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Enfermedad valvular

REC Interv Cardiol. 2021;3:166-174

Resultados del TAVI emergente comparado con el procedimiento electivo: metanálisis

Outcomes of emergency compared to elective TAVI: a meta-analysis

Álvaro Aparisia, Sandra Santos-Martíneza, José Raúl Delgado-Aranaa, Tania Rodríguez-Gabellaa, Alfredo Redondoa, Hipólito Gutiérreza, Gema Pastora, Carlos Verasa, Mario García Gómeza, Carlos Baladrónb, Manuel Carrasco-Moralejab, José Alberto San Romána,b e Ignacio J. Amat-Santosa,b,.

aServicio de Cardiología, Hospital Clínico Universitario de Valladolid, Instituto de Ciencias del Corazón (ICICOR), Valladolid, Spain

bCentro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain

RESUMEN

Introducción y objetivos: El implante percutáneo de válvula aórtica (TAVI) ha demostrado ser seguro y eficaz en pacientes tanto de bajo como de alto riesgo, pero los procedimientos emergentes se han excluido en los principales estudios. El objetivo fue determinar los resultados actuales y los condicionantes del pronóstico durante el TAVI emergente.

Métodos: Se realizó una búsqueda sistemática en PubMed y Google Scholar de cualquier estudio que comparara el TAVI electivo frente al emergente. Los términos empleados fueron «emergent» y/o «urgent», «elective», y «transcatheter valve replacement» y/o «heart failure» y/o «cardiogenic shock». Se consideró TAVI emergente todo procedimiento no programado realizado para tratar la insuficiencia cardiaca refractaria o el shock cardiogénico. Se utilizó un modelo de efectos aleatorios.

Resultados: Se incluyeron 7 estudios (84.427 pacientes) tratados con TAVI (14.241 emergentes y 70.186 electivos). Los casos electivos presentaron una mayor puntuación de riesgo (EuroSCORE logístico 65,9 ± 21 frente a 29,4 ± 18%, p < 0,001; Society of Thoracic Surgeons Risk Score 29,4 ± 27,4 frente a 13,7 ± 11,6%, p < 0,001). Presentaron una enfermedad cardiaca más avanzada, con peor función ventricular izquierda (39,5 ± 17,8 frente a 52,5 ± 12,8%; p < 0,001) y mayor diámetro telediastólico del ventrículo izquierdo (55 ± 9 frente a 48 ± 7 mm; p < 0,001), pese a tener similar área valvular aórtica y gradientes. El TAVI electivo tuvo mayor tasa de éxito (93,6 frente a 92,5%; odds ratio [OR] = 0,84; IC95%, 0,74-0,95; p = 0,005), con menor tasa de fallo renal agudo y menos necesidad de diálisis y de soporte circulatorio mecánico. En conjunto, los casos no emergentes tuvieron menor mortalidad intrahospitalaria (3,3 frente a 5,7%; p < 0,001), a 30 días (4,4 frente a 8,8%; p < 0,001) y a 1 año (19,7 frente a 34,75%; p = 0,0001). Los principales determinantes de mortalidad fueron la nueva necesidad de diálisis (OR = 2.26; IC95%, 1,84-2,76; p < 0,001) o requerir soporte circulatorio mecánico (OR = 2,55; IC95%, 1,14-5,67; p < 0,001).

Conclusiones: Los receptores de TAVI emergente presentaron peor riesgo basal y enfermedad cardiaca más avanzada, que determinaron una mayor mortalidad intrahospitalaria, a 30 días y a 1 año. La identificación precoz del riesgo de precisar soporte circulatorio mecánico o diálisis podría ayudar a una optimización de la indicación de TAVI emergente.

Palabras clave: Shock cardiogénico. Insuficiencia cardiaca. Implante percutáneo de válvula aórtica. Estenosis aórtica.

ABSTRACT

Introduction and objectives: Transcatheter aortic valve implantation (TAVI) has proven safe and effective in low-to-high risk patients, but emergency procedures have been excluded from the landmark trials. We aimed to assess the current outcomes and main factors conditioning the prognosis during emergency TAVI.

Methods: A systematic search in PubMed and Google Scholar was conducted for all studies comparing elective vs emergency TAVI. Searched terms were “emergency” and/or “urgent”, “elective”, and “transcatheter valve replacement” and/or “heart failure” and/or “cardiogenic shock”. Emergency TAVI was considered as any unscheduled TAVI performed to treat refractory heart failure or cardiogenic shock. A random-effects model was used.

Results: A total of 7 studies with 84 427 TAVI patients were included (14 241 emergency procedures; 70 186 elective TAVIs). Emergency cases presented higher risk scores (logistic EuroSCORE 65.9% ± 21% vs 29.4% ± 18%, P < .001; Society of Thoracic Surgeons Risk Score 29.4% ± 27.4% vs 13.7% ± 11.6%, P < .001). More advanced heart disease was observed with deterioration of left ventricular (LV) function (39.5% ± 17.8% vs 52.5% ± 12.8%; P < .001) and larger LV end-diastolic diameters (55 ± 9 mm vs 48 ± 7 mm; P < .001) despite similar aortic valve areas and gradients. Elective TAVIs presented a greater success rate (93.6% vs 92.5%; odds ratio [OR] = 0.84; 95%CI, 0.74-0.95; P = .005), less acute kidney injury, and a lower need for dialysis and mechanical circulatory support. Overall, non-emergency cases had lower in-hospital (3.3% vs 5.7%; P < .001), 30-day (4.4% vs 8.8%; P < .001) and 1-year mortality rates (19.7% vs 34.75%; P = .0001). The main determinants of mortality were need for new dialysis (OR = 2.26; 95%CI, 1.84-2.76; P < .001) or mechanical circulatory support (OR = 2.55; 95%CI, 1.14-5.67; P < .001).

Conclusions: Emergency TAVI recipients presented worse baseline risk and more advanced cardiac disease that determined greater in-hospital, 30-day, and 1-year mortality rates. The early identification of patients at risk for requiring mechanical circulatory support or dialysis may contribute to a better indication of TAVI in emergency scenarios.

Keywords: Cardiogenic shock. Heart failure. Transcatheter aortic valve replacement. Aortic stenosis.

Abreviaturas: EA: estenosis aórtica. IRC: insuficiencia renal crónica. SC: shock cardiogénico. IC: insuficiencia cardiaca. RVAQ: reemplazo valvular aórtico quirúrgico. TAVI: implante percutáneo de válvula aórtica.

INTRODUCCIÓN

La estenosis aórtica (EA) es la valvulopatía más tratada en los países occidentales1. En un porcentaje relativamente pequeño pero creciente de pacientes (de entre el 3,5 y el 12%), la EA puede presentarse como shock cardiogénico (SC) con un índice de mortalidad estimado a corto plazo de hasta el 70% si no se trata, de forma definitiva, bien quirúrgica o percutáneamente2. El SC se caracteriza por una inadecuada perfusión tisular que es resultado de una enfermedad cardiaca descompensada y que se traduce en un estado de bajo gasto cardiaco. El tratamiento inicial consiste en mantener un perfil hemodinámico estable y garantizar la oxigenación de los tejidos mediante medicación y soporte avanzado3. No obstante, se necesitan tratamientos específicos si se quiere garantizar una resolución completa, si bien el reemplazo valvular aórtico quirúrgico (RVAQ) convencional suele asociarse a un riesgo muy alto de mortalidad2.

Varios estudios han demostrado que el implante percutáneo de válvula aórtica (TAVI) resulta una alternativa segura al RVAQ en pacientes de riesgo entre bajo y alto y en situaciones estables. En la actualidad, se considera la opción de elección en pacientes con un elevado riesgo quirúrgico4-7. En cualquier caso, se calcularon las escalas de riesgo para los principales estudios que fijaron las evidencias para el TAVI tras excluir a pacientes con SC. Como consecuencia, los principales resultados en esta situación tan desafiante no se han comparados aleatoriamente a los de la cirugía. Esta comparativa quizás nunca llegue a realizarse debido al perfil basal tan variable y la desigual disponibilidad de recursos, como los dispositivos de asistencia mecánica circulatoria. Además, los diferentes resultados del TAVI de urgencia y electivos tampoco se han estudiado mucho; aun así, son clave para mejorar los resultados del peor escenario clínico posible. Nuestro objetivo fue valorar los resultados actuales del TAVI en condiciones de emergencia/urgencia, así como los principales factores condicionantes de su pronóstico a través de una revisión sistemática y un metanálisis.

