mod_menu (Publicaciones Permanyer) (384B) (112μs)
  • afterRenderRawModule mod_menu (Publicaciones Permanyer) (10.02KB) (457μs)
  • beforeRenderModule mod_menu (Publicaciones Permanyer) (720B) (3μs)
  • afterRenderModule mod_menu (Publicaciones Permanyer) (3.11KB) (123μs)
  • beforeRenderRawModule mod_menu (Footer Final ES) (4.28KB) (836μs)
  • afterRenderRawModule mod_menu (Footer Final ES) (27.89KB) (805μs)
  • beforeRenderModule mod_menu (Footer Final ES) (720B) (4μs)
  • afterRenderModule mod_menu (Footer Final ES) (3.55KB) (133μs)
  • afterRender (1.04MB) (69.26ms)
  • 1 x afterRenderModule mod_custom (Lo más compartido) (516.89KB) (39.55%)
    659ms
    1 x afterRenderModule mod_custom (Lo más leído) (1.13MB) (34.5%)
    575ms
    1 x afterRender (1.04MB) (4.16%)
    69.26ms
    1 x afterRenderComponent com_content (280.26KB) (3.06%)
    50.95ms
    1 x Before Access::getAssetRules (id:8 name:com_content) (1.23MB) (2.44%)
    40.71ms
    1 x afterInitialise (3.34MB) (2.21%)
    36.77ms
    1 x afterRenderModule mod_custom (Article Herramientas Estadísticas) (685.49KB) (1.36%)
    22.68ms
    1 x beforeRenderRawModule mod_breadcrumbs (Breadcrumbs ES) (1.07MB) (1.08%)
    17.94ms
    1 x afterRoute (514.16KB) (0.92%)
    15.30ms
    1 x afterRenderModule mod_custom (Header Article) (513.45KB) (0.84%)
    13.99ms
    1 x afterRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (98.42KB) (0.53%)
    8.77ms
    1 x afterRenderModule mod_custom (Article Herramientas Traducción) (256.53KB) (0.48%)
    7.96ms
    1 x afterRenderModule mod_custom (Article - Referencia ) (267.13KB) (0.46%)
    7.66ms
    1 x Before Access::getAssetRules (id:1 name:root.1) (403.9KB) (0.44%)
    7.38ms
    1 x afterRenderModule mod_custom (Article Herramientas Compartir) (258.3KB) (0.43%)
    7.10ms
    1 x afterRenderModule mod_custom (Debate Title) (380.8KB) (0.41%)
    6.80ms
    1 x afterRenderModule mod_custom (Article DOI activo) (256.56KB) (0.39%)
    6.57ms
    1 x afterRenderModule mod_custom (Article Subtitulo) (1.25MB) (0.38%)
    6.39ms
    1 x afterDispatch (366.61KB) (0.35%)
    5.83ms
    1 x afterRenderModule mod_custom (Article Category) (212.1KB) (0.33%)
    5.45ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Compartir) (204.58KB) (0.32%)
    5.25ms
    1 x afterRenderModule mod_custom (Article Herramientas Material Adicional) (169.11KB) (0.31%)
    5.09ms
    1 x afterRenderModule mod_custom (Foto Autor) (214.35KB) (0.3%)
    4.92ms
    1 x afterRenderModule mod_custom (Article Related contents) (167.99KB) (0.29%)
    4.91ms
    1 x afterRenderModule mod_custom (Article Authors) (150.82KB) (0.29%)
    4.88ms
    1 x afterRenderModule mod_custom (Article Translated Title) (148.94KB) (0.28%)
    4.69ms
    1 x afterRenderModule mod_custom (Separador) (119.41KB) (0.27%)
    4.55ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Traducción) (140.4KB) (0.27%)
    4.43ms
    1 x afterRenderModule mod_custom (Article Herramientas Descargar) (118.57KB) (0.26%)
    4.36ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Estadísticas) (128.25KB) (0.26%)
    4.32ms
    1 x afterRenderModule mod_custom (Article Title) (139.5KB) (0.26%)
    4.32ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Imprimir) (118.91KB) (0.26%)
    4.30ms
    1 x afterRenderModule mod_custom (Article Herramientas Imprimir) (119.06KB) (0.25%)
    4.24ms
    1 x afterRenderModule mod_custom (EMAIL Y TWITTER) (183.98KB) (0.25%)
    4.24ms
    1 x After Access::preloadPermissions (com_content) (963.7KB) (0.23%)
    3.86ms
    1 x afterLoad (74.86KB) (0.16%)
    2.60ms
    1 x beforeRenderRawModule mod_custom (Publicación de la Sociedad Española de Cardiología) (10.5KB) (0.13%)
    2.23ms
    1 x afterRenderRawModule mod_languages (Cambiar Idioma) (34.08KB) (0.09%)
    1.56ms
    1 x afterRenderRawModule mod_articles_good_search (Articles Good Search Total (Lateral)) (34.48KB) (0.07%)
    1.17ms
    1 x afterRenderRawModule mod_breadcrumbs (Breadcrumbs ES) (10.02KB) (0.06%)
    978μs
    1 x beforeRenderRawModule mod_menu (Footer Final ES) (4.28KB) (0.05%)
    836μs
    1 x afterRenderRawModule mod_menu (Publicar) (29.62KB) (0.05%)
    832μs
    1 x After Access::preloadComponents (all components) (129.18KB) (0.05%)
    831μs
    1 x afterRenderRawModule mod_menu (Footer Final ES) (27.89KB) (0.05%)
    805μs
    1 x Before Access::preloadComponents (all components) (35.46KB) (0.05%)
    789μs
    1 x beforeRenderRawModule mod_custom (Separador) (4.71KB) (0.05%)
    784μs
    1 x afterRenderRawModule mod_menu (Contenido) (18.41KB) (0.04%)
    745μs
    1 x beforeRenderRawModule mod_menu (Contenido) (4.88KB) (0.04%)
    737μs
    1 x afterRenderRawModule mod_menu (Sobre nosotros) (22.12KB) (0.04%)
    737μs
    1 x afterRenderRawModule mod_menu (Sidebar Menú ES) (9.53KB) (0.04%)
    631μs
    1 x afterRenderRawModule mod_menu (Sidebar - REC: Publications) (15.85KB) (0.03%)
    516μs
    1 x afterRenderRawModule mod_menu (Publicaciones Permanyer) (10.02KB) (0.03%)
    457μs
    1 x afterRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (6.73KB) (0.03%)
    450μs
    1 x afterRenderRawModule mod_custom (Header Article) (4.16KB) (0.02%)
    373μs
    1 x beforeRenderComponent com_content (12.8KB) (0.02%)
    344μs
    1 x afterRenderModule mod_breadcrumbs (Breadcrumbs ES) (4.09KB) (0.02%)
    326μs
    1 x afterRenderRawModule mod_lightbox (Lightbox) (8.16KB) (0.02%)
    297μs
    1 x beforeRenderRawModule mod_custom (Debate Title) (576B) (0.02%)
    271μs
    1 x beforeRenderRawModule mod_custom (Header Article) (1.6KB) (0.01%)
    200μs
    1 x afterRenderModule mod_custom (Home Concurso Hemodinamica) (4.48KB) (0.01%)
    195μs
    1 x beforeRenderRawModule mod_custom (Home Concurso Hemodinamica) (496B) (0.01%)
    190μs
    1 x afterRenderModule mod_articles_good_search (Articles Good Search Total (Lateral)) (10.48KB) (0.01%)
    156μs
    1 x afterRenderModule mod_dms3_refs (Article Herramientas Exportar) (3.27KB) (0.01%)
    155μs
    1 x afterRenderModule mod_menu (Contenido) (3.3KB) (0.01%)
    155μs
    1 x afterRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (5.39KB) (0.01%)
    145μs
    1 x afterRenderModule mod_languages (Cambiar Idioma) (4.13KB) (0.01%)
    133μs
    1 x afterRenderModule mod_menu (Footer Final ES) (3.55KB) (0.01%)
    133μs
    1 x afterRenderModule mod_custom (Publicación de la Sociedad Española de Cardiología) (2.81KB) (0.01%)
