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Valvular pathology

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https://www.readbyqxmd.com/read/29674478/quadruple-valve-replacement-in-a-patient-with-severe-rheumatic-heart-disease
#1
Isaac Adembesa, Adriaan Myburgh, Justiaan Swanevelder
INTRODUCTION: RHD is the leading cause of cardiovascular morbidity and mortality among young people. TOE is valuable in confirming valvular heart pathology. DISCUSSION: We present a patient with severe rheumatic heart disease involving all the heart valves. TOE confirmed severe mitral stenosis, severe aortic regurgitation, severe tricuspid regurgitation and stenosis and severe pulmonary stenosis. This was consistent with TTE findings preoperatively. The patient underwent successful quadruple valve replacement in a single operation...
April 19, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#2
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29630054/technique-and-patient-selection-criteria-of-right-anterior-mini-thoracotomy-for-minimal-access-aortic-valve-replacement
#3
Reza Tavakoli, Pascal Leprince, Max Gassmann, Peiman Jamshidi, Nassrin Yamani, Julien Amour, Guillaume Lebreton
Aortic valve stenosis has become the most prevalent valvular heart disease in developed countries, and is due to the aging of these populations. The incidence of the pathology increases with growing age after 65 years. Conventional surgical aortic valve replacement through median sternotomy has been the gold standard of patient care for symptomatic aortic valve stenosis. However, as the risk profile of patients worsens, other therapeutic strategies have been introduced in an attempt to maintain the excellent results obtained by the established surgical treatment...
March 26, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29618659/mesenchymal-tnfr2-promotes-the-development-of-polyarthritis-and-comorbid-heart-valve-stenosis
#4
Maria Sakkou, Panagiotis Chouvardas, Lydia Ntari, Alejandro Prados, Kristin Moreth, Helmut Fuchs, Valerie Gailus-Durner, Martin Hrabe de Angelis, Maria C Denis, Niki Karagianni, George Kollias
Mesenchymal TNF signaling is etiopathogenic for inflammatory diseases such as rheumatoid arthritis and spondyloarthritis (SpA). The role of Tnfr1 in arthritis has been documented; however, Tnfr2 functions are unknown. Here, we investigate the mesenchymal-specific role of Tnfr2 in the TnfΔARE mouse model of SpA in arthritis and heart valve stenosis comorbidity by cell-specific, Col6a1-cre-driven gene targeting. We find that TNF/Tnfr2 signaling in resident synovial fibroblasts (SFs) and valvular interstitial cells (VICs) is detrimental for both pathologies, pointing to common cellular mechanisms...
April 5, 2018: JCI Insight
https://www.readbyqxmd.com/read/29617977/aortic-sarcoidosis-complicated-by-a-pulmonary-artery-aneurysm
#5
Wataru Uchida, Yoshiyuki Tokuda, Masato Mutsuga, Akihiko Usui
A 76-year-old woman, who had a history of ocular sarcoidosis, was incidentally found to have a huge pulmonary artery aneurysm, along with aortic, mitral and tricuspid valve insufficiency. She underwent pulmonary artery plication along with surgeries for 3 valves. A specimen of the slightly enlarged ascending aorta revealed the involvement of sarcoidosis in the aortic wall. The systemic granulomatous inflammation process of sarcoidosis possibly affected the valvular and vascular pathology. Herein, we report a rare case of aortic sarcoidosis complicated by a pulmonary artery aneurysm...
March 29, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29588317/spatiotemporal-multi-omics-mapping-generates-a-molecular-atlas-of-the-aortic-valve-and-reveals-networks-driving-disease
#6
Florian Schlotter, Arda Halu, Shinji Goto, Mark C Blaser, Simon C Body, Lang H Lee, Hideyuki Higashi, Daniel M DeLaughter, Joshua D Hutcheson, Payal Vyas, Tan Pham, Maximillian A Rogers, Amitabh Sharma, Christine E Seidman, Joseph Loscalzo, Jonathan G Seidman, Masanori Aikawa, Sasha A Singh, Elena Aikawa
Background -No pharmacological therapy exists for calcific aortic valve disease (CAVD), which confers a dismal prognosis without invasive valve replacement. The search for therapeutics and early diagnostics is challenging since CAVD presents in multiple pathological stages. Moreover, it occurs in the context of a complex, multi-layered tissue architecture, a rich and abundant extracellular matrix phenotype, and a unique, highly plastic and multipotent resident cell population. Methods -A total of 25 human stenotic aortic valves obtained from valve replacement surgeries were analyzed by multiple modalities, including transcriptomics and global unlabeled and label-based tandem-mass-tagged proteomics...
March 27, 2018: Circulation
https://www.readbyqxmd.com/read/29574794/acromegalic-cardiomyopathy-epidemiology-diagnosis-and-management
#7
REVIEW
Ajay N Sharma, Marilyn Tan, Ezra A Amsterdam, Gagan D Singh
Acromegalic cardiomyopathy is the leading cause of morbidity and all-cause mortality in patients with acromegaly. Though acromegaly is a rare condition, the associated derangements are vast and severe. Stemming from an increase in circulating growth hormone (GH) and insulin-like growth factor-1 levels (IGF-1), acromegalic cardiomyopathy results in pathological changes in myocyte growth and structure, cardiac contractility, and vascular function. These molecular changes manifest commonly as biventricular hypertrophy, diastolic and systolic dysfunction, and valvular regurgitation...
