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Valvular diseases

Arnaud Bisson, Alexandre Bodin, Nicolas Clementy, Anne Bernard, Dominique Babuty, Gregory Y H Lip, Laurent Fauchier
AIMS: We compared thromboembolic (TE) and bleeding risks in patients with atrial fibrillation (AF) according to the new 'Evaluated Heartvalves, Rheumatic or Artificial' (EHRA) valve classification. METHODS: Patients were divided into 3 categories: (i) EHRA type 1 corresponds to the previous 'valvular' AF patients, with either rheumatic mitral valve stenosis or mechanical prosthetic heart valves; (ii) EHRA type 2 includes AF patients with other valvular heart disease (VHD) and valve bioprosthesis or repair; and (iii) 'non-VHD controls' i...
March 7, 2018: International Journal of Cardiology
Volha Dziadzko, Marie-Annick Clavel, Mikhail Dziadzko, Jose R Medina-Inojosa, Hector Michelena, Joseph Maalouf, Vuyisile Nkomo, Prabin Thapa, Maurice Enriquez-Sarano
BACKGROUND: Mitral regurgitation is the most common valve disease worldwide but whether the community-wide prevalence, poor patient outcomes, and low rates of surgical treatment justify costly development of new therapeutic interventions remains uncertain. Therefore, we did an observational cohort study to assess the clinical characteristics, outcomes, and degree of undertreatment of mitral regurgitation in a community setting. METHODS: We used data from Mayo Clinic electronic health records and the Rochester Epidemiology Project to identify all cases of moderate or severe isolated single-valvular mitral regurgitation (with no other severe left-sided valvular disease or previous mitral surgery) diagnosed during a 10-year period in the community setting in Olmsted County (MN, USA)...
March 10, 2018: Lancet
Yang Liu, Xiao-Hui Niu, Xiaomeng Yin, Yue-Jian Liu, Chao Han, Jie Yang, Xin Huang, Xiaohong Yu, Lianjun Gao, Yan-Zong Yang, Yun-Long Xia, Hui-Hua Li
BACKGROUND: In atrial fibrillation (AF), a more extensively fibrotic left atrium (LA) provides a substrate for arrhythmias and increases risk of relapse following ablation. Fibrocytes are bone marrow-derived circulating mesenchymal progenitors that have been identified in the atrium of patients with AF who have valvular diseases. The present study investigates the associations between circulating fibrocytes and LA fibrosis or the prevalence of recurrence after ablation in patients with persistent AF...
March 13, 2018: Journal of the American Heart Association
Tasalak Thonghong, Ole De Backer, Lars Søndergaard
New European guidelines on the management of valvular heart disease-supported by the European Society of Cardiology (ESC) and European Association of CardioThoracic Surgery (EACTS)-were recently published. Although these guidelines are very comprehensive, these typically are not very inviting to read. In this document, we aimed to distil all the information about transcatheter aortic valve replacement (TAVR) in the new 2017 ESC/EACTS guidelines to the essential and give additional comments on the position of TAVR in 2017...
2018: Open Heart
Fabian Plank, Christoph Beyer, Guy Friedrich, Markus Stühlinger, Florian Hintringer, Wolfgang Dichtl, Matthias Wildauer, Gudrun Feuchtner
OBJECTIVE: Vitamin K antagonists (VKA) are associated with increased vascular calcification which may lead to an elevated cardiovascular risk. If the direct anticoagulants (DOACs) have similar negative vascular effects is unknown. We evaluated the influence of different anticoagulation strategies on coronary artery disease (CAD) using coronary computed tomography angiography (CTA). METHODS: Overall 702 consecutive patients with non-valvular atrial fibrillation (AF) who underwent CTA for AF ablation planning were enrolled and stratified according to their anticoagulation into VKA, DOAC (all agents) and a control group without oral anticoagulation...