    132μs
    1 x beforeRenderRawModule mod_menu (Publicar) (1.38KB) (0.01%)
    131μs
    1 x afterRenderModule mod_menu (Sobre nosotros) (3.42KB) (0.01%)
    128μs
    1 x afterRenderModule mod_lightbox (Lightbox) (4.36KB) (0.01%)
    127μs
    1 x afterRenderRawModule mod_custom (Separador) (1.13KB) (0.01%)
    126μs
    1 x afterRenderModule mod_custom (Article - Disponible Online) (2.67KB) (0.01%)
    124μs
    1 x afterRenderModule mod_menu (Publicar) (3.55KB) (0.01%)
    124μs
    1 x afterRenderModule mod_menu (Publicaciones Permanyer) (3.11KB) (0.01%)
    123μs
    1 x afterRenderModule mod_menu (Sidebar Menú ES) (2.92KB) (0.01%)
    122μs
    1 x afterRenderModule mod_menu (Sidebar - REC: Publications) (3.45KB) (0.01%)
    117μs
    1 x afterRenderModule mod_custom (Factor de Impacto) (2.84KB) (0.01%)
    116μs
    1 x beforeRenderRawModule mod_menu (Sobre nosotros) (400B) (0.01%)
    113μs
    1 x beforeRenderRawModule mod_menu (Publicaciones Permanyer) (384B) (0.01%)
    112μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Traducción) (1.16KB) (0.01%)
    107μs
    1 x beforeRenderRawModule mod_lightbox (Lightbox) (6.94KB) (0.01%)
    105μs
    1 x afterRenderRawModule mod_custom (Publicación de la Sociedad Española de Cardiología) (1.09KB) (0.01%)
    99μs
    1 x beforeRenderRawModule mod_languages (Cambiar Idioma) (5.67KB) (0.01%)
    98μs
    1 x afterRenderRawModule mod_custom (EMAIL Y TWITTER) (1.02KB) (0.01%)
    98μs
    1 x After Access::getAssetRules (id:711 name:com_content.article.1082) (8.3KB) (0.01%)
    94μs
    1 x afterRenderRawModule mod_custom (Lo más compartido) (912B) (0.01%)
    93μs
    1 x afterRenderRawModule mod_custom (Article - Referencia ) (1.02KB) (0.01%)
    93μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Compartir) (928B) (0.01%)
    91μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (928B) (0.01%)
    91μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Traducción) (1.03KB) (0.01%)
    89μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Descargar) (992B) (0.01%)
    89μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (11.91KB) (0.01%)
    88μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Compartir) (928B) (0.01%)
    88μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Estadísticas) (928B) (0.01%)
    88μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Material Adicional) (944B) (0.01%)
    88μs
    1 x afterRenderRawModule mod_custom (Debate Title) (976B) (0.01%)
    86μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Imprimir) (928B) (0.01%)
    86μs
    1 x afterRenderRawModule mod_custom (Article Translated Title) (992B) (0.01%)
    84μs
    1 x afterRenderRawModule mod_custom (Article DOI activo) (1.02KB) (0%)
    81μs
    1 x afterRenderRawModule mod_custom (Article Title) (976B) (0%)
    81μs
    1 x afterRenderRawModule mod_custom (Foto Autor) (1.02KB) (0%)
    80μs
    1 x afterRenderRawModule mod_custom (Home Concurso Hemodinamica) (928B) (0%)
    80μs
    1 x afterRenderRawModule mod_custom (Article Authors) (976B) (0%)
    80μs
    1 x afterRenderRawModule mod_custom (Article Subtitulo) (976B) (0%)
    79μs
    1 x afterRenderRawModule mod_custom (Article Related contents) (3.41KB) (0%)
    79μs
    1 x afterRenderRawModule mod_custom (Article - Disponible Online) (2.23KB) (0%)
    78μs
    1 x afterRenderRawModule mod_custom (Factor de Impacto) (976B) (0%)
    77μs
    1 x afterRenderRawModule mod_custom (Article Category) (1.02KB) (0%)
    75μs
    1 x afterRenderRawModule mod_custom (Lo más leído) (912B) (0%)
    74μs
    1 x beforeRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (2.36KB) (0%)
    44μs
    1 x Before Access::getAssetRules (id:711 name:com_content.article.1082) (34.65KB) (0%)
    42μs
    1 x beforeRenderRawModule mod_articles_good_search (Articles Good Search Total (Lateral)) (9.48KB) (0%)
    37μs
    1 x beforeRenderRawModule mod_custom (Lo más compartido) (2.38KB) (0%)
    35μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (5.47KB) (0%)
    32μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Traducción) (2.11KB) (0%)
    31μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Compartir) (6.36KB) (0%)
    30μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Estadísticas) (3.52KB) (0%)
    30μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Material Adicional) (3.53KB) (0%)
    28μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Traducción) (1.48KB) (0%)
    27μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Imprimir) (1.39KB) (0%)
    27μs
    1 x beforeRenderRawModule mod_custom (EMAIL Y TWITTER) (1.66KB) (0%)
    27μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Compartir) (432B) (0%)
    27μs
    1 x beforeRenderRawModule mod_custom (Article Translated Title) (1.11KB) (0%)
    26μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Descargar) (1.45KB) (0%)
    26μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (1.48KB) (0%)
    26μs
    1 x beforeRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (2.83KB) (0%)
    24μs
    1 x After Access::getAssetRules (id:1 name:root.1) (6.48KB) (0%)
    23μs
    1 x beforeRenderRawModule mod_custom (Article - Disponible Online) (1.98KB) (0%)
    23μs
    1 x beforeRenderRawModule mod_custom (Article - Referencia ) (1.61KB) (0%)
    23μs
    1 x beforeRenderRawModule mod_custom (Foto Autor) (1.69KB) (0%)
    23μs
    1 x beforeRenderRawModule mod_custom (Article Title) (1.44KB) (0%)
    23μs
    1 x beforeRenderRawModule mod_custom (Article Subtitulo) (1.44KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Article Authors) (1.5KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Article Related contents) (1.23KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Article DOI activo) (1.22KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_menu (Sidebar Menú ES) (NANB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Factor de Impacto) (13.19KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_menu (Sidebar - REC: Publications) (880B) (0%)
    19μs
    1 x beforeRenderRawModule mod_custom (Lo más leído) (2.64KB) (0%)
    18μs
    1 x beforeRenderRawModule mod_custom (Article Category) (832B) (0%)
    17μs
    1 x Before Access::preloadPermissions (com_content) (1.79KB) (0%)
    11μs
    1 x After Access::getAssetRules (id:8 name:com_content) (1.28KB) (0%)
