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mitral regurgitation guidelines

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https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#1
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29300869/educational-needs-and-application-of-guidelines-in-the-management-of-patients-with-mitral-regurgitation-a-european-mixed-methods-study
#2
Bernard Iung, Victoria Delgado, Patrice Lazure, Suzanne Murray, Per Anton Sirnes, Raphael Rosenhek, Susanna Price, Marco Metra, Céline Carrera, Michele De Bonis, Michael Haude, Gerhard Hindricks, Jeroen Bax, Alec Vahanian
Aims: To assess the knowledge and application of European Society of Cardiology (ESC) Guidelines in the management of mitral regurgitation (MR). Methods and results: A mixed-methods educational needs assessment was performed. Following a qualitative phase (interviews), an online survey was undertaken using three case scenarios (asymptomatic severe primary MR, symptomatic severe primary MR in the elderly, and severe secondary MR) in 115 primary care physicians (PCPs), and 439 cardiologists or cardiac surgeons from seven European countries...
January 2, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29291344/diagnosis-and-management-of-ischemic-mitral-regurgitation-evidence-based-clinical-decision-making-at-the-point-of-care
#3
Ajay Kumar Jha, Vishwas Malik
Anatomical, functional, and pathophysiologic mechanisms of ischemic mitral regurgitation (IMR) are markedly different from the primary mitral regurgitation. The older and ubiquitous cutoff of EROA (effective regurgitant orifice area) and Rvol (regurgitant volume) for IMR has been reinstated in the new guideline after a brief hiatus. There had always been a lack of good-quality evidence for its introduction for guiding IMR severity in the previous guideline, and we still do not have quality evidences that could justify its reintroduction...
December 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29277857/percutaneous-mitral-valve-interventions-and-heart-failure
#4
Abhishek Sharma, Sunny Goel, Sahil Agarwal
Mitral regurgitation (MR) is the most frequent Valvular Heart Disease (VHD) and is an important cause of heart failure. MR can be caused by primary valve abnormality (Degenerative MR/Primary MR) or it can be secondary to cardiomyopathy (Functional MR/Secondary MR). Medical management alleviates symptoms but does not alter the progression of the disease. Current guidelines recommend surgery for moderate-to-severe (Grade > 3) MR in patients with symptoms or evidence of left ventricular dysfunction. Despite current practice guidelines, the majority of patients with severe MR do not undergo surgery...
December 27, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29236990/outcome-reporting-for-surgical-treatment-of-degenerative-mitral-valve-disease-a-systematic-review-and-critical-appraisal
#5
Anton Tomšic, Bardia Arabkhani, Jan W Schoones, Thomas J van Brakel, Johanna J M Takkenberg, Meindert Palmen, Robert J M Klautz
OBJECTIVES: Standardized outcome reporting is of critical importance for performance monitoring, improvement of existing techniques and introduction of novel technologies. Whether outcome reporting for surgical treatment of degenerative mitral valve disease complies with the guidelines has not been assessed to date. METHODS: A systematic review of PubMed, EMBASE, Web of Science and the Cochrane Library was conducted for articles published between 1 January 2009 and 7 March 2016...
December 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29232249/clinical-trials-in-valvular-surgery-a-2018-update
#6
Bobby Yanagawa, Amine Mazine, Derrick Y Tam, Subodh Verma
PURPOSE OF REVIEW: There is a growing emphasis on the conduct of large-scale, multicenter randomized controlled trials (RCTs) to guide decision-making in cardiac surgery. Here we review recent landmark RCTs in cardiac valvular surgery. RECENT FINDINGS: RCTs are the gold-standard level of data in medicine. However, there are unique challenges of conducting large-scale surgical trials including funding, blinding, generalizability, nonstandardization of the surgical technique, crossover, among others...