MÉTODOS

Estrategia de búsqueda en la literatura científica

Entre enero de 2014 y enero de 2020, 2 autores independientes (AA y MCM) llevaron a cabo una revisión sistemática de todos los artículos publicados en las bases de datos de PubMed y Google Scholar sobre TAVI en condiciones de emergencia/urgencia frente a TAVI electivo para el tratamiento de la EA grave. Los términos objeto de la búsqueda fueron: «Emergente», «urgent», «elective» y «transcatheter valve replacement», «TAVR», «heart failure» o «cardiogenic shock». La definición de intervención en condiciones de emergencia/urgencia fue variable, si bien el consenso que se alcanzó para este artículo fue la inclusión de pacientes que necesitaron un TAVI no programado para tratar su insuficiencia cardiaca o SC refractarios y corregir esta patología durante las 72 horas siguientes a la hospitalización. Se escogió un total de 7 estudios8-14 y los criterios de inclusión establecidos por nuestro grupo fueron: a) la población del estudio incluyó a pacientes con estenosis aórtica que recibieron TAVI; b) solo se incluyeron estudios que hubieran comparado TAVI realizados en condiciones de emergencia o urgencia frente a procedimientos electivos; c) solo se escogieron artículos escritos completamente en inglés revisados por pares de los que se tenían suficientes datos. Los criterios de exclusión seleccionados fueron: a) resúmenes; b) casos clínicos; c) editoriales; d) opiniones de expertos y e) estudios repetitivos. Las discrepancias entre los revisores se resolvieron mediante discusión y consenso. La figura 1 muestra un diagrama de flujo y la tabla 1 del material adicional, las características principales de los estudios incluidos.

Figura 1. Diagrama de flujo con los resultados y selección de los estudios incluidos en el metanálisis.

Tabla 1. Características clínicas y ecocardiográficas basales de pacientes tratados con TAVI electivo o emergente

Variable Nº de pacientes Población TAVI global n = 84.427 TAVI electivo n = 70.186 (83,1%) TAVI emergente/urgente n = 14.241 (16,9%) p
Características clínicas
 Sexo (varón) (%) 84.427 43.735/84.427 (51,8%) 36.576/70.186 (52,11%) 7.159/14.241 (50,27%) < 0,001
 Edad (años) 44.385 81,12 ± 8,47 81,16 ± 8,27 80,96 ± 9,08 0,041
 EuroSCORE (%) 1.387 31,24 ± 18,15 29,42 ± 17,99 68,88 ± 20,97 < 0,001
 Escala STS (%) 985 14,76 ± 13,34 13,66 ± 11,61 29,39 ± 27,39 < 0,001
 Anemia (%) 42.524 11.415/42.524 (26,84%) 8.004/32.382 (24,71%) 3.411/10.142 (33,63%) < 0,001
 Fibrilación auricular (%) 41.185 17.373/41.885 (41,47%) 15.304/37.780 (40,51%) 2.069/4.105 (50,40%) < 0,001
 EC (%) 41.329 25.723/41.329 (62,24%) 23.178/37.308 (62,13%) 2.545/4.021 (63,29%) 0,147
 ERC (%) 83.308 17.948 /83.308 (21,54%) 13.368/69.187 (19,32%) 4.580/14.121 (32,43%) < 0,001
 EPOC (%) 84.398 25.081/84.398 (29,72%) 20.315/70.157 (28,96%) 4.766/14.241 (33,47%) < 0,001
 Diabetes (%) 84.040 29.670/84.040 (35,30%) 24.571/69.820 (35,19%) 5.099/14.220 (35,86%) 0,130
 Hipertensión (%) 83.308 70.608/83.308 (84,75%) 59.117/69.187 (85,44%) 11.491/14.121 (81,38%) < 0,001
 NYHA III-IV (%) 41.143 33.056/41.143 (80,34%) 29.297/37.065 (79,04%) 3.759/4.078 (92,17%) < 0,001
 EAP (%) 84.069 25.236/84.069 (30,02%) 20.933/69.849 (29,96%) 4.303/14.220 (30,26%) 0,490
 Aorta de porcelana (%) 40.669 2.158/40.669 (5,3%) 1.914/36.669 (5,22%) 244/4.000 (6,1%) 0,018
 RVA previo (%) 40.658 1.599/40.658 (3,93%) 1.292/36.664 (3,53%) 307/3.994 (7,69%) < 0,001
 CABG previo (%) 83.656 20.924/83.656 (25,01%) 18.000/69.442 (25,92%) 2.924/14.214 (20,57%) < 0,001
 IM previo (%) 83.040 15.173/83.040 (18,27%) 12.597/68.868 (18,29%) 2.576/14.172 (18,18%) 0,747
 ICP previa (%) 83.029 22.118/83.029 (26,64%) 18.979/68.863 (27,56%) 3.139/14.166 (22,16%) < 0,001
 MP/DCI previo 40.774 8.304/40.774 (20,36%) 7.401/36.723 (20,15%) 903/4.051 (22,29%) 0,001
 ACV/AIT previo (%) 42.244 8.815/42.244 (20,87%) 7.884/38.118 (20,68%) 931/4.126 (22,57%) 0,005
Características ecocardiográficas
 Área valvular aórtica (cm²) 2.230 0,7 ± 0,23 0,7 ± 0,23 0,66 ± 0,21 0,308
 DTDVI (mm) 616 48,98 ± 7,34 48,53 ± 7,20 55,05 ± 9,03 < 0,001
 FEVI (%) 1.861 51,51 ± 13,24 52,23 ± 12,71 29,58 ± 14,89 < 0,001
 Gradiente medio (mmHg) 1.398 43,71 ± 16,42 43,91 ± 16,31 40,26 ± 18,29 0,061
 IA III-IV (%) 41.032 8.156/41.032 (19,88%) 7.159/37.033 (19,33%) 997/3.999 (24,93%) < 0,001
 HTP (%) 43.251 2.003/43.251 (4,63%) 1.536/33.088 (4,64%) 467/10.163 (4,6%) 0,843

DCI: desfibrilador-cardioversor implantable; DTDVI: diámetro telediastólico del ventrículo izquierdo; EAP: enfermedad arterial periférica; EC: enfermedad coronaria; EPOC: enfermedad pulmonar obstructiva crónica; FEVI: fracción de eyección del ventrículo izquierdo; IA: insuficiencia aórtica; HTP: hipertensión pulmonar; ICP: intervención coronaria percutánea; IM: infarto de miocardio; ERC: enfermedad renal crónica; MP: marcapasos; NYHA: New York Heart Association; RVA: reemplazo valvular aórtico; STS: Society of Thoracic Surgeons score; TAVI: implante percutáneo de válvula aórtica.

Objetivos primarios

Los objetivos primarios fueron la mortalidad a corto plazo y el éxito de la intervención. Los objetivos secundarios fueron las complicaciones perioperatorias. Las complicaciones se reportaron utilizando, principalmente, las definiciones establecidas por el Valve Academic Research Consortium-215.

Análisis estadístico

Las variables cualitativas se expresaron como frecuencia absoluta y porcentaje; las continuas, como media ± desviación estándar salvo que se especificara de otro modo. Para comparar las variables demográficas y los factores de riesgo entre ambos grupos se emplearon la prueba de la X2 o la prueba exacta de Fisher para el estudio de las variables categóricas. La prueba t de Student se empleó para comparar las variables continuas, si así fuese necesario.

Como medida del efecto combinado, los estudios incorporaron el odds ratio (OR), un intervalo de confianza del 95% y significación estadística. La homogeneidad entre los distintos estudios se comparó utilizando la estadística QH. Con respecto a la baja sensibilidad de esta prueba, valores p < 0,10 se consideraron significativos. Para superar, de alguna forma, esta limitación se calculó también el índice estadístico I2, que mide el porcentaje de variación global de los estudios explicado por la heterogeneidad y por su IC95%. Se empleó un modelo de efectos aleatorios para casos con índices estadísticos I2 > 50%y un modelo de efectos fijos para los casos contrarios. El posible seso de publicación se valoró mediante un gráfico de embudo y empleando la prueba de Egger y la de correlación de rango ajustado de Begg y Mazumdar. En presencia de sesgo de publicación, se empleó el método de recorte y relleno para volver a valorar el OR combinado. También se realizaron análisis de sensibilidad para eliminar secuencialmente estudios distintos.

Todos los valores de p fueron bilaterales. Los análisis estadísticos se realizaron utilizando el software R, versión 3.6.1 (proyecto R para estadística computacional) y Review Manager 5.3.

