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calcific aortic valve disease

Marvin Louis Roy Lu, Shuchita Gupta, Abel Romero-Corral, Magdaléna Matejková, Toni De Venecia, Edinrin Obasare, Vikas Bhalla, Gregg S Pressman
BACKGROUND: Calcium deposits in the aortic valve and mitral annulus have been associated with cardiovascular events and mortality. However, there is no accepted standard method for scoring such cardiac calcifications, and most existing methods are simplistic. The aim of this study was to test the hypothesis that a semiquantitative score, one that accounts for all visible calcium on echocardiography, could predict all-cause mortality and stroke in a graded fashion. METHODS: This was a retrospective study of 443 unselected subjects derived from a general echocardiography database...
October 11, 2016: Journal of the American Society of Echocardiography
Noman Ahmed Jang Khan, Masroor A Khan, Guillermo Juan Morell Chardon
End stage renal disease has a list of consequences, cardiovascular being the most common. Inefficient dialysis can cause significant deposition of calcium all over the body, including heart valves making heart function impaired. We illustrate a case of 38-year-old female with end stage renal disease on peritoneal dialysis. The patient had been complaining of pain and swelling of the right hand for the last few months and had been seen by hand surgeon and was admitted electively for the biopsy of hand lesions...
2016: Case Reports in Cardiology
Tania A Pawade, Timothy R G Cartlidge, William S A Jenkins, Philip D Adamson, Phillip Robson, Christophe Lucatelli, Edwin J R Van Beek, Bernard Prendergast, Alan R Denison, Laura Forsyth, James H F Rudd, Zahi A Fayad, Alison Fletcher, Sharon Tuck, David E Newby, Marc R Dweck
BACKGROUND: 18F-Fluoride positron emission tomography (PET) and computed tomography (CT) can measure disease activity and progression in aortic stenosis. Our objectives were to optimize the methodology, analysis, and scan-rescan reproducibility of aortic valve 18F-fluoride PET-CT imaging. METHODS AND RESULTS: Fifteen patients with aortic stenosis underwent repeated 18F-fluoride PET-CT. We compared nongated PET and noncontrast CT, with a modified approach that incorporated contrast CT and ECG-gated PET...
October 2016: Circulation. Cardiovascular Imaging
Laura Mourino-Alvarez, Montserrat Baldan-Martin, Laura Gonzalez-Calero, Carlos Martinez-Laborde, Tamara Sastre-Oliva, Rafael Moreno-Luna, Luis F Lopez-Almodovar, Pedro L Sanchez, Francisco Fernandez-Aviles, Fernando Vivanco, Luis R Padial, Finn Akerstrom, Gloria Alvarez-Llamas, Fernando de la Cuesta, María G Barderas
BACKGROUND: The most common valve diseases are calcific aortic stenosis (AS) and aortic regurgitation (AR). The former is characterized by thickening of valve leaflets followed by progressive calcification, which produces progressive aortic valve (AV) narrowing, increased pressure afterload on the left ventricle (LV) and subsequent LV hypertrophy. On the other hand, AR is due to malcoaptation of the valve leaflets with resultant diastolic reflux of blood from aorta back to the LV producing volume and pressure overload and progressive LV dilatation...
September 26, 2016: International Journal of Cardiology
Tolga Han Efe, Kadriye Gayretli Yayla, Cagri Yayla, Ahmet Goktug Ertem, Tolga Cimen, Hilal Erken Pamukcu, Murat Bilgin, Mehmet Erat, Mehmet Dogan, Ekrem Yeter
INTRODUCTION: Calcific aortic valve disease, a chronic progressive disorder, is the leading cause of valve replacement among elderly patients. The lymphocyte/monocyte ratio has been recently put forward as an inflammatory marker of relevance in several cancers as well as in cardiovascular disease. This study aims to assess the correlation between severity of calcific aortic stenosis and the lymphocyte/monocyte ratio. METHODS: The study retrospectively included 178 patients with a diagnosis of calcific aortic stenosis and 139 age- and gender-matched controls...
September 30, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Heather N Hutson, Taylor Marohl, Matthew Anderson, Kevin Eliceiri, Paul Campagnola, Kristyn S Masters
Disorganization of the valve extracellular matrix (ECM) is a hallmark of calcific aortic valve disease (CAVD). However, while microarchitectural features of the ECM can strongly influence the biological and mechanical behavior of tissues, little is known about the ECM microarchitecture in CAVD. In this work, we apply advanced imaging techniques to quantify spatially heterogeneous changes in collagen microarchitecture in CAVD. Human aortic valves were obtained from individuals between 50 and 75 years old with no evidence of valvular disease (healthy) and individuals who underwent valve replacement surgery due to severe stenosis (diseased)...