December 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29206746/mitral-valve-and-subvalvular-repair-for-secondary-mitral-regurgitation-rationale-and-clinical-outcomes-of-the-papillary-muscle-sling
#7
Christos G Mihos, Romain Capoulade, Evin Yucel, Steve Xydas, Francesco Nappi, Roy F Williams, Orlando Santana
Secondary mitral regurgitation (MR) is a common finding in patients with dilated cardiomyopathy, and it is associated with poor outcomes. It is the result of incomplete systolic closure of the mitral valve (MV) as a consequence of left ventricular dilatation, papillary muscle displacement with impaired systolic shortening, and mitral leaflet tethering. MV surgery may be performed in cases of significant secondary MR despite guideline-directed medical therapy. However, MV repair, which is most commonly performed with an undersized ring annuloplasty, is associated with a 30-60% recurrence of moderate or greater MR at mid-term follow-up...
January 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29166877/a-prospective-study-examining-the-role-of-myocardial-fibrosis-in-outcome-following-mitral-valve-repair-in-degenerative-mitral-regurgitation-rationale-and-design-of-the-mitral-finder-study
#8
Boyang Liu, Nicola C Edwards, Desley A H Neal, Christopher Weston, Gerard Nash, Nicolas Nikolaidis, Thomas Barker, Ramesh Patel, Moninder Bhabra, Richard P Steeds
BACKGROUND: The optimal management of chronic severe primary degenerative mitral regurgitation (MR) is to repair the valve but identification of the optimal timing of surgery remains challenging. Current guidelines suggest 'watchful waiting' until the onset of symptoms or left ventricular (LV) dysfunction but these have been challenged as promoting 'rescue surgery'. Better predictors are required to inform decision-making in relation to the necessity and timing of surgery. Chronic volume overload is a stimulus for adverse adaptive LV remodelling...
November 22, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29128265/atrial-flutter-has-less-left-atrial-spontaneous-contrast-and-higher-left-atrial-appendage-emptying-velocity-compared-with-atrial-fibrillation
#9
Jennifer J Huang, Sridhar Reddy, Tam H Truong, Prakash Suryanarayana, Joseph S Alpert
BACKGROUND: The risk of stroke and thromboembolism in atrial fibrillation is established. There are clear guidelines in anticoagulation management of patient's with atrial fibrillation, however, the evidence surrounding the risk of thromboembolism in patients with atrial flutter is not as clear. We hypothesized that atrial flutter would have indicators of less risk for thromboembolism compared with atrial fibrillation on transesophageal echocardiography (TEE); thereby possibly leading to a lower stroke risk...
November 8, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29111121/invasive-validation-of-the-echocardiographic-assessment-of-left-ventricular-filling-pressures-using-the-2016-diastolic-guidelines-head-to-head-comparison-with-the-2009-guidelines
#10
Bhavna Balaney, Diego Medvedofsky, Anuj Mediratta, Amita Singh, Boguslawa Ciszek, Eric Kruse, Atman P Shah, Karima Addetia, Roberto M Lang, Victor Mor-Avi
BACKGROUND: Recent American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guidelines for echocardiographic evaluation of left ventricular (LV) diastolic function provide a practical, simplified diagnostic algorithm for estimating LV filling pressure. The aim of this study was to test the accuracy of this algorithm against invasively measured pressures and compare it with the accuracy of the previous 2009 guidelines in the same patient cohort...
January 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29106577/pacing-for-hypertrophic-obstructive-cardiomyopathy-an-update-and-future-directions
#11
Claude Daubert, Fredrik Gadler, Philippe Mabo, Cecilia Linde
In hypertrophic cardiomyopathy (HCM) patients with symptoms caused by left ventricular outflow tract obstruction (LVOTO), treatment options include negative inotropic drugs, myectomy, septal alcohol ablation and AV sequential pacing with or without an implantable cardioverter defibrillator (ICD). Pacing is rarely used in spite of its relative simplicity and promising results. In this review the current evidence of AV sequential pacing from observational, randomised studies and long and very long-term follow-up studies is given and put in the context of present guidelines recommendations...