    9μs
    1 x beforeRenderModule mod_breadcrumbs (Breadcrumbs ES) (704B) (0%)
    5μs
    1 x beforeRenderModule mod_dms3_refs (Article Herramientas Exportar) (736B) (0%)
    5μs
    1 x beforeRenderModule mod_custom (Debate Title) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_articles_good_search (Articles Good Search Total (Lateral)) (752B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Sidebar Menú ES) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Sidebar - REC: Publications) (736B) (0%)
    4μs
    1 x beforeRenderModule mod_custom (Separador) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Contenido) (704B) (0%)
    4μs
    1 x beforeRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (752B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Sobre nosotros) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_custom (Header Article) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Footer Final ES) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_custom (Article - Disponible Online) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article - Referencia ) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Publicación de la Sociedad Española de Cardiología) (752B) (0%)
    3μs
    1 x beforeRenderModule mod_lightbox (Lightbox) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Factor de Impacto) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Home Concurso Hemodinamica) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Descargar) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Traducción) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Imprimir) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (EMAIL Y TWITTER) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Compartir) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Compartir) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Estadísticas) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Material Adicional) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_menu (Publicar) (704B) (0%)
    3μs
    1 x beforeRenderModule mod_menu (Publicaciones Permanyer) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article DOI activo) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Foto Autor) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Title) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Subtitulo) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_languages (Cambiar Idioma) (704B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Lo más leído) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Lo más compartido) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Traducción) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Translated Title) (736B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Authors) (720B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Herramientas Estadísticas) (736B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Category) (720B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Related contents) (736B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Imprimir) (736B) (0%)
    2μs
101 statements were executed, 26 of which were duplicates, 75 unique1.23s2.26MB
  • SELECT @@SESSION.sql_mode;149μs968B/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:308Copy
  • SELECT `data` FROM `yzfp0_session` WHERE `session_id` = ?155μs1008BParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:250Copy
  • SELECT `session_id` FROM `yzfp0_session` WHERE `session_id` = :session_id LIMIT 1142μs1.3KBParams/libraries/src/Session/MetadataManager.php:187Copy
  • INSERT INTO `yzfp0_session` (`session_id`,`guest`,`time`,`userid`,`username`,`client_id`) VALUES (:session_id, :guest, :time, :user_id, :username, :client_id)218μs944BParams/libraries/src/Session/MetadataManager.php:260Copy
  • SELECT `extension_id` AS `id`,`element` AS `option`,`params`,`enabled` FROM `yzfp0_extensions` WHERE `type` = 'component' AND `state` = 0 AND `enabled` = 1258μs1.73KB/libraries/src/Component/ComponentHelper.php:399Copy
  • SELECT `id`,`rules` FROM `yzfp0_viewlevels`125μs656B/libraries/src/Access/Access.php:955Copy
  • SELECT `b`.`id` FROM `yzfp0_usergroups` AS `a` LEFT JOIN `yzfp0_usergroups` AS `b` ON `b`.`lft` <= `a`.`lft` AND `b`.`rgt` >= `a`.`rgt` WHERE `a`.`id` = :guest178μs1.33KBParams/libraries/src/Access/Access.php:868Copy
  • SELECT `folder` AS `type`,`element` AS `name`,`params` AS `params`,`extension_id` AS `id` FROM `yzfp0_extensions` WHERE `enabled` = 1 AND `type` = 'plugin' AND `state` IN (0,1) AND `access` IN (:preparedArray1,:preparedArray2) ORDER BY `ordering`645μs21.48KBParams/libraries/src/Plugin/PluginHelper.php:294Copy
  • SELECT * FROM `yzfp0_languages` WHERE `published` = 1 ORDER BY `ordering` ASC226μs2.23KB/libraries/src/Language/LanguageHelper.php:177Copy
  • SELECT `element`,`name`,`client_id`,`extension_id` FROM `yzfp0_extensions` WHERE `type` = 'language' AND `state` = 0 AND `enabled` = 1185μs784B/libraries/src/Language/LanguageHelper.php:250Copy
  • SELECT `m`.`id`,`m`.`menutype`,`m`.`title`,`m`.`alias`,`m`.`note`,`m`.`link`,`m`.`type`,`m`.`level`,`m`.`language`,`m`.`browserNav`,`m`.`access`,`m`.`params`,`m`.`home`,`m`.`img`,`m`.`template_style_id`,`m`.`component_id`,`m`.`parent_id`,`m`.`path` AS `route`,`e`.`element` AS `component` FROM `yzfp0_menu` AS `m` LEFT JOIN `yzfp0_extensions` AS `e` ON `m`.`component_id` = `e`.`extension_id` WHERE ( (`m`.`published` = 1 AND `m`.`parent_id` > 0 AND `m`.`client_id` = 0) AND (`m`.`publish_up` IS NULL OR `m`.`publish_up` <= :currentDate1)) AND (`m`.`publish_down` IS NULL OR `m`.`publish_down` >= :currentDate2) ORDER BY `m`.`lft`1.66ms199.3KBParams/libraries/src/Menu/SiteMenu.php:166Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray1,:preparedArray2)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`435μs3.92KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `id` FROM `yzfp0_content` WHERE `alias` = :segment AND `catid` = :id210μs1.34KBParams/components/com_content/src/Service/Router.php:263Copy
  • SELECT `id`,`home`,`template`,`s`.`params`,`inheritable`,`parent` FROM `yzfp0_template_styles` AS `s` LEFT JOIN `yzfp0_extensions` AS `e` ON `e`.`element` = `s`.`template` AND `e`.`type` = 'template' AND `e`.`client_id` = `s`.`client_id` WHERE `s`.`client_id` = 0 AND `e`.`enabled` = 1278μs1.23KB/administrator/components/com_templates/src/Model/StyleModel.php:775Copy