2016: PloS One
Bettina Langhammer, Christoph Huber, Stephan Windecker, Thierry Carrel
Surgical techniques for the treatment of mitral valve disease (MVD) have continuously evolved; however, anatomical details like severe annular calcification remain challenging and require sophisticated surgical strategies. Among patients with symptomatic MVD referred for surgical valve repair or replacement, four presented with circumferential calcification of the mitral annulus precluding conventional surgical techniques. Successful treatment by implanting a balloon-expandable transcatheter aortic heart valve using an antegrade surgical access was performed...
September 27, 2016: European Journal of Cardio-thoracic Surgery
Armelle Meershoek, Rogier A van Dijk, Sander Verhage, Jaap F Hamming, Antoon J van den Bogaerdt, Ad J J C Bogers, Alexander F Schaapherder, Jan H Lindeman
BACKGROUND/OBJECTIVES: Carotid intimal media thickness (IMT) and coronary calcium scores (CCS) are thought to reflect atherosclerotic burden. The validity of this assumption for IMT is challenged by recent meta-analyses; for CCS by absence of a relationship between negative scores, and freedom of future events. As such, we considered evaluation of the relationship between tissue IMT and CCS, and extend of atherosclerotic disease relevant. METHODS: Analyses were performed on donor aortas obtained during renal graft procurement, and on coronary arteries collected during heart valve procurement for tissue donation...
September 17, 2016: International Journal of Cardiology
Nicholas J Viney, Julian C van Capelleveen, Richard S Geary, Shuting Xia, Joseph A Tami, Rosie Z Yu, Santica M Marcovina, Steven G Hughes, Mark J Graham, Rosanne M Crooke, Stanley T Crooke, Joseph L Witztum, Erik S Stroes, Sotirios Tsimikas
BACKGROUND: Elevated lipoprotein(a) (Lp[a]) is a highly prevalent (around 20% of people) genetic risk factor for cardiovascular disease and calcific aortic valve stenosis, but no approved specific therapy exists to substantially lower Lp(a) concentrations. We aimed to assess the efficacy, safety, and tolerability of two unique antisense oligonucleotides designed to lower Lp(a) concentrations. METHODS: We did two randomised, double-blind, placebo-controlled trials...
September 21, 2016: Lancet
Jonathon Leipsic, Philipp Blanke
The treatment of both aortic and now mitral valvular disease has been transformed through transcatheter valvular interventions. TAVR has rapidly become the treatment of choice for symptomatic severe aortic stenosis in both high, and now intermediate-risk patients. Building upon this success the last two years have seen the clinical introduction of transcatheter mitral valve replacement (TMVR), with a number of devices being utilised in first-in-man and feasibility studies. These experiences have helped determine the anatomical requirements and specifications that enable successful device deployment and avoidance of complications...
September 18, 2016: EuroIntervention
Philippe J van Rosendael, Vasileios Kamperidis, William K F Kong, Alexander R van Rosendael, Nina A Marsan, Jeroen J Bax, Victoria Delgado
The aim of this study was to compare the calcium burden of the aortic valve and coronary arteries with multidetector computed tomography (MDCT) in a propensity score-matched population of patients with a bicuspid versus a tricuspid aortic valve. From an ongoing clinical registry of patients who underwent MDCT, 70 patients with bicuspid aortic valve and 210 patients with tricuspid aortic valve were matched based on age, gender, cardiovascular risk factors, chest pain symptoms, and MDCT indication. Aortic valve calcium and the presence and severity of coronary artery disease were analyzed...
August 23, 2016: American Journal of Cardiology
Tetsuo Yamanaka, Toru Fukatsu, Yoshimaro Ichinohe, Hirotaka Komatsu, Masahiro Seki, Kenichi Sasaki, Hideaki Takai, Takashi Kunihara, Yasunobu Hirata
We herein report an adult case of unicommissural unicuspid aortic valve (UAV). A 59-year-old man, who was noted to have a cardiac murmur at 31 years of age, was admitted to our hospital due to acute heart failure. Severe calcification in the aortic valve with severe low-flow/low-gradient aortic stenosis and moderate aortic regurgitation was observed and thought to be the cause of heart failure, however, the etiology of aortic valve dysfunction was not clear. Aortic valve replacement was subsequently performed, and unicommissural UAV was diagnosed according to the intraoperative findings...
2016: Internal Medicine
Jae-Joon Jung, Mahmoud Razavian, Hye-Yeong Kim, Yunpeng Ye, Reza Golestani, Jakub Toczek, Jiasheng Zhang, Mehran M Sadeghi
Calcific aortic valve disease (CAVD) is the most common cause of aortic stenosis. Currently, there is no non-invasive medical therapy for CAVD. Matrix metalloproteinases (MMPs) are upregulated in CAVD and play a role in its pathogenesis. Here, we evaluated the effect of doxycycline, a nonselective MMP inhibitor on CAVD progression in the mouse. Apolipoprotein (apo)E(-/-) mice (n = 20) were fed a Western diet (WD) to induce CAVD. After 3 months, half of the animals was treated with doxycycline, while the others continued WD alone...