March 6, 2018: International Journal of Cardiology
Eva A H Lanters, Christophe P Teuwen, Ameeta Yaksh, Charles Kik, Lisette J M E van der Does, Elisabeth M J P Mouws, Paul Knops, Nicole J van Groningen, Thijmen Hokken, Ad J J C Bogers, Natasja M S de Groot
BACKGROUND: Early postoperative atrial fibrillation (EPoAF) is associated with thromboembolic events, prolonged hospitalization, and development of late PoAF (LPoAF). It is, however, unknown if EPoAF can be predicted by intraoperative AF inducibility. The aims of this study are therefore to explore (1) the value of intraoperative inducibility of AF for development of both EPoAF and LPoAF and (2) the predictive value of de novo EPoAF for recurrence of LPoAF. METHODS AND RESULTS: Patients (N=496, 75% male) undergoing cardiothoracic surgery for coronary and/or valvular heart disease were included...
March 10, 2018: Journal of the American Heart Association
Michael Gottlieb, Brit Long, Alex Koyfman
INTRODUCTION: Aortic stenosis is a common condition among older adults that can be associated with dangerous outcomes, due to both the disease itself and its influence on other conditions. OBJECTIVE: This review provides an evidence-based summary of the current emergency department (ED) evaluation and management of aortic stenosis. DISCUSSION: Aortic stenosis refers to significant narrowing of the aortic valve and can be caused by calcific disease, congenital causes, or rheumatic valvular disease...
March 7, 2018: Journal of Emergency Medicine
Vasiliki V Georgiopoulou, Arash Velayati, Greg Burkman, Song Li, Kanwal Farooq, Ayman Samman-Tahhan, Lampros Papadimitriou, Javed Butler, Andreas P Kalogeropoulos
Patients with heart failure and preserved ejection fraction (HFpEF) tend to be older and have a high co-morbidity burden. The impact of co-morbid conditions and sociodemographic risk factors on outcomes in these patients has not been quantified. We evaluated 445 consecutive outpatients with HFpEF, defined as established diagnosis of heart failure (HF) with left ventricular ejection fraction at presentation >40% and no previous left ventricular ejection fraction ≤40%. Patients with specific cardiomyopathies, congenital heart disease, primary right-sided disease, valvular disease, or previous advanced HF therapies were excluded...
February 12, 2018: American Journal of Cardiology
Hongyan Wu, Qing Chang
Valvular diseases are common health problems that are strongly related to high morbidity and mortality; aortic valve allograft transplantation may be a promising way to improve survival and relieve symptoms. However, ideal tissue viability has not been observed with common valve cryopreservation methods, which could lead to apoptosis and necrosis in cryopreserved tissue. It has been observed that trehalose plays a positive role by acting to maintain cell structures and protect cells from stress responses. In this study, we studied the effects of trehalose in protecting rat valve tissue from the cooling process...
2018: PloS One
Shu-Zhen Xu, Yan Liang, Xiang-Pei Li, Xiao-Mei Li, Zong-Wen Shuai, Rui-Xue Leng, Hai-Feng Pan, Dong-Qing Ye
Pulmonary arterial hypertension (PAH) is an increasingly recognized complication of systemic lupus erythematosus (SLE). This study aims to estimate the point prevalence of PAH and identify risk factors for PAH in a large cohort of hospitalized SLE patients. We have collected the medical records of patients hospitalized with SLE at the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital. Resting transthoracic echocardiography (TTE) was used to estimate pulmonary artery pressure (PAP) and PAH was defined as systolic PAP (PASP) > 30 mmHg...