RESULTADOS

Distribución de los pacientes y características basales

Se seleccionaron 7 estudios con un total de 84.427 pacientes tratados con TAVI [70.186 procedimientos electivos (83,1%) y 14.241 emergentes (16,9%)]. Las principales características basales según el carácter electivo o emergente del procedimiento se muestran en la tabla 1 y los análisis de sensibilidad y asimetría en la tabla 2 del material adicional y figura 1 del material adicional. Se detectó asimetría en el daño renal agudo, por lo que hubo que emplear el método de recorte y relleno para volver a valorar el odds ratio. El porcentaje de varones que recibieron procedimientos electivos (52,1%) fue mayor que el de aquellos que recibieron procedimientos de emergencia (50,27%, p < 0,01). En líneas generales, los pacientes tratados en condiciones de emergencia/urgencia tuvieron más comorbilidades tal y como revelaron la escala EuroSCORE logistic (65,9% ± 21% frente al 29,4% ± 18%, p < 0,001) y el modelo de riesgo de la escala de riesgo de la Society of Thoracic Surgeons (STS) (29,4 ± 27,4 frente a 13,7 ± 11,6, p < 0,001). No obstante, los factores tradicionales de riesgo cardiovascular no variaron entre los distintos grupos (hipertensión y diabetes mellitus) y los índices de infarto de miocardio e intervención coronaria percutánea fueron similares. Por el contrario, los pacientes más propensos a ser tratados en condiciones de urgencia ya habían sido tratados mediante reemplazo valvular aórtico quirúrgico previo. En lo que a las principales características ecocardiográficas se refiere, los procedimientos emergentes se realizaron en pacientes con deterioro de la función del ventrículo izquierdo (VI) (39,5% ± 17,8% frente al 52,5% ± 12,8%; p < 0,001), diámetros telediastólicos VI más grandes (55 ± 9 frente a 48 ± 7; p < 0,001), pero áreas valvulares aórticas (0,66 ± 0,21 frente a 0,70 ± 0,23; p < 0,308) y gradientes medios transaórticos similares (40,3 ± 18,3 frente a 43,9 ± 16,3; p < 0,061).

Tabla 2. Características de la intervención de pacientes tratados con TAVI electivo o emergente/urgente

Variable Nº de pacientes Población TAVI global TAVI electivo TAVI emergente/urgente p
Índice de éxito (%) 41.140 38.765/41.440 (93,54%) 35.038/37.413 (93,65%) 3.727/4.027 (92,55%) 0,007
Migración del dispositivo (%) 40.042 105/40.042 (0,26%) 90/36.090 (0,25%) 15/3.952 (0,38%) 0,129
Anestesia general (%) 40.669 34.419/40.669 (84,6%) 31.004/36.669 (84,55%) 3.415/4.000 (85,37%) 0,170
Transapical (%) 83.953 14.742/83.953 (17,56%) 12.194/69.790 (17,47%) 2.548/14.163 (18%) 0,139
Transfemoral (%) 83.811 66.526/83.811 (79,38%) 55.196/69.612 (79,29%) 11.330/14.199 (79,79%) 0,177
Transubclavio (%) 40.813 643/40.813 (1,57%) 573/36.834 (1,55%) 70/3.979 (1,76%) 0,327
Soporte circulatorio mecánico (%) 83.326 1.858/83.326 (2,29%) 1.355/69.211 (1,96%) 503/14.115 (3,56%) < 0,001

TAVI: implante percutáneo de válvula aórtica.

Características perioperatorias

Los resultados de la intervención en los estudios incluidos se muestran en la tabla 2. El abordaje transfemoral (79,3% frente al 76.8%; p = 0,177) y el uso de anestesia general (84.5% frente a 85.4%; p = 0,17) fueron los abordajes preferidos en los 2 grupos. El índice de éxito quirúrgico de los procedimientos electivos fue mayor (93,6% frente al 92,5%; p = 0,007) y la necesidad de soporte circulatorio mecánico menor (1,96% frente al 3,56 %; p < 0,001). Otros resultados de la intervención fueron comparables entre ambas cohortes.

Resultados posoperatorios

Los principales resultados posoperatorios se muestran en la tabla 3 y en la figura 2. Los OR para el infarto de miocardio, hemorragias amenazantes para la vida, necesidad de implantar un marcapasos permanente y accidentes cerebrovasculares perioperatorios fueron similares con independencia de que el procedimiento fuera programado o emergente. Por el contrario, la cohorte electiva tuvo índices más bajos de daño renal agudo (9,6% frente al 22,4%; OR = 2,26; IC95%, 1,84-2,76; p < 0,001) y necesidad de diálisis (1,1% frente al 2,8%; OR = 2,37; IC95%, 2,09-2,68; p < 0,001). En líneas generales, esto se tradujo en estancias hospitalarias más cortas para los casos electivos y en índices, también más bajos, de mortalidad intrahospitalaria (3,3% frente al 5,75%; OR = 1,32; IC95%, 1,32-2,83; p < 0,001), a los 30 días (4,43% frente al 8,84%; OR = 3,13; IC95%, 1,68-5,80; p < 0,001) y a 1 año (19,7% frente al 34,47%; OR = 2,87; IC95%, 1,67-4,94; p = 0,0001) para los procedimientos electivos (figura 3).

Tabla 3. Principales resultados posoperatorios de pacientes tratados con TAVI electivo o emergente/urgente

Variable Nº de pacientes Población TAVI global TAVI electivo TAVI emergente/urgente p
Resultados clínicos
 Hemorragias amenazantes para la vida (%) 83.811 13.170/83.811 (15,71%) 9.903/69.612 (14,22%) 3.267/14.199 (23,01%) < 0,001
 Hemorragias mayores (%) 43.400 14.725/43.400 (33,93%) 11.065/33.180 (33,35%) 3.660/10.220 (35,81%) < 0,001
 Complicaciones vasculares mayores (%) 41.656 513/41.656 (1,23%) 460/37.572 (1,22%) 53/4.084 (1,29%) 0,686
 Infarto de miocardio (%) 82.671 1.299/82.671 (1,57%) 557/68.526 (0,81%) 742/14.145 (5,24%) < 0,001
 Daño renal agudo (%) 83.811 9.856/83.811 (11,75%) 6.678/69.612 (9,59%) 3.178/14.199 (22,38%) < 0,001
 Necesidad de diálisis (%) 82.197 1.178/82.197 (1,43%) 782/68.130 (1,15%) 396/14.067 (2,81%) < 0,001
 IMP (%) 84.069 8.786/84.069 (10,45%) 7.188/69.849 (10,29%) 1.598/14.220 (11,24%) < 0,001
 ACV (%) 83.442 2.242/83.442 (2,69%) 1.824/69.270 (2,63%) 418/14.172 (2,94%) 0,034
 Índice de mortalidad intrahospitalaria 83.427 3.099/83.427 (3,71%) 2.284/69.255 (3,3%) 815/14.172 (5,75%) < 0,001
 Índice de mortalidad a 30 días 46.228 2.268/46.228 (4,9%) 1.830/41.274 (4,43%) 430/4.954 (8,84%) < 0,001
 Índice de mortalidad a 1 año 41.156 8.706/41.156 (21 15%) 7.327/37.156 (19,72%) 1.379/4.000 (34,75%) < 0,001
Resultados ecocardiográficos
 Gradiente medio (mmHg) 369 7,75 ± 4,15 7,82 ± 4,22 6,9 ± 3,2 0,269
 IA III-IV (%) 17.977 1.465/17.977 (8,15%) 1.299/16.125 (8,05%) 166/1.852 (8,96%) 0,176

ACV: accidente cerebrovascular; IA: insuficiencia aórtica; IMP: implante de marcapasos permanente; TAVI: implante percutáneo de válvula aórtica.

Figura 2. Diagrama de bosque con las principales complicaciones posoperatorias de pacientes incluidos en el metanálisis.* * La línea vertical representa un punto «sin diferencia» entre los grupos de TAVI emergente o electivo. Las líneas horizontales representan el IC95%. Los cuadrados representan el OR para cada estudio (el tamaño de cada cuadrado es la cantidad de información proporcionada por cada estudio). Los rombos representan los OR combinados de todos los estudios.

Figura 3. Diagrama de bosque con los índices de mortalidad intrahospitalaria y a 1 año de pacientes incluidos en el metanálisis.* * La línea vertical representa un punto «sin diferencia» entre los grupos de TAVI emergente o electivo. Las líneas horizontales representan el IC95%. Los cuadrados representan el OR para cada estudio (el tamaño de cada cuadrado es la cantidad de información proporcionada por cada estudio). Los rombos representan los OR combinados de todos los estudios.