  • SELECT s.id, s.template, s.home, s.title AS long_title, s.params FROM yzfp0_template_styles AS s WHERE s.client_id = 0 AND s.template = 'g5_helium' ORDER BY s.id202μs1.17KB/libraries/gantry5/src/classes/Gantry/Joomla/StyleHelper.php:69Copy
  • SELECT `id`,`name`,`rules`,`parent_id` FROM `yzfp0_assets` WHERE `name` IN (:preparedArray1,:preparedArray2,:preparedArray3,:preparedArray4,:preparedArray5,:preparedArray6,:preparedArray7,:preparedArray8,:preparedArray9,:preparedArray10,:preparedArray11,:preparedArray12,:preparedArray13,:preparedArray14,:preparedArray15,:preparedArray16,:preparedArray17,:preparedArray18,:preparedArray19,:preparedArray20,:preparedArray21,:preparedArray22,:preparedArray23,:preparedArray24,:preparedArray25,:preparedArray26,:preparedArray27,:preparedArray28,:preparedArray29,:preparedArray30,:preparedArray31,:preparedArray32,:preparedArray33,:preparedArray34,:preparedArray35,:preparedArray36,:preparedArray37,:preparedArray38,:preparedArray39,:preparedArray40,:preparedArray41,:preparedArray42,:preparedArray43,:preparedArray44,:preparedArray45)520μs7.81KBParams/libraries/src/Access/Access.php:357Copy
  • SELECT `id`,`name`,`rules`,`parent_id` FROM `yzfp0_assets` WHERE `name` LIKE :asset OR `name` = :extension OR `parent_id` = 02.71ms94.73KBParams/libraries/src/Access/Access.php:301Copy
  • SHOW FULL COLUMNS FROM `yzfp0_content`321μs1.77KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:587Copy
  • UPDATE `yzfp0_content` SET `hits` = (`hits` + 1) WHERE `id` = '1082'397μs48B/libraries/src/Table/Table.php:1348Copy
  • SELECT `a`.`id`,`a`.`asset_id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`state`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`version`,`a`.`ordering`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`metadata`,`a`.`featured`,`a`.`language`,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`fp`.`ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1) AS `rating`,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE ( (`a`.`id` = :pk AND `c`.`published` > 0 AND `a`.`language` IN (:preparedArray1,:preparedArray2)) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp)) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`state` IN (:preparedArray3,:preparedArray4)354μs110.19KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`361μs3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)455μs3.98KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SHOW FULL COLUMNS FROM `yzfp0_users`387μs1.58KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:587Copy
  • SELECT * FROM `yzfp0_users` WHERE `id` = :userid202μs3.16KBParams/libraries/src/Table/User.php:106Copy
  • SELECT `g`.`id`,`g`.`title` FROM `yzfp0_usergroups` AS `g` INNER JOIN `yzfp0_user_usergroup_map` AS `m` ON `m`.`group_id` = `g`.`id` WHERE `m`.`user_id` = :muserid228μs1.37KBParams/libraries/src/Table/User.php:134Copy
  • SELECT * FROM `yzfp0_users` WHERE `id` = :userid165μs3.16KBParams/libraries/src/Table/User.php:106Copy
  • SELECT `g`.`id`,`g`.`title` FROM `yzfp0_usergroups` AS `g` INNER JOIN `yzfp0_user_usergroup_map` AS `m` ON `m`.`group_id` = `g`.`id` WHERE `m`.`user_id` = :muserid164μs1.37KBParams/libraries/src/Table/User.php:134Copy
  • SELECT `b`.`id` FROM `yzfp0_user_usergroup_map` AS `map` LEFT JOIN `yzfp0_usergroups` AS `a` ON `a`.`id` = `map`.`group_id` LEFT JOIN `yzfp0_usergroups` AS `b` ON `b`.`lft` <= `a`.`lft` AND `b`.`rgt` >= `a`.`rgt` WHERE `map`.`user_id` = :userId195μs1.33KBParams/libraries/src/Access/Access.php:868Copy
  • SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'articles' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id349μs1.48KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`394μs3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT DISTINCT a.id, a.title, a.name, a.checked_out, a.checked_out_time, a.note, a.state, a.access, a.created_time, a.created_user_id, a.ordering, a.language, a.fieldparams, a.params, a.type, a.default_value, a.context, a.group_id, a.label, a.description, a.required, a.only_use_in_subform,l.title AS language_title, l.image AS language_image,uc.name AS editor,ag.title AS access_level,ua.name AS author_name,g.title AS group_title, g.access as group_access, g.state AS group_state, g.note as group_note FROM yzfp0_fields AS a LEFT JOIN `yzfp0_languages` AS l ON l.lang_code = a.language LEFT JOIN yzfp0_users AS uc ON uc.id=a.checked_out LEFT JOIN yzfp0_viewlevels AS ag ON ag.id = a.access LEFT JOIN yzfp0_users AS ua ON ua.id = a.created_user_id LEFT JOIN yzfp0_fields_groups AS g ON g.id = a.group_id LEFT JOIN `yzfp0_fields_categories` AS fc ON fc.field_id = a.id WHERE ( (`a`.`context` = :context AND (`fc`.`category_id` IS NULL OR `fc`.`category_id` IN (:preparedArray1,:preparedArray2,:preparedArray3)) AND `a`.`access` IN (:preparedArray4,:preparedArray5)) AND (`a`.`group_id` = 0 OR `g`.`access` IN (:preparedArray6,:preparedArray7)) AND `a`.`state` = :state) AND (`a`.`group_id` = 0 OR `g`.`state` = :gstate) AND `a`.`only_use_in_subform` = :only_use_in_subform AND `a`.`language` IN (:preparedArray8,:preparedArray9) ORDER BY a.ordering ASC1.54ms53.69KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:164Copy
  • SELECT `field_id`,`value` FROM `yzfp0_fields_values` WHERE `field_id` IN (:preparedArray1,:preparedArray2,:preparedArray3,:preparedArray4,:preparedArray5,:preparedArray6,:preparedArray7,:preparedArray8,:preparedArray9,:preparedArray10,:preparedArray11,:preparedArray12,:preparedArray13,:preparedArray14,:preparedArray15,:preparedArray16,:preparedArray17,:preparedArray18,:preparedArray19,:preparedArray20,:preparedArray21,:preparedArray22,:preparedArray23,:preparedArray24,:preparedArray25,:preparedArray26,:preparedArray27,:preparedArray28,:preparedArray29,:preparedArray30,:preparedArray31,:preparedArray32,:preparedArray33,:preparedArray34,:preparedArray35,:preparedArray36,:preparedArray37,:preparedArray38,:preparedArray39,:preparedArray40,:preparedArray41,:preparedArray42,:preparedArray43,:preparedArray44,:preparedArray45,:preparedArray46,:preparedArray47,:preparedArray48,:preparedArray49) AND `item_id` = :itemid867μs7.45KBParams/administrator/components/com_fields/src/Model/FieldModel.php:739Copy