2016: Scientific Reports
Neal S Kleiman, Brijeshwar J Maini, Michael J Reardon, John Conte, Stanley Katz, Vivek Rajagopal, James Kauten, Alan Hartman, Raymond McKay, Robert Hagberg, Jian Huang, Jeffrey Popma
BACKGROUND: The risk for stroke after transcatheter aortic valve replacement (TAVR) is an important concern. Identification of predictors for stroke is likely to be a critical factor aiding patient selection and management as TAVR use becomes widespread. METHODS AND RESULTS: Patients enrolled in the CoreValve US Extreme Risk and High Risk Pivotal Trials or Continued Access Study treated with the self-expanding CoreValve bioprosthesis were included in this analysis...
September 2016: Circulation. Cardiovascular Interventions
Hasan Bushnaq, Dietrich Metz, Asen Petrov, Stefan Frantz, Ulrich Hofmann, Christoph Raspé, Hendrik Treede
OBJECTIVE: The standard procedure of transcatheter aortic valve implantation involves transfemoral access. Nevertheless, the use of this access route is limited by the vessel diameter, calcification, and tortuosity, making a subgroup of patients ineligible for peripheral access. We report the first use of direct aortic transcatheter aortic valve implantation with the Direct Flow Medical valve (Direct Flow Medical, Inc, Santa Rosa, Calif) in 15 patients at the Halle-Wittenberg University...
August 12, 2016: Journal of Thoracic and Cardiovascular Surgery
Raquel Del Toro, Raphael Chèvre, Cristina Rodríguez, Antonio Ordóñez, José Martínez-González, Vicente Andrés, Simón Méndez-Ferrer
Atherosclerosis is a leading death cause. Endothelial and smooth muscle cells participate in atherogenesis, but it is unclear whether other mesenchymal cells contribute to this process. Bone marrow (BM) nestin(+) cells cooperate with endothelial cells in directing monocyte egress to bloodstream in response to infections. However, it remains unknown whether nestin(+) cells regulate inflammatory cells in chronic inflammatory diseases, such as atherosclerosis. Here, we show that nestin(+) cells direct inflammatory cell migration during chronic inflammation...
2016: Nature Communications
Tuomas Peltonen, Pauli Ohukainen, Heikki Ruskoaho, Jaana Rysä
Calcific aortic valve disease (CAVD) represents a spectrum of disease spanning from milder degrees of calcification of valve leaflets, i.e. aortic sclerosis, to severe calcification i.e. aortic stenosis (AS) with hemodynamic instability. The prevalence of CAVD is increasing rapidly due to the aging of the population, being up to 2,8% among patients over 75 years of age. Even without significant aortic valve stenosis, aortic sclerosis is associated with a 50% increased risk of myocardial infarction and death from cardiovascular causes...
September 1, 2016: Annals of Medicine
Patrizia Carità, Giuseppe Coppola, Giuseppina Novo, Giuseppa Caccamo, Marco Guglielmo, Fabio Balasus, Salvatore Novo, Sebastiano Castrovinci, Marco Moscarelli, Khalil Fattouch, Egle Corrado
Aortic stenosis (AS) is a common valvular heart disease in the Western populations, with an estimated overall prevalence of 3% in adults over 75 years. To understand its patho-biological processes represents a priority. In elderly patients, AS usually involves trileaflet valves and is referred to as degenerative calcific processes. Scientific evidence suggests the involvement of an active "atherosclerosis-like" pathogenesis in the initiation phase of degenerative AS. To the contrary, the progression could be driven by different forces (such as mechanical stress, genetic factors and interaction between inflammation and calcification)...
September 2016: Journal of Geriatric Cardiology: JGC
Talal S Alnabelsi, Yaser Alhamshari, Ramzi H Mulki, Jose N Codolosa, Nikoloz Koshkelashvili, Igor Goykhman, Gregg S Pressman, Abel Romero-Corral
Epicardial adipose tissue (EAT) has been linked to coronary artery calcium deposits and atherosclerotic disease. Mitral annular (MAC) and aortic valve calcium (AVC) have also been associated with atherosclerosis. This study examined the possible relation between EAT thickness and valvular calcium deposits. We included 294 patients aged ≥65 years who had noncontrast computed tomography scans of the chest. Mean age was 76 ± 7 years; 47% were men. Using reconstructed images, EAT thickness was measured at various locations...
October 1, 2016: American Journal of Cardiology
Gianluca Lucchese, Nicholas Montarello, Vinayak Bapat
Transcatheter aortic valve implantation (TAVI) is now routinely performed to treat inoperable and high-risk patients with severe aortic stenosis (AS). Transapical or transaortic approaches are alternative routes used when peripheral accesses are unsuitable.Correct placement of the device is achieved with the help of an angiography performed with a pigtail catheter to identify the deployment view. However, in patients with severe vascular disease, placement of a pigtail catheter may not be possible.We report a modified single-puncture technique, whereby a single access point is used to perform both angiography and TAVI by using visible calcification landmarks as reference points...
August 12, 2016: Thoracic and Cardiovascular Surgeon
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