DISCUSIÓN

Cuando pacientes con EA presentan insuficiencia cardiaca (IC) aguda grave o SC, la mortalidad por cualquier causa al cabo de 5 años está por encima del 60% a pesar de la implementación de terapias para tratar la valvulopatía, un índice que no resiste la comparación en pacientes sin IC (~20%) ni síntomas de IC crónica (~30%) en este marco (16). Determinar qué factores condicionan un índice de mortalidad tan alto es clave para mejorar el manejo de este grupo de pacientes que va en aumento. Los principales hallazgos de este estudio son: a) los pacientes que precisaron TAVI emergentes presentaban un riesgo basal más alto que los que precisaron procedimientos programados, no solo por la situación de emergencia sino también por la alta carga de comorbilidades y deterioro de la función VI; b) aunque el índice de éxito de la intervención fue mucho mayor en los casos programados, la diferencia fue poca (93,6% frente al 92,5%; p = 0,007). Esto sugiere que los índices más altos de mortalidad a corto y medio plazo de los casos emergentes se debieron, principalmente, a las complicaciones posoperatorias y no al procedimiento propiamente dicho; c) la necesidad de soporte circulatorio mecánico y diálisis fue mayor después de los casos emergentes. Identificar precozmente qué pacientes de riesgo podrían requerir estos tratamientos es útil para una mejor indicación de TAVI en situaciones de emergencia.

Características basales y mortalidad estimada

En nuestro estudio, los pacientes con TAVI emergente/urgente presentaban muchas más comorbilidades que los que recibieron el procedimiento electivo. Se debe mencionar que la escala de STS se viene empleando para valorar el riesgo de mortalidad en pacientes con RVAQ17. En cualquier caso, es posible que la escala desarrollada por el grupo de trabajo Transcatheter Valve Therapy (TVT) para evaluar los índices de mortalidad intrahospitalaria y al cabo de 30 días18 sea más precisa. Según esa escala, el pronóstico tiene mucho que ver con la presencia de enfermedad renal crónica (ERC), enfermedad pulmonar obstructiva crónica y necesidad de TAVI emergente. Cabe destacar que la EA con ERC concomitante se asocia a índices de mortalidad por cualquier causa y cardiovascular más altos que la EA sin dicha patología; de hecho, esta mayor mortalidad por cualquier causa se correlaciona exponencialmente con un descenso de la tasa de filtración glomerular19. Además, tanto el índice más alto de anemia20 como el mayor riesgo hemorrágico de pacientes con ERC son bien conocidos, lo cual condiciona una mayor necesidad de transfusión de glóbulos rojos21 y, paralelamente, el deterioro de la función renal y del índice de supervivencia.

La función del VI es un factor pronóstico bien conocido de la valvulopatía y su deterioro condiciona el tratamiento quirúrgico o percutáneo de la válvula aórtica, incluso en pacientes asintomáticos22. Se debe mencionar que el similar gradiente transaórtico, a pesar de una función VI reducida en los casos basales emergentes, y el mayor índice de insuficiencia aórtica de esta cohorte sugieren la presencia de una valvulopatía más grave y de probables válvulas nativas más calcificadas y degeneradas. Por esta razón, un abordaje multidisciplinario y con múltiples imágenes podría ser especialmente útil a efectos de programar la intervención y con vistas a mejorar los resultados23.

Mortalidad y complicaciones asociadas a la intervención

La mayoría de las complicaciones asociadas a la intervención fueron similares tanto en los procedimientos electivos como en los emergentes. Aunque esto podría explicarse, en parte, por la mayor experiencia de los operadores, a nivel internacional, y por la falta de diferencias en el índice de abordaje transfemoral24, el mayor uso de dispositivos de soporte circulatorio mecánico podría haber sido especialmente relevante en cohortes emergentes/urgentes. De hecho, la reserva contráctil del VI más limitada de este grupo de pacientes puede condicionar un rápido deterioro en presencia de complicaciones tales como shunt perianular, insuficiencia aórtica severa u obstrucción coronaria. Por lo tanto, la presencia de factores de riesgo para estas complicaciones sugiere la necesidad de implantar dispositivos de soporte circulatorio en determinados casos antes implantar la prótesis valvular como posible estrategia para evitar los pronósticos nefastos que pueden llegar a darse en los procedimientos emergentes25-27. Anteriores experiencias con el dispositivo Impella y el oxigenador extracorpóreo de membrana (ECMO) se pueden consultar en la tabla 3 del material adicional; no obstante, si hay diferencias de mortalidad entre pacientes con y sin soporte mecánico es algo que se debe seguir investigando. Como el éxito de la intervención fue similar al que se obtiene en el ámbito estándar, la traducción clínica que se puede hacer de esto es que, aunque estos casos pueden resolverse con éxito en todos los centros que realizan TAVI, este perfil de pacientes solo debería tratarse en centros que dispongan de dispositivos de soporte circulatorio mecánico, sobre todo ECMO. Los centros de bajo volumen o los no quirúrgicos quedarían excluidos.

El presente metanálisis no incluyó ningún caso tratado exclusivamente mediante valvuloplastia aórtica. Esta estrategia tiene un nivel de evidencia clase IIb-C en la última versión de las guías clínicas, pero se suele emplear como terapia puente hasta el TAVI definitivo en pacientes hemodinámicamente inestables28,29. Un estudio retrospectivo de un único centro halló que el procedimiento de TAVI podría ser superior solo a la valvuloplastia aórtica y al tratamiento médico en pacientes con EA y SC graves, ya que la valvuloplastia aórtica aislada no está exenta de complicaciones (~25%) y presenta índices de mortalidad más altos30. A pesar de esto, se echan en falta extensos estudios controlados y aleatorizados que exploren este escenario con TAVI.

Complicaciones posoperatorias asociadas a un índice más alto de mortalidad

En esta revisión sistemática y metanálisis, se descubrió que los procedimientos TAVI realizados en condiciones de emergencia/urgencia tenían un índice mucho más alto de daño renal agudo (DRA), hemodiálisis y mortalidad. Esto coincide con lo descrito en casos anteriores que confirmaron que los pacientes con DRA post-TAVI eran más propensos a fallecer. El DRA es, además, un predictor de la sepsis, que es, a su vez, un predictor independiente de la mortalidad. Los principales factores que aumentan el riesgo de DRA son la ERC, enfermedad arterial periférica, la diabetes mellitus y el deterioro de la función VI31,32. La estrategia profiláctica va desde la simple hidratación con una solución salina normal hasta diuresis forzada con medidas de soporte precoz33; de hecho, se ha explorado el uso de diálisis profiláctica en pacientes tratados con TAVI y alto riesgo de DRA que podría ser especialmente útil en el ámbito de la emergencia.

Limitaciones del estudio

Son varias las limitaciones asociadas a esta revisión sistemática y metanálisis. En primer lugar, los estudios incluidos fueron observacionales porque no se pudo encontrar ningún estudio aleatorizado multicéntrico que abordara específicamente esta cuestión. En segundo lugar, la definición de procedimiento emergente/urgente fue variable en los diferentes estudios, si bien el equipo del estudio logró elaborar una definición inclusiva. Por último, los resultados podrían no ser extrapolables por lo que deberían interpretarse con cautela debido a la alta heterogeneidad descrita, lo cual estaría asociado a la variabilidad de las muestras y diseños de los estudios.

CONCLUSIONES

La relación entre TAVI en condiciones de emergencia/urgencia y un índice más alto de mortalidad a corto/medio plazo se debe, principalmente, a un perfil basal de riesgo alto, a la fase avanzada de la enfermedad cardiaca y a un índice más alto de daño renal agudo. La identificación y derivación precoces de pacientes de alto riesgo de colapso circulatorio o DRA se debe llevar a cabo convenientemente para reducir el índice de mortalidad asociado a TAVI. Se necesitan seguir investigando para determinar el papel del TAVI en escenarios emergentes o urgentes.

FINANCIACIÓN

Ninguna.

CONFLICTO DE INTERESES

I.J. Amat-Santos es proctor de Boston Scientific.

¿QUÉ SE SABE DEL TEMA?

  • El TAVI se realiza, principalmente, en pacientes estables a nivel hemodinámico. De lo contrario, la valvuloplastia aórtica es el tratamiento empírico preferido como terapia puente hasta poder realizar el TAVI. No obstante, son pocos los estudios que han analizado el TAVI en escenarios amenazantes para la vida e inexistentes los estudios controlados aleatorizados y multicéntricos realizados a este respecto.

¿QUÉ APORTA DE NUEVO?