March 25, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29548280/comprehensive-microrna-profiling-reveals-potential-augmentation-of-the-il1-pathway-in-rheumatic-heart-valve-disease
#8
Qiyu Lu, Yi Sun, Yuyin Duan, Bin Li, Jianming Xia, Songhua Yu, Guimin Zhang
BACKGROUND: Valvular heart disease is a leading cause of cardiovascular mortality, especially in China. More than a half of valvular heart diseases are caused by acute rheumatic fever. microRNA is involved in many physiological and pathological processes. However, the miRNA profile of the rheumatic valvular heart disease is unknown. This research is to discuss microRNAs and their target gene pathways involved in rheumatic heart valve disease. METHODS: Serum miRNA from one healthy individual and four rheumatic heart disease patients were sequenced...
March 16, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29516748/a-contemporary-16-year-review-of-coxiella-burnetii-infective-endocarditis-in-a-tertiary-cardiac-center-in-queensland-australia
#9
Mark R Armstrong, Kate L McCarthy, Robert L Horvath
BACKGROUND: Coxiella burnetii endocarditis can be difficult to diagnose leading to delays in treatment. This retrospective case series study was undertaken to understand the epidemiologic trends and clinical features of Q fever endocarditis in Southeast Queensland, Australia. METHODS: Clinical records of patients from a single center with coding diagnosis of C. burnetii, or serology consistent with chronic Q fever, were reviewed from 1999 to 2015. Data from patients with probable or confirmed Q fever endocarditis was abstracted...
March 8, 2018: Infectious Diseases
https://www.readbyqxmd.com/read/29505892/crystallinity-of-hydroxyapatite-drives-myofibroblastic-activation-and-calcification-in-aortic-valves
#10
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
https://www.readbyqxmd.com/read/29502778/open-surgical-reconstruction-for-deep-venous-occlusion-and-valvular-incompetence
#11
REVIEW
Katherin E Leckie, Michael C Dalsing
This article considers the potential options for open deep venous reconstructions based on pathologic complication (obstruction vs insufficiency), anatomic location, presence of disease-free venous architecture, and patient need. Other things being equal, less invasive techniques and disease locations will be attempted as first-line therapy. When other options fail and symptoms persist, open venous surgery by means of bypass for obstructive disease and valve repair or replacement for deep venous insufficiency remains a viable option...
April 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29482977/transcatheter-mitral-valve-repair-using-the-edge-to-edge-clip
#12
REVIEW
Charles B Nyman, G Burkhard Mackensen, Srdjan Jelacic, Stephen H Little, Thomas W Smith, Feroze Mahmood
Percutaneous intervention for mitral valve (MV) disease has been established as an alternative to open surgical MV repair in patients with prohibitive surgical risk. Multiple percutaneous approaches have been described and are in various stages of development. Edge-to-edge leaflet plication with the MitraClip (Abbott, Menlo Park, CA) is currently the only Food and Drug Administration-approved device specifically for primary or degenerative lesions. Use of the edge-to-edge clip for secondary mitral regurgitation is currently under investigation and may result in expanded indications...
April 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29480349/fill-in-the-gaps-of-secondary-mitral-regurgitation-a-continuum-challenge-from-pathophysiology-to-prognosis
#13
REVIEW
Riccardo M Inciardi, Andrea Rossi, Giovanni Benfari, Mariantonietta Cicoira
PURPOSE OF REVIEW: Mitral regurgitation (MR) is one of the most frequent valvular heart diseases encountered in clinical practice. In contrast to primary MR, less is still known about the pathophysiology, diagnosis, and prognosis of secondary MR. The purpose of this report is to provide a review, upon the last knowledge reported in the literature, on the role and management of secondary MR in clinical practice. RECENT FINDINGS: Recent data highlight secondary MR not as a single pathological entity but as a wide spectrum of interconnected conditions which portend poor outcome...
February 26, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29475857/comorbid-tnf-mediated-heart-valve-disease-and-chronic-polyarthritis-share-common-mesenchymal-cell-mediated-aetiopathogenesis
#14
Lydia Ntari, Maria Sakkou, Panagiotis Chouvardas, Iordanis Mourouzis, Alejandro Prados, Maria C Denis, Niki Karagianni, Constantinos Pantos, George Kollias
OBJECTIVES: Patients with rheumatoid arthritis and spondyloarthritisshow higher mortality rates, mainly caused by cardiac comorbidities. The TghuTNF (Tg197) arthritis model develops tumour necrosis factor (TNF)-driven and mesenchymalsynovial fibroblast (SF)-dependent polyarthritis. Here, we investigate whether this model develops, similarly to human patients, comorbid heart pathology and explore cellular and molecular mechanisms linking arthritis to cardiac comorbidities. METHODS: Histopathological analysis and echocardiographic evaluation of cardiac function were performed in the Tg197 model...