  • SELECT a.id,a.asset_id,a.title,a.alias,a.introtext,a.fulltext,a.state,a.catid,a.created,a.created_by,a.created_by_alias,CASE WHEN a.modified = '0000-00-00 00:00:00' THEN a.created ELSE a.modified END as modified,a.modified_by,a.checked_out,a.checked_out_time,a.publish_up,a.publish_down,a.images,a.urls,a.attribs,a.version,a.ordering,a.metakey,a.metadesc,a.access,a.hits,a.metadata,a.featured,a.language,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`lft` AS `category_lft`,`c`.`lft` AS `category_ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,ROUND(v.rating_sum / v.rating_count, 0) AS rating,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `v`.`content_id` = `a`.`id` WHERE `a`.`id` = 1110 AND `c`.`published` > 0 AND (`a`.`state` = 1 AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= '2025-04-03 05:36:52') AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` = '0000-00-00 00:00:00' OR `a`.`publish_down` > '2025-04-03 05:36:52'))402μs111.44KB/libraries/regularlabs/src/Article.php:94Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`294μs3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `a`.`id`,`a`.`asset_id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`state`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`version`,`a`.`ordering`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`metadata`,`a`.`featured`,`a`.`language`,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`fp`.`ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1) AS `rating`,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE ( (`a`.`id` = :pk AND `c`.`published` > 0 AND `a`.`language` IN (:preparedArray1,:preparedArray2)) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp)) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`state` IN (:preparedArray3,:preparedArray4)429μs110.23KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)346μs3.98KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT c.id FROM yzfp0_content AS c LEFT JOIN yzfp0_fields_values AS f1 ON c.id = f1.item_id AND f1.field_id = (SELECT id FROM yzfp0_fields WHERE name = "orden-nuevo") LEFT JOIN yzfp0_fields_values AS f2 ON c.id = f2.item_id AND f2.field_id = (SELECT id FROM yzfp0_fields WHERE name = "dms3-volumen") LEFT JOIN yzfp0_fields_values AS f3 ON c.id = f3.item_id AND f3.field_id = (SELECT id FROM yzfp0_fields WHERE name = "dms3-numero") WHERE c.language = 'es-ES' AND f1.value = '7' AND f2.value = '5' AND f3.value = '4' LIMIT 17.07ms536B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:168Copy
  • SELECT c.id FROM yzfp0_content AS c LEFT JOIN yzfp0_fields_values AS f1 ON c.id = f1.item_id AND f1.field_id = (SELECT id FROM yzfp0_fields WHERE name = "orden-nuevo") LEFT JOIN yzfp0_fields_values AS f2 ON c.id = f2.item_id AND f2.field_id = (SELECT id FROM yzfp0_fields WHERE name = "dms3-volumen") LEFT JOIN yzfp0_fields_values AS f3 ON c.id = f3.item_id AND f3.field_id = (SELECT id FROM yzfp0_fields WHERE name = "dms3-numero") WHERE c.language = 'es-ES' AND f1.value = '5' AND f2.value = '5' AND f3.value = '4' LIMIT 15.45ms536B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:168Copy
  • SELECT `catid`,`alias`,`language` FROM `yzfp0_content` WHERE `id` = '1072'180μs656B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:227Copy
  • SELECT `alias` FROM `yzfp0_categories` WHERE `id` = '81'121μs536B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:239Copy
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  • SELECT `alias` FROM `yzfp0_categories` WHERE `id` = '38'132μs536B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:239Copy
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  • SELECT `language`,`id` FROM `yzfp0_menu` WHERE `home` = '1' AND `published` = 1 AND `client_id` = 0274μs624B/libraries/src/Language/Multilanguage.php:123Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id230μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id144μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `c2`.`language`,CONCAT_WS(':', `c2`.`id`, `c2`.`alias`) AS `id`,CONCAT_WS(':', `ca`.`id`, `ca`.`alias`) AS `catid` FROM `yzfp0_content` AS `c` INNER JOIN `yzfp0_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `yzfp0_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `yzfp0_content` AS `c2` ON `a2`.`id` = `c2`.`id` INNER JOIN `yzfp0_categories` AS `ca` ON `c2`.`catid` = `ca`.`id` AND `ca`.`extension` = :extension2 WHERE `c`.`id` = :id AND c2.access IN (1,5) AND c2.language != 'es-ES' AND (c2.publish_up IS NULL OR c2.publish_up <= '2025-04-03 05:36:52') AND (c2.publish_down IS NULL OR c2.publish_down >= '2025-04-03 05:36:52') AND c2.state = 1324μs1.48KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT `m`.`id`,`m`.`title`,`m`.`module`,`m`.`position`,`m`.`content`,`m`.`showtitle`,`m`.`params`,`mm`.`menuid` FROM `yzfp0_modules` AS `m` LEFT JOIN `yzfp0_modules_menu` AS `mm` ON `mm`.`moduleid` = `m`.`id` LEFT JOIN `yzfp0_extensions` AS `e` ON `e`.`element` = `m`.`module` AND `e`.`client_id` = `m`.`client_id` WHERE ( ( (`m`.`published` = 1 AND `e`.`enabled` = 1 AND `m`.`client_id` = :clientId AND `m`.`access` IN (:preparedArray1,:preparedArray2)) AND (`m`.`publish_up` IS NULL OR `m`.`publish_up` <= :publishUp)) AND (`m`.`publish_down` IS NULL OR `m`.`publish_down` >= :publishDown)) AND (`mm`.`menuid` = :itemId OR `mm`.`menuid` <= 0) AND `m`.`language` IN (:preparedArray3,:preparedArray4) ORDER BY `m`.`position`,`m`.`ordering`1.37ms179.84KBParams/libraries/src/Cache/Controller/CallbackController.php:51Copy
  • SELECT `a`.`menutype`,`a`.`title` FROM `yzfp0_menu_types` AS `a` WHERE `a`.`client_id` = 0220μs1KB/libraries/gantry5/src/classes/Gantry/Framework/Menu.php:138Copy
  • SELECT m.id, m.alias, m.path AS route, m.level, m.parent_id FROM yzfp0_menu AS m WHERE m.menutype = 'menu-es-new' AND m.parent_id > 0 AND m.client_id = 0 AND m.published >= 0 ORDER BY m.lft375μs1.61KB/libraries/gantry5/src/classes/Gantry/Framework/Menu.php:791Copy