  • En este extenso metanálisis combinado (n = 84.427) los TAVI emergentes no fueron algo excepcional sino que se asociaron a índices más altos de mortalidad intrahospitalaria, a 30 días y 1 año comparados con los TAVI electivos. La necesidad de diálisis o soporte circulatorio mecánico condicionó el índice de mortalidad post-TAVI emergente. La identificación precoz de pacientes en riesgo de colapso circulatorio o daño renal agudo podría ayudar a determinar si el TAVI es fútil en este ámbito.

MATERIAL ADICIONAL


BIBLIOGRAFÍA

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* Autor para correspondencia: Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Ramón y Cajal 3, 47005 Valladolid, España.

Correo electrónico: ijamat@gmail.com (I.J. Amat-Santos)

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  • beforeRenderRawModule mod_custom (Separador) (2.04KB) (971μs)
  • afterRenderRawModule mod_custom (Separador) (1.13KB) (132μs)
  • beforeRenderModule mod_custom (Separador) (720B) (3μs)
  • afterRenderModule mod_custom (Separador) (128.77KB) (4.23ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Descargar) (1.45KB) (22μs)
  • afterRenderRawModule mod_custom (Article Herramientas Descargar) (992B) (81μs)
  • beforeRenderModule mod_custom (Article Herramientas Descargar) (736B) (3μs)
  • afterRenderModule mod_custom (Article Herramientas Descargar) (127.94KB) (3.98ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Traducción) (1.48KB) (21μs)
  • afterRenderRawModule mod_custom (Article Herramientas Traducción) (1.16KB) (78μs)
  • beforeRenderModule mod_custom (Article Herramientas Traducción) (736B) (3μs)
  • afterRenderModule mod_custom (Article Herramientas Traducción) (276.37KB) (7.55ms)
  • beforeRenderRawModule mod_custom (Innovacion Herramientas Traducción) (2.05KB) (21μs)
  • afterRenderRawModule mod_custom (Innovacion Herramientas Traducción) (1.03KB) (78μs)
  • beforeRenderModule mod_custom (Innovacion Herramientas Traducción) (736B) (3μs)
  • afterRenderModule mod_custom (Innovacion Herramientas Traducción) (151.14KB) (4.22ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Imprimir) (1.52KB) (21μs)
  • afterRenderRawModule mod_custom (Article Herramientas Imprimir) (928B) (78μs)
  • beforeRenderModule mod_custom (Article Herramientas Imprimir) (736B) (3μs)
  • afterRenderModule mod_custom (Article Herramientas Imprimir) (128.43KB) (3.99ms)
  • beforeRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (1.48KB) (21μs)
  • afterRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (928B) (78μs)
  • beforeRenderModule mod_custom (Innovacion Herramientas Imprimir) (736B) (3μs)
  • afterRenderModule mod_custom (Innovacion Herramientas Imprimir) (128.27KB) (4.01ms)
  • beforeRenderRawModule mod_custom (EMAIL Y TWITTER) (1.41KB) (21μs)
  • afterRenderRawModule mod_custom (EMAIL Y TWITTER) (1.02KB) (82μs)
  • beforeRenderModule mod_custom (EMAIL Y TWITTER) (720B) (3μs)
  • afterRenderModule mod_custom (EMAIL Y TWITTER) (129.35KB) (4.05ms)
  • beforeRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (3.08KB) (18μs)
  • afterRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (111.32KB) (8.85ms)
  • beforeRenderModule mod_dms3_refs (Article Herramientas Exportar) (736B) (4μs)
  • afterRenderModule mod_dms3_refs (Article Herramientas Exportar) (3.23KB) (122μs)
  • beforeRenderRawModule mod_custom (Article Herramientas Compartir) (304B) (20μs)
  • afterRenderRawModule mod_custom (Article Herramientas Compartir) (928B) (76μs)
  • beforeRenderModule mod_custom (Article Herramientas Compartir) (736B) (3μs)
  • afterRenderModule mod_custom (Article Herramientas Compartir) (277.6KB) (6.86ms)
  • beforeRenderRawModule mod_custom (Innovacion Herramientas Compartir) (5.36KB) (22μs)
  • afterRenderRawModule mod_custom (Innovacion Herramientas Compartir) (928B) (77μs)
  • beforeRenderModule mod_custom (Innovacion Herramientas Compartir) (736B) (3μs)
  • afterRenderModule mod_custom (Innovacion Herramientas Compartir) (218.51KB) (4.94ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Estadísticas) (3.52KB) (21μs)
  • afterRenderRawModule mod_custom (Article Herramientas Estadísticas) (928B) (78μs)
  • beforeRenderModule mod_custom (Article Herramientas Estadísticas) (736B) (3μs)
  • afterRenderModule mod_custom (Article Herramientas Estadísticas) (738.48KB) (21.1ms)
  • beforeRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (5.47KB) (22μs)
  • afterRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (928B) (78μs)
  • beforeRenderModule mod_custom (Innovacion Herramientas Estadísticas) (736B) (3μs)
  • afterRenderModule mod_custom (Innovacion Herramientas Estadísticas) (137.62KB) (4.19ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Material Adicional) (3.53KB) (21μs)
  • afterRenderRawModule mod_custom (Article Herramientas Material Adicional) (944B) (78μs)
  • beforeRenderModule mod_custom (Article Herramientas Material Adicional) (736B) (3μs)
  • afterRenderModule mod_custom (Article Herramientas Material Adicional) (193.45KB) (5.47ms)
  • beforeRenderRawModule mod_menu (Contenido) (4.72KB) (622μs)
  • afterRenderRawModule mod_menu (Contenido) (18.63KB) (693μs)
  • beforeRenderModule mod_menu (Contenido) (704B) (4μs)
  • afterRenderModule mod_menu (Contenido) (3.08KB) (126μs)
  • beforeRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (2.36KB) (20μs)
  • afterRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (7.09KB) (276μs)
  • beforeRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (752B) (3μs)
  • afterRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (5.48KB) (140μs)
  • beforeRenderRawModule mod_menu (Publicar) (1.61KB) (119μs)
  • afterRenderRawModule mod_menu (Publicar) (29.84KB) (817μs)
  • beforeRenderModule mod_menu (Publicar) (704B) (3μs)
  • afterRenderModule mod_menu (Publicar) (3.33KB) (124μs)
  • beforeRenderRawModule mod_menu (Sobre nosotros) (160B) (111μs)
  • afterRenderRawModule mod_menu (Sobre nosotros) (22.34KB) (743μs)
  • beforeRenderModule mod_menu (Sobre nosotros) (720B) (3μs)
  • afterRenderModule mod_menu (Sobre nosotros) (3.2KB) (121μs)
  • beforeRenderRawModule mod_menu (Publicaciones Permanyer) (144B) (108μs)
  • afterRenderRawModule mod_menu (Publicaciones Permanyer) (10.24KB) (451μs)
  • beforeRenderModule mod_menu (Publicaciones Permanyer) (720B) (3μs)
  • afterRenderModule mod_menu (Publicaciones Permanyer) (2.89KB) (118μs)
  • beforeRenderRawModule mod_menu (Footer Final ES) (4.92KB) (742μs)
  • afterRenderRawModule mod_menu (Footer Final ES) (28.11KB) (769μs)
  • beforeRenderModule mod_menu (Footer Final ES) (720B) (4μs)
  • afterRenderModule mod_menu (Footer Final ES) (3.33KB) (129μs)
  • afterRender (1.03MB) (82.57ms)
  • 1 x afterRenderModule mod_custom (Lo más compartido) (578.53KB) (34.07%)
    452ms
    1 x afterRenderModule mod_custom (Lo más leído) (1.44MB) (30.45%)
    404ms
    1 x afterRender (1.03MB) (6.23%)
    82.57ms
    1 x afterRenderComponent com_content (303.29KB) (5.4%)
    71.64ms
    1 x Before Access::getAssetRules (id:8 name:com_content) (1.37MB) (4.48%)
    59.49ms
    1 x afterInitialise (3.53MB) (3.02%)
    40.00ms
    1 x afterRenderModule mod_custom (Article Herramientas Estadísticas) (738.48KB) (1.59%)
    21.10ms
    1 x beforeRenderRawModule mod_breadcrumbs (Breadcrumbs ES) (1.1MB) (1.34%)
    17.74ms
    1 x afterRoute (384.77KB) (1.11%)
    14.78ms
    1 x afterRenderModule mod_custom (Debate Title) (659.63KB) (0.98%)
    13.04ms
    1 x afterRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (111.32KB) (0.67%)
    8.85ms
    1 x afterRenderModule mod_custom (Article Herramientas Traducción) (276.37KB) (0.57%)
    7.55ms
    1 x afterRenderModule mod_custom (Article - Referencia ) (294.97KB) (0.57%)
    7.54ms
    1 x afterRenderModule mod_custom (Article DOI activo) (258.73KB) (0.52%)
    6.92ms
    1 x afterRenderModule mod_custom (Article Herramientas Compartir) (277.6KB) (0.52%)
    6.86ms
    1 x Before Access::getAssetRules (id:1 name:root.1) (326.88KB) (0.49%)
    6.54ms
    1 x afterDispatch (396.03KB) (0.44%)
    5.85ms
    1 x afterRenderModule mod_custom (Article Herramientas Material Adicional) (193.45KB) (0.41%)
    5.47ms
    1 x afterRenderModule mod_custom (Article Category) (230.69KB) (0.4%)
    5.25ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Compartir) (218.51KB) (0.37%)
    4.94ms
    1 x afterRenderModule mod_custom (Article Related contents) (180.89KB) (0.36%)
    4.77ms
    1 x afterRenderModule mod_custom (Article Authors) (166.41KB) (0.36%)
    4.76ms
    1 x afterRenderModule mod_custom (Foto Autor) (167.69KB) (0.35%)
    4.67ms
    1 x afterRenderModule mod_custom (Article Subtitulo) (161.86KB) (0.34%)
    4.47ms
    1 x afterRenderModule mod_custom (Article Translated Title) (160.62KB) (0.33%)
    4.43ms
    1 x afterRenderModule mod_custom (Separador) (128.77KB) (0.32%)
    4.23ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Traducción) (151.14KB) (0.32%)
    4.22ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Estadísticas) (137.62KB) (0.32%)
    4.19ms
    1 x afterRenderModule mod_custom (Article Title) (150.15KB) (0.32%)
    4.19ms
    1 x afterRenderModule mod_custom (EMAIL Y TWITTER) (129.35KB) (0.31%)
    4.05ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Imprimir) (128.27KB) (0.3%)