February 23, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29458883/maternal-and-fetal-outcomes-in-pregnancies-with-pulmonary-hypertension-experience-of-a-tertiary-center
#15
Zehra Nihal Dolgun, Cihan Inan, N Cenk Sayin
OBJECTIVE: Pregnancies complicated with PHT are serious debates for obstetricians due to high maternal and fetal complication potentials. The aim of the study was to present our maternofetal outcomes in pregnant women with pulmonary hypertension. MATERIALS AND METHODS: This study was performed using data extracted from the medical files of 23 pregnancies of 18 patients with PHT who were followed-up in the obstetrics and gynecology department. RESULTS: The average age was 27...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29415911/inflammatory-mechanisms-of-cardiovascular-remodeling
#16
Toshihisa Anzai
Inflammation and fibrosis play an important role in the development and progression of cardiovascular diseases. Acute coronary syndrome (ACS) is caused by rupture of inflamed atherosclerotic plaque and subsequent atherothrombosis. Recent studies have shown that inflammatory markers such as C-reactive protein (CRP) can predict ACS development and have demonstrated the effectiveness of new therapeutic approaches targeting inflammation. Studies have also shown that an enhanced inflammatory response after myocardial infarction (MI) is associated with cardiac rupture, ventricular aneurysm formation, and exacerbation of left ventricular (LV) remodeling...
February 7, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29406946/valvular-heart-disease
#17
REVIEW
Zorana Mrsic, Scott P Hopkins, Jared L Antevil, Philip S Mullenix
This article outlines the diagnosis and management of commonly occurring valvular heart diseases for the primary care provider. Basic understanding of pathologic murmurs is important for appropriate referral. Echocardiography is the gold standard for diagnosis and severity grading. Patients with progressive valvular heart disease should be followed annually by cardiology and imaging should be performed based on the severity of valvular dysfunction. Surgery or intervention is recommended only when symptoms dictate or when changes in left ventricular function occur...
March 2018: Primary Care
https://www.readbyqxmd.com/read/29386201/cd301b-mgl2-mononuclear-phagocytes-orchestrate-autoimmune-cardiac-valve-inflammation-and-fibrosis
#18
Lee A Meier, Jennifer L Auger, Brianna J Engelson, Hannah M Cowan, Elise R Breed, Mayra I Gonzalez-Torres, Joshua D Boyer, Mayank Verma, Aubyn Marath, Bryce A Binstadt
Background -Valvular heart disease (VHD) is common and affects the mitral valve (MV) most frequently. Despite the prevalence of mitral valve disease (MVD), the cellular and molecular pathways that initiate and perpetuate it are not well understood. Methods -K/B.g7 T cell receptor (TCR) transgenic mice spontaneously develop systemic autoantibody-associated autoimmunity, leading to fully-penetrant fibro-inflammatory MVD and arthritis. We used multiparameter flow cytometry, intracellular cytokine staining, and immunofluorescent staining to characterize the cells in inflamed K/B...
January 31, 2018: Circulation
https://www.readbyqxmd.com/read/29357039/evolution-of-post-mortem-coronary-imaging-from-selective-coronary-arteriography-to-post-mortem-ct-angiography-and-beyond
#19
REVIEW
Emidio De Marco, Giuseppe Vacchiano, Paola Frati, Raffaele La Russa, Alessandro Santurro, Matteo Scopetti, Giuseppe Guglielmi, Vittorio Fineschi
Since the 1970s, remarkable efforts have been made in the post-mortem coronary study, especially by angiography, as an added tool to diagnose heart-related deaths. In more recent times, post-mortem CT (PMCT) and post-mortem CT-angiography (PMCTA) have become an established practice in numerous forensic units, because of the undeniable advantages these diagnostic instruments can offer: data acquisition times are increasingly fast, costs have become lower and, once acquired, data can be re-utilized and re-evaluated at any given time...
May 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29353438/examination-of-pituitary-adenylate-cyclase-activating-polypeptide-pacap-as-a-potential-biomarker-in-heart-failure-patients
#20
Zsolt Sarszegi, Dora Szabo, Balazs Gaszner, Attila Konyi, Dora Reglodi, Jozsef Nemeth, Beata Lelesz, Beata Polgar, Adel Jungling, Andrea Tamas
Pituitary adenylate cyclase-activating polypeptide (PACAP) is a pleiotropic and multifunctional neuropeptide having neurotrophic, neuroprotective, and general cytoprotective actions in a variety of tissues based on its anti-apoptotic, anti-inflammatory, and antioxidant effects. Several studies have demonstrated its cardioprotective effects in vitro and in various animal models. However, few data are available on the presence of PACAP in human cardiac tissues and its role in the pathomechanism and progression of different cardiac disorders, particularly heart failure...
January 20, 2018: Journal of Molecular Neuroscience: MN
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