March 8, 2018: Clinical Rheumatology
Elisabeth M J P Mouws, Eva A H Lanters, Christophe P Teuwen, Lisette J M E van der Does, Charles Kik, Paul Knops, Ameeta Yaksh, Jos A Bekkers, Ad J J C Bogers, Natasja M S de Groot
BACKGROUND: The influence of underlying heart disease or presence of atrial fibrillation (AF) on atrial excitation during sinus rhythm (SR) is unknown. We investigated atrial activation patterns and total activation times of the entire atrial epicardial surface during SR in patients with ischemic and/or valvular heart disease with or without AF. METHODS AND RESULTS: Intraoperative epicardial mapping (N=128/192 electrodes, interelectrode distances: 2 mm) of the right atrium, Bachmann's bundle (BB), left atrioventricular groove, and pulmonary vein area was performed during SR in 253 patients (186 male [74%], age 66±11 years) with ischemic heart disease (N=132, 52%) or ischemic valvular heart disease (N=121, 48%)...
March 8, 2018: Journal of the American Heart Association
Angelos Tsipis, Nikolaos Skandalakis, Nikolaos Kanakakis, Nektarios Pilatis, Evdokia Petropoulou
Infective endocarditis due to Enterococus Gallinarum is a rare clinical condition. We present a case of an 85 years old male with history of valvular disease and permanent pace maker with past medical history of repetitive urinary tract infections in the previous months, who presented to the emergency department with fever, urinary disturbances, general malaise and positive blood cultures for Enterococcus Gallinarum. Echocardiography was a useful diagnostic method in the present case, showing the vegetation on the tricuspid valve...
March 1, 2018: Cardiovascular & Hematological Disorders Drug Targets
Richard A Gray, Pras Pathmanathan
Patient-specific computer models have been developed representing a variety of aspects of the cardiovascular system spanning the disciplines of electrophysiology, electromechanics, solid mechanics, and fluid dynamics. These physiological mechanistic models predict macroscopic phenomena such as electrical impulse propagation and contraction throughout the entire heart as well as flow and pressure dynamics occurring in the ventricular chambers, aorta, and coronary arteries during each heartbeat. Such models have been used to study a variety of clinical scenarios including aortic aneurysms, coronary stenosis, cardiac valvular disease, left ventricular assist devices, cardiac resynchronization therapy, ablation therapy, and risk stratification...
March 6, 2018: Journal of Cardiovascular Translational Research
Anna Helgadottir, Gudmar Thorleifsson, Solveig Gretarsdottir, Olafur A Stefansson, Vinicius Tragante, Rosa B Thorolfsdottir, Ingileif Jonsdottir, Thorsteinn Bjornsson, Valgerdur Steinthorsdottir, Niek Verweij, Jonas B Nielsen, Wei Zhou, Lasse Folkersen, Andreas Martinsson, Mahyar Heydarpour, Siddharth Prakash, Gylfi Oskarsson, Tomas Gudbjartsson, Arnar Geirsson, Isleifur Olafsson, Emil L Sigurdsson, Peter Almgren, Olle Melander, Anders Franco-Cereceda, Anders Hamsten, Lars Fritsche, Maoxuan Lin, Bo Yang, Whitney Hornsby, Dongchuan Guo, Chad M Brummett, Gonçalo Abecasis, Michael Mathis, Dianna Milewicz, Simon C Body, Per Eriksson, Cristen J Willer, Kristian Hveem, Christopher Newton-Cheh, J Gustav Smith, Ragnar Danielsen, Gudmundur Thorgeirsson, Unnur Thorsteinsdottir, Daniel F Gudbjartsson, Hilma Holm, Kari Stefansson
Aortic valve stenosis (AS) is the most common valvular heart disease, and valve replacement is the only definitive treatment. Here we report a large genome-wide association (GWA) study of 2,457 Icelandic AS cases and 349,342 controls with a follow-up in up to 4,850 cases and 451,731 controls of European ancestry. We identify two new AS loci, on chromosome 1p21 near PALMD (rs7543130; odds ratio (OR) = 1.20, P = 1.2 × 10-22 ) and on chromosome 2q22 in TEX41 (rs1830321; OR = 1.15, P = 1.8 × 10-13 )...