    4.01ms
    1 x afterRenderModule mod_custom (Article Herramientas Imprimir) (128.43KB) (0.3%)
    3.99ms
    1 x afterRenderModule mod_custom (Article Herramientas Descargar) (127.94KB) (0.3%)
    3.98ms
    1 x After Access::preloadPermissions (com_content) (987.52KB) (0.29%)
    3.80ms
    1 x afterLoad (74.89KB) (0.18%)
    2.45ms
    1 x beforeRenderRawModule mod_custom (Publicación de la Sociedad Española de Cardiología) (13.92KB) (0.16%)
    2.15ms
    1 x afterRenderRawModule mod_languages (Cambiar Idioma) (36.48KB) (0.11%)
    1.48ms
    1 x afterRenderRawModule mod_articles_good_search (Articles Good Search Total (Lateral)) (34.63KB) (0.08%)
    1.10ms
    1 x beforeRenderRawModule mod_custom (Separador) (2.04KB) (0.07%)
    971μs
    1 x afterRenderRawModule mod_breadcrumbs (Breadcrumbs ES) (13.98KB) (0.07%)
    933μs
    1 x After Access::preloadComponents (all components) (125.96KB) (0.06%)
    839μs
    1 x afterRenderRawModule mod_menu (Publicar) (29.84KB) (0.06%)
    817μs
    1 x afterRenderRawModule mod_menu (Footer Final ES) (28.11KB) (0.06%)
    769μs
    1 x afterRenderRawModule mod_menu (Sobre nosotros) (22.34KB) (0.06%)
    743μs
    1 x beforeRenderRawModule mod_menu (Footer Final ES) (4.92KB) (0.06%)
    742μs
    1 x afterRenderRawModule mod_menu (Contenido) (18.63KB) (0.05%)
    693μs
    1 x Before Access::preloadComponents (all components) (196.7KB) (0.05%)
    683μs
    1 x afterRenderRawModule mod_menu (Sidebar Menú ES) (9.75KB) (0.05%)
    653μs
    1 x beforeRenderRawModule mod_menu (Contenido) (4.72KB) (0.05%)
    622μs
    1 x afterRenderRawModule mod_menu (Sidebar - REC: Publications) (16.07KB) (0.04%)
    507μs
    1 x afterRenderRawModule mod_menu (Publicaciones Permanyer) (10.24KB) (0.03%)
    451μs
    1 x afterRenderModule mod_custom (Home Concurso Hemodinamica) (6.23KB) (0.03%)
    425μs
    1 x afterRenderRawModule mod_custom (Debate Title) (4.13KB) (0.03%)
    361μs
    1 x beforeRenderRawModule mod_custom (Debate Title) (4.12KB) (0.03%)
    358μs
    1 x afterRenderModule mod_breadcrumbs (Breadcrumbs ES) (3.88KB) (0.02%)
    321μs
    1 x beforeRenderComponent com_content (12.84KB) (0.02%)
    314μs
    1 x afterRenderRawModule mod_lightbox (Lightbox) (83.07KB) (0.02%)
    295μs
    1 x afterRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (7.09KB) (0.02%)
    276μs
    1 x beforeRenderRawModule mod_custom (Home Concurso Hemodinamica) (80B) (0.01%)
    178μs
    1 x afterRenderModule mod_articles_good_search (Articles Good Search Total (Lateral)) (10.48KB) (0.01%)
    161μs
    1 x afterRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (5.48KB) (0.01%)
    140μs
    1 x afterRenderRawModule mod_custom (Separador) (1.13KB) (0.01%)
    132μs
    1 x afterRenderModule mod_lightbox (Lightbox) (4.45KB) (0.01%)
    131μs
    1 x afterRenderModule mod_languages (Cambiar Idioma) (3.97KB) (0.01%)
    131μs
    1 x afterRenderModule mod_custom (Publicación de la Sociedad Española de Cardiología) (2.81KB) (0.01%)
    130μs
    1 x afterRenderModule mod_menu (Footer Final ES) (3.33KB) (0.01%)
    129μs
    1 x afterRenderModule mod_menu (Contenido) (3.08KB) (0.01%)
    126μs
    1 x afterRenderModule mod_menu (Publicar) (3.33KB) (0.01%)
    124μs
    1 x afterRenderModule mod_dms3_refs (Article Herramientas Exportar) (3.23KB) (0.01%)
    122μs
    1 x afterRenderModule mod_menu (Sobre nosotros) (3.2KB) (0.01%)
    121μs
    1 x afterRenderModule mod_menu (Sidebar Menú ES) (2.7KB) (0.01%)
    119μs
    1 x afterRenderModule mod_menu (Sidebar - REC: Publications) (3.23KB) (0.01%)
    119μs
    1 x beforeRenderRawModule mod_menu (Publicar) (1.61KB) (0.01%)
    119μs
    1 x afterRenderModule mod_menu (Publicaciones Permanyer) (2.89KB) (0.01%)
    118μs
    1 x afterRenderModule mod_custom (Factor de Impacto) (2.84KB) (0.01%)
    112μs
    1 x beforeRenderRawModule mod_menu (Sobre nosotros) (160B) (0.01%)
    111μs
    1 x beforeRenderRawModule mod_menu (Publicaciones Permanyer) (144B) (0.01%)
    108μs
    1 x beforeRenderRawModule mod_lightbox (Lightbox) (7.17KB) (0.01%)
    104μs
    1 x beforeRenderRawModule mod_languages (Cambiar Idioma) (5.38KB) (0.01%)
    99μs
    1 x afterRenderRawModule mod_custom (Publicación de la Sociedad Española de Cardiología) (1.09KB) (0.01%)
    96μs
    1 x After Access::getAssetRules (id:1161 name:com_content.article.628) (9.4KB) (0.01%)
    93μs
    1 x afterRenderRawModule mod_custom (Lo más compartido) (912B) (0.01%)
    90μs
    1 x afterRenderRawModule mod_custom (Article DOI activo) (1.02KB) (0.01%)
    87μs
    1 x afterRenderRawModule mod_custom (Article Category) (1.02KB) (0.01%)
    83μs
    1 x afterRenderRawModule mod_custom (EMAIL Y TWITTER) (1.02KB) (0.01%)
    82μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Descargar) (992B) (0.01%)
    81μs
    1 x afterRenderRawModule mod_custom (Article Subtitulo) (976B) (0.01%)
    80μs
    1 x afterRenderRawModule mod_custom (Home Concurso Hemodinamica) (928B) (0.01%)
    80μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Traducción) (1.16KB) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Imprimir) (928B) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Traducción) (1.03KB) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (928B) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Estadísticas) (928B) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (928B) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Material Adicional) (944B) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Article - Referencia ) (3.52KB) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Factor de Impacto) (976B) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Compartir) (928B) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Foto Autor) (1.02KB) (0.01%)
    76μs
    1 x afterRenderRawModule mod_custom (Article Authors) (976B) (0.01%)
    76μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Compartir) (928B) (0.01%)
    76μs
    1 x afterRenderRawModule mod_custom (Article Translated Title) (992B) (0.01%)
    76μs
    1 x afterRenderRawModule mod_custom (Article Related contents) (928B) (0.01%)
    76μs
    1 x afterRenderRawModule mod_custom (Article Title) (976B) (0.01%)
    75μs
    1 x afterRenderRawModule mod_custom (Lo más leído) (912B) (0.01%)
    74μs
    1 x Before Access::getAssetRules (id:1161 name:com_content.article.628) (66.8KB) (0%)
    46μs
    1 x beforeRenderRawModule mod_custom (Lo más compartido) (640B) (0%)
    35μs
    1 x beforeRenderRawModule mod_articles_good_search (Articles Good Search Total (Lateral)) (9.73KB) (0%)
    34μs
    1 x beforeRenderRawModule mod_custom (Article DOI activo) (1.22KB) (0%)
    27μs
    1 x beforeRenderRawModule mod_custom (Article Category) (2KB) (0%)
    26μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (5.47KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Descargar) (1.45KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Compartir) (5.36KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Article Related contents) (2.14KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Estadísticas) (3.52KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article Title) (1.69KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article Subtitulo) (1.13KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Factor de Impacto) (13.19KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Traducción) (1.48KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Traducción) (2.05KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Imprimir) (1.52KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (1.48KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (EMAIL Y TWITTER) (1.41KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Material Adicional) (3.53KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article - Referencia ) (1.61KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Foto Autor) (1.44KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Article Translated Title) (1.61KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_menu (Sidebar Menú ES) (768B) (0%)
    20μs
    1 x beforeRenderRawModule mod_menu (Sidebar - REC: Publications) (1.61KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Compartir) (304B) (0%)
    20μs
    1 x beforeRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (2.36KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Article Authors) (1.44KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Lo más leído) (2.39KB) (0%)
    19μs
    1 x beforeRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (3.08KB) (0%)
    18μs
    1 x After Access::getAssetRules (id:1 name:root.1) (7.41KB) (0%)
    17μs
    1 x Before Access::preloadPermissions (com_content) (4.16KB) (0%)
    10μs
    1 x After Access::getAssetRules (id:8 name:com_content) (1.59KB) (0%)
    10μs
    1 x beforeRenderModule mod_languages (Cambiar Idioma) (704B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Sidebar Menú ES) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_dms3_refs (Article Herramientas Exportar) (736B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Footer Final ES) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_breadcrumbs (Breadcrumbs ES) (704B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Contenido) (704B) (0%)