  • SHOW FULL COLUMNS FROM `yzfp0_content`336μs1.77KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:587Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[821] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[871] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 1082 LIMIT 1150μs592B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT category.id,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[263] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getUnpublishedCategoryIds\n[711] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_categories` AS `category` LEFT JOIN `yzfp0_categories` AS `parent` ON `category`.`parent_id` = `parent`.`id` WHERE `category`.`extension` = 'com_content' AND (`category`.`published` IN (0,-1,-2) OR `parent`.`published` IN (0,-1,-2)) GROUP BY category.id227μs592B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[883] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByFilters\n[329] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE ((`article`.`state` = 1 AND (`article`.`publish_up` IS NULL OR `article`.`publish_up` <= '2025-04-03 05:36:52') AND (`article`.`publish_down` IS NULL OR `article`.`publish_down` = '0000-00-00 00:00:00' OR `article`.`publish_down` > '2025-04-03 05:36:52')) AND `article`.`access` IN (1,5) AND `article`.`language` IN ('es-ES','*')) AND `article`.`id` = 1082 AND `article`.`catid` != 121 ORDER BY FIELD(article.id, 1082)184μs592B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[885] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[871] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 1082 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1129μs656B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)322μs3.98KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)309μs3.98KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id136μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`252μs3.94KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id133μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT field.name,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[834] RegularLabs.Plugin.System.ArticlesAnywhere.DataGroups.Field.getFieldNames\n[829] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_fields` AS `field` WHERE field.context = 'com_content.article'245μs33.81KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[821] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[871] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 1082 LIMIT 1166μs704B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`title` AS `article.title`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[885] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[871] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 1082 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1163μs768B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[885] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[871] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 1082 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1156μs11.69KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,`category`.`id` AS `category.id`,`category`.`title` AS `category.title`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[885] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[871] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` LEFT JOIN `yzfp0_categories` AS `category` ON `category`.`id` = `article`.`catid` WHERE `article`.`id` = 1082 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1192μs832B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)508μs3.98KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)478μs3.98KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT `c2`.`language`,`c2`.`id` FROM `yzfp0_menu` AS `c` INNER JOIN `yzfp0_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `yzfp0_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `yzfp0_menu` AS `c2` ON `a2`.`id` = `c2`.`id` WHERE `c`.`id` = :id343μs1.41KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT * FROM `yzfp0_fields` AS `a` WHERE a.state IN (:preparedArray1,:preparedArray2) AND `a`.`context` = 'com_content.article'451μs52.86KBParams/plugins/system/articlesanywhere/src/DataGroups/Helpers/Fields.php:105Copy
  • SELECT *,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[620] RegularLabs.Plugin.System.ArticlesAnywhere.DataGroups.Field.getFieldFromDatabase\n[800] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_fields` AS `field` WHERE field.context = 'com_content.article' AND `field`.`name` = 'dms3-content-type'363μs2.84KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT value.item_id,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[479] RegularLabs.Plugin.System.ArticlesAnywhere.DataGroups.Field.getWhere\n[700] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_fields_values` AS `value` INNER JOIN `yzfp0_fields` AS `field` ON `field`.`id` = `value`.`field_id` WHERE `field`.`name` = 'dms3-content-type' AND `field`.`state` = 1 AND `field`.`context` = 'com_content.article' AND `value`.`value` = 'dms3_article'2.85ms484.56KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[770] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByFilters\n[329] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` LEFT JOIN `yzfp0_fields` AS `field-dms3-content-type` ON `field-dms3-content-type`.`name` = 'dms3-content-type' AND `field-dms3-content-type`.`state` = 1 AND `field-dms3-content-type`.`context` = 'com_content.article' LEFT JOIN `yzfp0_fields_values` AS `field_value-dms3-content-type` ON `field_value-dms3-content-type`.`field_id` = `field-dms3-content-type`.`id` AND `field_value-dms3-content-type`.`item_id` = article.id WHERE ((`article`.`state` = 1 AND (`article`.`publish_up` IS NULL OR `article`.`publish_up` <= '2025-04-03 05:36:52') AND (`article`.`publish_down` IS NULL OR `article`.`publish_down` = '0000-00-00 00:00:00' OR `article`.`publish_down` > '2025-04-03 05:36:52')) AND `article`.`access` IN (1,5) AND `article`.`language` IN ('es-ES','*')) AND `article`.`id` IN 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AND `article`.`catid` != 121545ms236.56KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[800] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByArticleIds\n[301] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` IN (1259,3,4,5,6,7,8,9,10,11,12,13,15,16,21,22,23,31,36,37,1288,1287,1286,1279,1278,1277,1276,1303,261,1315,260,57,56,753,1053,1272,242,241,240,239,230,229,228,227,226,225,214,213,212,211,210,1309,1310,1311,1314,1322,1323,1324,1331,1332,1335,1298,1297,1293,1292,1291,1290,1265,1264,1263,1262,1258,1257,1256,1255,1251,1244,1234,1230,1229,1227,1224,1223,1222,1220,1214,1212,1211,1210,1209,1208,1207,1206,1205,1204,1199,1195,1190,1185,1184,1179,1178,1174,1165,1164,1163,1159,1158,1157,1156,1154,1153,1152,1151,1149,1148,1147,1144,1139,1138,1137,1135,1123,1119,1118,1117,1116,1115,1113,1107,1105,1104,1098,1097,1096,1095,1094,1091,1084,1083,1082,1081,1076,1075,1074,1073,1072,1066,1065,1060,1057,1052,1047,1046,1045,1044,1043,1037,1033,1032,1031,1027,1025,1024,1022,1020,1019,1016,1012,1010,1008,1007,1004,1003,1000,995,992,984,979,977,976,975,974,973,972,971,970,969,968,967,966,965,964,963,962,961,949,938,935,934,933,927,926,925,923,919,918,917,916,914,908,906,905,904,903,899,897,892,890,884,883,882,881,880,878,877,873,862,861,860,857,856,852,850,849,848,838,837,836,835,833,831,830,829,828,823,821,805,804,803,801,800,799,798,797,793,792,791,790,789,780,779,778,767,55,755,754,752,751,750,749,748,747,746,744,743,742,741,737,735,734,731,729,723,719,718,717,712,711,710,708,707,706,704,689,686,685,683,676,675,672,671,666,665,664,649,648,647,643,642,637,634,633,629,628,622,621,614,613,608,605,604,603,602,561,560,556,547,543,542,540,535,528,520,519,518,509,508,506,505,503,502,484,483,482,479,477,476,460,459,458,457,455,454,453,452,450,433,432,431,430,429,423,422,421,420,413,412,411,410,403,402,401,399,385,384,383,382,381,376,375,374,373,372,371,370,369,361,360,359,358,356,354,353,352,351,350,276,275,274,273,272,271,270,264,54,59,60,253,345,344,339,333,332,331,322,321,320,319,318,317,316,315,314,308,307,305,300,299,298,287,286,285,587,584,572,183,182,181,178,177,175,171,170,169,164,163,161,1261,847,846,1317,1260,663,607,570,569,567,566,565,564,563,562,493,492,491,438,437,436,435,434,283,258,256,255,254,184,174,173,172,166,165,160,159,158,149,148,147,139,138,137,136,134,133,132,131,130,124,121,119,116,115,113,2586,2589,2590,2591,2592,2594,2595,2596,2598,2599,2600,2605,2611,2612,2622,2623,2624,2625,2630,2632,2633,2634,2635,2638,2640,2641,2647,2648,2649,2650) AND `article`.`catid` != 121 ORDER BY `article`.`hits` IS NULL, CAST(`article`.`hits` AS CHAR(1)) = '', CAST(`article`.`hits` AS CHAR(10)) = '0000-00-00', CAST(`article`.`hits` AS SIGNED INTEGER) = 0, CAST(`article`.`hits` AS SIGNED INTEGER) DESC, `article`.`hits` DESC LIMIT 31.8ms624B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`title` AS `article.title`,`article`.`alias` AS `article.alias`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[808] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[871] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` IN (320,344,211) ORDER BY FIELD(article.id,320,344,211)282μs864B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`492μs3.97KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`439μs3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id188μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id220μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[800] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByArticleIds\n[301] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` LEFT JOIN `yzfp0_fields` AS `field-dms3-shares` ON `field-dms3-shares`.`name` = 'dms3-shares' AND `field-dms3-shares`.`state` = 1 AND `field-dms3-shares`.`context` = 'com_content.article' LEFT JOIN `yzfp0_fields_values` AS `field_value-dms3-shares` ON `field_value-dms3-shares`.`field_id` = `field-dms3-shares`.`id` AND `field_value-dms3-shares`.`item_id` = article.id WHERE `article`.`id` IN (1259,3,4,5,6,7,8,9,10,11,12,13,15,16,21,22,23,31,36,37,1288,1287,1286,1279,1278,1277,1276,1303,261,1315,260,57,56,753,1053,1272,242,241,240,239,230,229,228,227,226,225,214,213,212,211,210,1309,1310,1311,1314,1322,1323,1324,1331,1332,1335,1298,1297,1293,1292,1291,1290,1265,1264,1263,1262,1258,1257,1256,1255,1251,1244,1234,1230,1229,1227,1224,1223,1222,1220,1214,1212,1211,1210,1209,1208,1207,1206,1205,1204,1199,1195,1190,1185,1184,1179,1178,1174,1165,1164,1163,1159,1158,1157,1156,1154,1153,1152,1151,1149,1148,1147,1144,1139,1138,1137,1135,1123,1119,1118,1117,1116,1115,1113,1107,1105,1104,1098,1097,1096,1095,1094,1091,1084,1083,1082,1081,1076,1075,1074,1073,1072,1066,1065,1060,1057,1052,1047,1046,1045,1044,1043,1037,1033,1032,1031,1027,1025,1024,1022,1020,1019,1016,1012,1010,1008,1007,1004,1003,1000,995,992,984,979,977,976,975,974,973,972,971,970,969,968,967,966,965,964,963,962,961,949,938,935,934,933,927,926,925,923,919,918,917,916,914,908,906,905,904,903,899,897,892,890,884,883,882,881,880,878,877,873,862,861,860,857,856,852,850,849,848,838,837,836,835,833,831,830,829,828,823,821,805,804,803,801,800,799,798,797,793,792,791,790,789,780,779,778,767,55,755,754,752,751,750,749,748,747,746,744,743,742,741,737,735,734,731,729,723,719,718,717,712,711,710,708,707,706,704,689,686,685,683,676,675,672,671,666,665,664,649,648,647,643,642,637,634,633,629,628,622,621,614,613,608,605,604,603,602,561,560,556,547,543,542,540,535,528,520,519,518,509,508,506,505,503,502,484,483,482,479,477,476,460,459,458,457,455,454,453,452,450,433,432,431,430,429,423,422,421,420,413,412,411,410,403,402,401,399,385,384,383,382,381,376,375,374,373,372,371,370,369,361,360,359,358,356,354,353,352,351,350,276,275,274,273,272,271,270,264,54,59,60,253,345,344,339,333,332,331,322,321,320,319,318,317,316,315,314,308,307,305,300,299,298,287,286,285,587,584,572,183,182,181,178,177,175,171,170,169,164,163,161,1261,847,846,1317,1260,663,607,570,569,567,566,565,564,563,562,493,492,491,438,437,436,435,434,283,258,256,255,254,184,174,173,172,166,165,160,159,158,149,148,147,139,138,137,136,134,133,132,131,130,124,121,119,116,115,113,2586,2589,2590,2591,2592,2594,2595,2596,2598,2599,2600,2605,2611,2612,2622,2623,2624,2625,2630,2632,2633,2634,2635,2638,2640,2641,2647,2648,2649,2650) AND `article`.`catid` != 121 ORDER BY `field_value-dms3-shares`.`value` IS NULL, CAST(`field_value-dms3-shares`.`value` AS CHAR(1)) = '', CAST(`field_value-dms3-shares`.`value` AS CHAR(10)) = '0000-00-00', CAST(`field_value-dms3-shares`.`value` AS SIGNED INTEGER) = 0, CAST(`field_value-dms3-shares`.`value` AS SIGNED INTEGER) DESC, `field_value-dms3-shares`.`value` DESC LIMIT 3638ms624B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`title` AS `article.title`,`article`.`alias` AS `article.alias`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[808] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[871] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` IN (543,1314,354) ORDER BY FIELD(article.id,543,1314,354)256μs864B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`481μs3.97KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`400μs3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `a`.`id`,`a`.`asset_id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`state`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`version`,`a`.`ordering`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`metadata`,`a`.`featured`,`a`.`language`,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`fp`.`ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1) AS `rating`,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE ( (`a`.`id` = :pk AND `c`.`published` > 0 AND `a`.`language` IN (:preparedArray1,:preparedArray2)) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp)) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`state` IN (:preparedArray3,:preparedArray4)583μs110.23KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`title` AS `article.title`,`article`.`alias` AS `article.alias`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[885] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[871] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 1082 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1161μs832B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`hits` AS `article.hits`,'https://recintervcardiol.org/es/cardiopatia-isquemica/estudio-de-la-vasorreactividad-y-la-funcion-microvascular-por-termodilucion-en-ausencia-de-enfermedad-coronaria-obstructiva\n[885] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[871] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 1082 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1168μs656B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT * FROM `yzfp0_schemaorg` WHERE `itemId` = :itemId AND `context` = :context204μs1.55KBParams/plugins/system/schemaorg/src/Extension/Schemaorg.php:403Copy
  • SELECT `a`.`id`,`a`.`asset_id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`state`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`version`,`a`.`ordering`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`metadata`,`a`.`featured`,`a`.`language`,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`fp`.`ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1) AS `rating`,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE ( (`a`.`id` = :pk AND `c`.`published` > 0 AND `a`.`language` IN (:preparedArray1,:preparedArray2)) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp)) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`state` IN (:preparedArray3,:preparedArray4)573μs110.23KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
  • SELECT `a`.`id`,`a`.`asset_id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`state`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`version`,`a`.`ordering`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`metadata`,`a`.`featured`,`a`.`language`,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`fp`.`ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1) AS `rating`,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE ( (`a`.`id` = :pk AND `c`.`published` > 0 AND `a`.`language` IN (:preparedArray1,:preparedArray2)) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp)) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`state` IN (:preparedArray3,:preparedArray4)351μs110.23KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
  • SELECT SUM(CASE WHEN `a`.`next_execution` <= :now THEN 1 ELSE 0 END) AS due_count,SUM(CASE WHEN `a`.`locked` IS NULL THEN 0 ELSE 1 END) AS locked_count FROM `yzfp0_scheduler_tasks` AS `a` WHERE `a`.`state` = 1175μs1.37KBParams/administrator/components/com_scheduler/src/Model/TasksModel.php:465Copy
  • SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'head' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id334μs1.52KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT m.condition_id,m.item_id FROM yzfp0_conditions_map as m LEFT JOIN yzfp0_conditions as c ON c.id = m.condition_id WHERE `m`.`extension` = 'com_rereplacer' AND `c`.`published` = 1237μs576B/administrator/components/com_conditions/src/Model/ItemModel.php:821Copy
  • SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'body' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id477μs17.8KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `item_id` = '1082' AND `field_id` = 30251μs520B/tmp/regularlabs/custom_php/12820_af27ee991d0d77889539c6cba39057bf:36Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `item_id` = '1082' AND `field_id` = 19227μs536B/tmp/regularlabs/custom_php/12820_af27ee991d0d77889539c6cba39057bf:61Copy
  • SELECT a.id,a.asset_id,a.title,a.alias,a.introtext,a.fulltext,a.state,a.catid,a.created,a.created_by,a.created_by_alias,CASE WHEN a.modified = '0000-00-00 00:00:00' THEN a.created ELSE a.modified END as modified,a.modified_by,a.checked_out,a.checked_out_time,a.publish_up,a.publish_down,a.images,a.urls,a.attribs,a.version,a.ordering,a.metakey,a.metadesc,a.access,a.hits,a.metadata,a.featured,a.language,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`lft` AS `category_lft`,`c`.`lft` AS `category_ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,ROUND(v.rating_sum / v.rating_count, 0) AS rating,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `v`.`content_id` = `a`.`id` WHERE `a`.`id` = 1082 AND `c`.`published` > 0 AND (`a`.`state` = 1 AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= '2025-04-03 05:36:52') AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` = '0000-00-00 00:00:00' OR `a`.`publish_down` > '2025-04-03 05:36:52'))346μs108.94KB/libraries/regularlabs/src/Article.php:94Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `field_id` = 18 AND `item_id` = 10821.37ms536B/tmp/regularlabs/custom_php/12820_20d16d1e6db57666571c51c2623628e6:28Copy
  • SELECT COUNT(*) FROM `yzfp0_contentitem_tag_map` WHERE `type_alias` = 'com_content.article' AND `content_item_id` = 1082371μs536B/tmp/regularlabs/custom_php/12820_2242f97af332d54d4fb204c150bc00a4:36Copy
  • SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'everywhere' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id269μs1.56KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `session_id` FROM `yzfp0_session` WHERE `session_id` = ?165μs1KBParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:277Copy
  • UPDATE `yzfp0_session` SET `data` = ? , `time` = ? WHERE `session_id` = ?499μs592BParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:301Copy
  • infoplg_system_j2xml - plgSystemJ2xml::__construct
  • infoplg_system_basicauth - plgSystemBasicauth::__construct
  • infoplg_system_basicauth - PHP_SAPI: fpm-fcgi
  • infoplg_system_basicauth - authorization:
  • infoplg_system_basicauth - plgSystemBasicauth::onAfterRoute
  • infoplg_system_j2xml - plgSystemJ2xml::onAfterDispatch
  • infoplg_system_basicauth - plgSystemBasicauth::onBeforeRender