March 7, 2018: Nature Communications
Saoussen Antit, Lilia Zakhama, Sarra Chenik, Mohamed Saadi, Ahmed Houmed, Samar Mohamed, Elhem Boussabeh, Moez Thameur, Soraya Ben Youssef
Carcinoid tumors are rare, mainly located in the gastrointestinal tract particularly in the small intestine. Cardiac involvement, fairly frequent and usually affecting right sided heart valves, had a poor prognosis that is improved by an earlier detection and valve surgery. We report the case of a 50-years old woman with neuroendocrine tumor and liver metastases, in whom carcinoid involvement of the right heart was diagnosed following exertional dyspnea. She had dilated right cavities, severe tricuspid regurgitation, mild tricuspid stenosis and a moderate pulmonary stenosis...
May 2017: La Tunisie Médicale
Karima Taamallah, Sinda Sahraoui, Walid Ghodhbane, Hakim Messaoudi, Mohamed Ziedi, Mokhles Lajmi, Slim Chenik
INTRODUCTION: Cardiovascular disease is the most common cause of death in chronic hemodialysis patients(1). Cardiac surgery in hemodialysis patients exposes to higher risks inherent in the particular status of these patients. The aim of our study is to report the perioperative particularities of hemodialysis patients undergoing cardiac surgery, and to determine the impact of preoperative clinical status on hospital and late morbidity and mortality. METHODS: Between January 1998 and December 2012, 48 patients in chronic hemodialysis (HD) and candidates for cardiac surgery on cardiopulmonary bypass were retrospectively included...
May 2017: La Tunisie Médicale
H Yang, J F Heidendael, J R de Groot, T C Konings, G Veen, A P J van Dijk, F J Meijboom, G Tj Sieswerda, M C Post, M M Winter, B J M Mulder, B J Bouma
BACKGROUND: Current guidelines on oral anticoagulation (OAC) in adults with congenital heart disease (ACHD) and atrial arrhythmias (AA) consist of heterogeneous and divergent recommendations with limited level of evidence, possibly leading to diverse OAC management and different outcomes. Therefore, we aimed to evaluate real-world implementation and outcome of three guidelines on OAC management in ACHD patients with AA. METHODS: The ESC GUCH 2010, PACES/HRS 2014 and ESC atrial fibrillation (AF) 2016 guidelines were assessed for implementation...
April 15, 2018: International Journal of Cardiology
Eloisa Arbustini, Valentina Favalli, Alessandro Di Toro, Lorenzo Giuliani, Giuseppe Limongelli
The concept "common presentation of rare diseases" implies that rare diseases are masked by common phenotypic manifestations. This concept applies to both aneurysmal and valvular diseases that can be syndromic and non-syndromic. Syndromic disorders include genetic connective tissue diseases and chromosomal disorders that are diagnosed independently from the aneurysm or valve disease. Non-syndromic diseases, on the other hand, are defined by the presence of aneurysm or valve disease or both. The reasons for suspecting these rare diseases include young age, the absence of risk factors, a positive family history for aortic or valvular disease/event, and extra-cardiovascular traits for syndromes...
April 15, 2018: International Journal of Cardiology
Jennifer M Richards, Jennie A M R Kunitake, Heather B Hunt, Alexa N Wnorowski, Debra W Lin, Adele L Boskey, Eve Donnelly, Lara A Estroff, Jonathan T Butcher
Calcific aortic valve disease (CAVD) is an inexorably degenerative pathology characterized by progressive calcific lesion formation on the valve leaflets. The interaction of valvular cells in advanced lesion environments is not well understood yet highly relevant as clinically detectable CAVD exhibits calcifications composed of non-stoichiometric hydroxyapatite (HA). In this study, Fourier transform infrared spectroscopic imaging was used to spatially analyze mineral properties as a function of disease progression...
March 2, 2018: Acta Biomaterialia
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2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
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