    4μs
    1 x beforeRenderModule mod_custom (Debate Title) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Category) (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_custom (Article Translated Title) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Authors) (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 (Home Concurso Hemodinamica) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_menu (Sidebar - REC: Publications) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Separador) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Traducción) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Compartir) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Material Adicional) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (752B) (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 (Article - Referencia ) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_articles_good_search (Articles Good Search Total (Lateral)) (752B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Factor de Impacto) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Lo más compartido) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Descargar) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Traducción) (736B) (0%)
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    1 x beforeRenderModule mod_custom (Article Herramientas Imprimir) (736B) (0%)
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    1 x beforeRenderModule mod_custom (Innovacion Herramientas Imprimir) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (EMAIL Y TWITTER) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Compartir) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Estadísticas) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Estadísticas) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_menu (Sobre nosotros) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Related contents) (736B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Lo más leído) (720B) (0%)
    2μs
95 statements were executed, 23 of which were duplicates, 72 unique878ms2.12MB
  • SELECT @@SESSION.sql_mode;113μs1.57KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:308Copy
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  • 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` = :guest164μs1.64KBParams/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`769μs21.8KBParams/libraries/src/Plugin/PluginHelper.php:294Copy
  • SELECT * FROM `yzfp0_languages` WHERE `published` = 1 ORDER BY `ordering` ASC225μs3.48KB/libraries/src/Language/LanguageHelper.php:177Copy
  • SELECT `element`,`name`,`client_id`,`extension_id` FROM `yzfp0_extensions` WHERE `type` = 'language' AND `state` = 0 AND `enabled` = 1169μs1.08KB/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`1.18ms200.55KBParams/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`348μs5.17KBParams/libraries/src/Categories/Categories.php:375Copy
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  • 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` = 1313μs1.55KB/administrator/components/com_templates/src/Model/StyleModel.php:775Copy
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  • 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)489μs112.69KBParams/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`309μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
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  • SHOW FULL COLUMNS FROM `yzfp0_users`273μs2.2KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:587Copy
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  • 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` = :userId157μs1.64KBParams/libraries/src/Access/Access.php:868Copy
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  • 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`440μs5.23KBParams/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 ASC1.46ms54.94KBParams/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` = :itemid1.12ms7.77KBParams/administrator/components/com_fields/src/Model/FieldModel.php:747Copy
  • 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` = 615 AND `c`.`published` > 0 AND (`a`.`state` = 1 AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= '2024-11-25 07:44:42') AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` = '0000-00-00 00:00:00' OR `a`.`publish_down` > '2024-11-25 07:44:42'))377μs114.44KB/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`374μs5.23KBParams/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)365μs112.73KBParams/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)405μs5.23KBParams/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 = '5' AND f2.value = '3' AND f3.value = '3' LIMIT 113.46ms856B/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 = '3' AND f2.value = '3' AND f3.value = '3' LIMIT 119.67ms856B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:168Copy
  • SELECT `catid`,`alias`,`language` FROM `yzfp0_content` WHERE `id` = '648'190μs976B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:227Copy
  • SELECT `alias` FROM `yzfp0_categories` WHERE `id` = '118'133μs856B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:239Copy
  • SELECT `catid`,`alias`,`language` FROM `yzfp0_content` WHERE `id` = '643'137μs976B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:227Copy
  • SELECT `alias` FROM `yzfp0_categories` WHERE `id` = '36'139μs856B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:239Copy
  • 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`337μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'component' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id412μs2.11KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `language`,`id` FROM `yzfp0_menu` WHERE `home` = '1' AND `published` = 1 AND `client_id` = 0293μs944B/libraries/src/Language/Multilanguage.php:123Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id145μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id116μs1.63KBParams/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 <= '2024-11-25 07:44:42') AND (c2.publish_down IS NULL OR c2.publish_down >= '2024-11-25 07:44:42') AND c2.state = 1307μs1.8KBParams/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`1.56ms163.91KBParams/libraries/src/Cache/Controller/CallbackController.php:51Copy
  • SELECT `a`.`menutype`,`a`.`title` FROM `yzfp0_menu_types` AS `a` WHERE `a`.`client_id` = 0182μs1.31KB/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.lft343μs1.92KB/libraries/gantry5/src/classes/Gantry/Framework/Menu.php:791Copy
  • SHOW FULL COLUMNS FROM `yzfp0_content`360μs2.39KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:587Copy
  • SELECT field.name,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[804] RegularLabs.Plugin.System.ArticlesAnywhere.DataGroups.Field.getFieldNames\n[799] 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'339μs34.13KB/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/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[779] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] 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` = 628 LIMIT 1122μs1KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT category.id,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[263] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getUnpublishedCategoryIds\n[668] 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.id264μs896B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[840] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByFilters\n[324] 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` <= '2024-11-25 07:44:42') AND (`article`.`publish_down` IS NULL OR `article`.`publish_down` = '0000-00-00 00:00:00' OR `article`.`publish_down` > '2024-11-25 07:44:42')) AND article.access IN (1,5) AND article.language IN ('es-ES','*')) AND `article`.`id` = 628172μs912B/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/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] 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` = 628 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 1140μs1.06KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id133μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id101μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] 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` = 628 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 1142μs1KB/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/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] 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` = 628 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 1189μs1.13KB/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)655μs5.23KBParams/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)456μs5.23KBParams/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` = :id253μs1.69KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[779] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] 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` = 628 LIMIT 1154μs8.89KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT * FROM `yzfp0_fields` AS `a` WHERE a.state IN (:preparedArray1,:preparedArray2) AND `a`.`context` = 'com_content.article'580μs54.11KBParams/plugins/system/articlesanywhere/src/DataGroups/Helpers/Fields.php:105Copy
  • SELECT *,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[590] RegularLabs.Plugin.System.ArticlesAnywhere.DataGroups.Field.getFieldFromDatabase\n[770] 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'361μs4.09KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT value.item_id,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[443] RegularLabs.Plugin.System.ArticlesAnywhere.DataGroups.Field.getWhere\n[670] 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'3.47ms420.88KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[727] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByFilters\n[324] 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` <= '2024-11-25 07:44:42') AND (`article`.`publish_down` IS NULL OR `article`.`publish_down` = '0000-00-00 00:00:00' OR `article`.`publish_down` > '2024-11-25 07:44:42')) AND article.access IN (1,5) AND article.language IN ('es-ES','*')) AND article.id IN 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  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[757] 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 (1259,3,4,5,6,7,8,9,10,11,12,13,15,16,21,22,23,31,36,37,1288,1287,1286,1279,1278,1277,1276,1303,261,1315,260,753,1053,1272,242,241,240,239,230,229,228,227,226,225,214,213,212,211,210,1309,1310,1311,1314,1322,1323,1324,1331,1332,1335,1298,1297,1293,1292,1291,1290,1265,1264,1263,1262,1258,1257,1256,1255,1251,1244,1234,1230,1229,1227,1224,1223,1222,1220,1214,1212,1211,1210,1209,1208,1207,1206,1205,1204,1199,1195,1190,1185,1184,1179,1178,1174,1165,1164,1163,1159,1158,1157,1156,1154,1153,1152,1151,1149,1148,1147,1144,1139,1138,1137,1135,1123,1119,1118,1117,1116,1115,1113,1107,1105,1104,1098,1097,1096,1095,1094,1091,1084,1083,1082,1081,1076,1075,1074,1073,1072,1066,1065,1060,1057,1052,1047,1046,1045,1044,1043,1037,1033,1032,1031,1027,1025,1024,1022,1020,1019,1016,1012,1010,1008,1007,1004,1003,1000,995,992,984,979,977,976,975,974,973,972,971,970,969,968,967,966,965,964,963,962,961,949,938,935,934,933,927,926,925,923,919,918,917,916,914,908,906,905,904,903,899,897,892,890,884,883,882,881,880,878,877,873,862,861,860,857,856,852,850,849,848,838,837,836,835,833,831,830,829,828,823,821,805,804,803,801,800,799,798,797,793,792,791,790,789,780,779,778,767,55,755,754,752,751,750,749,748,747,746,744,743,742,741,737,735,734,731,729,723,719,718,717,712,711,710,708,707,706,704,689,686,685,683,676,675,672,671,666,665,664,649,648,647,643,642,637,634,633,629,628,622,621,614,613,608,605,604,603,602,561,560,556,547,543,542,540,535,528,520,519,518,509,508,506,505,503,502,484,483,482,479,477,476,460,459,458,457,455,454,453,452,450,433,432,431,430,429,423,422,421,420,413,412,411,410,403,402,401,399,385,384,383,382,381,376,375,374,373,372,371,370,369,361,360,359,358,356,354,353,352,351,350,276,275,274,273,272,271,270,264,54,59,60,253,345,344,339,333,332,331,322,321,320,319,318,317,316,315,314,308,307,305,300,299,298,287,286,285,587,584,572,183,182,181,178,177,175,171,170,169,164,163,161,1261,847,846,1317,1260,663,607,570,569,567,566,565,564,563,562,493,492,491,438,437,436,435,434,283,258,256,255,254,184,174,173,172,166,165,160,159,158,149,148,147,139,138,137,136,134,133,132,131,130,124,121,119,116,115,113,2586,2589,2590,2591,2592,2594,2595,2596,2598,2599,2600,2605,2611) 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 31.53ms944B/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/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[765] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] 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 (320,344,339) ORDER BY FIELD(article.id,320,344,339)224μs1.16KB/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`539μs5.22KBParams/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`360μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id131μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id128μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[757] 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 (1259,3,4,5,6,7,8,9,10,11,12,13,15,16,21,22,23,31,36,37,1288,1287,1286,1279,1278,1277,1276,1303,261,1315,260,753,1053,1272,242,241,240,239,230,229,228,227,226,225,214,213,212,211,210,1309,1310,1311,1314,1322,1323,1324,1331,1332,1335,1298,1297,1293,1292,1291,1290,1265,1264,1263,1262,1258,1257,1256,1255,1251,1244,1234,1230,1229,1227,1224,1223,1222,1220,1214,1212,1211,1210,1209,1208,1207,1206,1205,1204,1199,1195,1190,1185,1184,1179,1178,1174,1165,1164,1163,1159,1158,1157,1156,1154,1153,1152,1151,1149,1148,1147,1144,1139,1138,1137,1135,1123,1119,1118,1117,1116,1115,1113,1107,1105,1104,1098,1097,1096,1095,1094,1091,1084,1083,1082,1081,1076,1075,1074,1073,1072,1066,1065,1060,1057,1052,1047,1046,1045,1044,1043,1037,1033,1032,1031,1027,1025,1024,1022,1020,1019,1016,1012,1010,1008,1007,1004,1003,1000,995,992,984,979,977,976,975,974,973,972,971,970,969,968,967,966,965,964,963,962,961,949,938,935,934,933,927,926,925,923,919,918,917,916,914,908,906,905,904,903,899,897,892,890,884,883,882,881,880,878,877,873,862,861,860,857,856,852,850,849,848,838,837,836,835,833,831,830,829,828,823,821,805,804,803,801,800,799,798,797,793,792,791,790,789,780,779,778,767,55,755,754,752,751,750,749,748,747,746,744,743,742,741,737,735,734,731,729,723,719,718,717,712,711,710,708,707,706,704,689,686,685,683,676,675,672,671,666,665,664,649,648,647,643,642,637,634,633,629,628,622,621,614,613,608,605,604,603,602,561,560,556,547,543,542,540,535,528,520,519,518,509,508,506,505,503,502,484,483,482,479,477,476,460,459,458,457,455,454,453,452,450,433,432,431,430,429,423,422,421,420,413,412,411,410,403,402,401,399,385,384,383,382,381,376,375,374,373,372,371,370,369,361,360,359,358,356,354,353,352,351,350,276,275,274,273,272,271,270,264,54,59,60,253,345,344,339,333,332,331,322,321,320,319,318,317,316,315,314,308,307,305,300,299,298,287,286,285,587,584,572,183,182,181,178,177,175,171,170,169,164,163,161,1261,847,846,1317,1260,663,607,570,569,567,566,565,564,563,562,493,492,491,438,437,436,435,434,283,258,256,255,254,184,174,173,172,166,165,160,159,158,149,148,147,139,138,137,136,134,133,132,131,130,124,121,119,116,115,113,2586,2589,2590,2591,2592,2594,2595,2596,2598,2599,2600,2605,2611) 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 3432ms944B/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/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[765] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] 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)231μs1.16KB/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`503μs5.22KBParams/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`464μs5.23KBParams/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)750μs112.73KBParams/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/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] 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` = 628 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 1186μs1.13KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`hits` AS `article.hits`,'https://recintervcardiol.org/es/enfermedad-valvular/resultados-del-tavi-emergente-comparado-con-el-procedimiento-electivo-metanalisis\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] 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` = 628 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 1223μs976B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT * FROM `yzfp0_schemaorg` WHERE `itemId` = :itemId AND `context` = :context159μs1.86KBParams/plugins/system/schemaorg/src/Extension/Schemaorg.php:411Copy
  • 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)416μs112.73KBParams/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` = 1187μs1.68KBParams/administrator/components/com_scheduler/src/Model/TasksModel.php:466Copy
  • 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.id287μs2.14KB/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` = 1183μs896B/administrator/components/com_conditions/src/Model/ItemModel.php:815Copy
  • 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.id338μs18.42KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `item_id` = '628' AND `field_id` = 30246μs840B/tmp/regularlabs/custom_php/11057_af27ee991d0d77889539c6cba39057bf:36Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `item_id` = '628' AND `field_id` = 19220μs856B/tmp/regularlabs/custom_php/11057_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` = 628 AND `c`.`published` > 0 AND (`a`.`state` = 1 AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= '2024-11-25 07:44:42') AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` = '0000-00-00 00:00:00' OR `a`.`publish_down` > '2024-11-25 07:44:42'))454μs111.44KB/libraries/regularlabs/src/Article.php:94Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `field_id` = 18 AND `item_id` = 6281.46ms856B/tmp/regularlabs/custom_php/11057_20d16d1e6db57666571c51c2623628e6:28Copy
  • 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.id357μs2.19KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `session_id` FROM `yzfp0_session` WHERE `session_id` = ?213μs1.63KBParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:277Copy
  • UPDATE `yzfp0_session` SET `data` = ? , `time` = ? WHERE `session_id` = ?485μs912BParams/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