June 30, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29039623/the-challenge-of-takotsubo-syndrome-heterogeneity-of-clinical-features
#12
Susanne Anna Schlossbauer, Jelena-Rima Ghadri, Frank Scherff, Christian Templin
Takotsubo syndrome (TTS) was first described in 1991 as a rare, spontaneous and completely reversible left ventricular regional systolic dysfunction. Today the incidence of TTS is estimated at 2% in patients with an initial diagnosis of acute coronary syndrome (ACS). Notably, the incidence can be as high as 5.9 to 7.5% in female patients. TTS occurs predominantly in postmenopausal women, but both sexes may be affected, at any age. Acute chest pain or dyspnoea is a characteristic symptom of TTS, but initial presentation can also include more severe disease manifestation such as acute heart failure with pulmonary oedema or haemodynamic instability, especially in an in-hospital setting...
October 17, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29034311/left-atrial-deformation-useful-index-for-early-detection-of-cardiac-damage-in-chronic-mitral-regurgitation
#13
REVIEW
M Cameli, E Incampo, S Mondillo
In chronic mitral regurgitation (MR) left atrium is one of the first cardiac structures that is involved in remodeling and ultrastructural changes for a progressive volume overload. Severe left atrial (LA) dilation on echocardiography and new onset of atrial fibrillation in asymptomatic patients with preserved Left Ventricular (LV) function, appeared as a Class IIb recommendation for consideration for surgical mitral valve repair in the actual guidelines. However, before atrial dilatation and dysfunction, several ultrastructural changes appear in the atrial muscle tissue that are difficult to identify with the standard echocardiography...
December 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/29020352/the-mida-mortality-risk-score-development-and-external-validation-of-a-prognostic-model-for-early-and-late-death-in-degenerative-mitral-regurgitation
#14
Francesco Grigioni, Marie-Annick Clavel, Jean-Louis Vanoverschelde, Christophe Tribouilloy, Rodolfo Pizarro, Marianne Huebner, Jean-Francois Avierinos, Andrea Barbieri, Rakesh Suri, Agnés Pasquet, Dan Rusinaru, Gaetano D Gargiulo, Pablo Oberti, Alexis Théron, Francesca Bursi, Hector Michelena, Siham Lazam, Catherine Szymanski, Vuyisile T Nkomo, Martin Schumacher, Letizia Bacchi-Reggiani, Maurice Enriquez-Sarano
Aims: In degenerative mitral regurgitation (DMR), lack of mortality scores predicting death favours misperception of individual patients' risk and inappropriate decision-making. Methods and results: The Mitral Regurgitation International Database (MIDA) registries include 3666 patients (age 66 ± 14 years; 70% males; follow-up 7.8 ± 5.0 years) with pure, isolated, DMR consecutively diagnosed by echocardiography at tertiary (European/North/South-American) centres...
August 13, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28859755/guideline-directed-medical-therapy-for-secondary-mitral-regurgitation-more-questions-than-answers
#15
EDITORIAL
Michael Mack, Paul Grayburn
No abstract text is available yet for this article.
September 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28857729/a-rapid-echocardiographic-screening-protocol-for-rheumatic-heart-disease-in-samoa-a-high-prevalence-of-advanced-disease
#16
Marvin Allen, John Allen, Take Naseri, Rebecca Gardner, Dennis Tolley, Lori Allen
BACKGROUND: Echocardiography has been proposed as a method to screen children for rheumatic heart disease. The World Heart Federation has established guidelines for echocardiographic screening. In this study, we describe a rapid echocardiogram screening protocol according to the World Heart Federation guidelines in Samoa, endemic for rheumatic heart disease. METHODS: We performed echocardiogram screening in schoolchildren in Samoa between 2013 and 2015. A brief screening echocardiogram was performed on all students...
October 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28833463/an-easy-to-use-scoring-index-to-determine-severity-of-mitral-regurgitation-by-2d-echocardiography-in-clinical-practice
#17
Rosemarijn Jansen, Einar A Hart, Max Peters, Kim Urgel, Jolanda Kluin, Wouter J Tietge, Koen Zwart, Kirsten C Sybrandy, Maarten J M Cramer, Steven A J Chamuleau
PURPOSE: Mitral regurgitation (MR) grading by two-dimensional transthoracic echocardiography is challenging, but important to determine the best treatment strategy in patients with MR. Current guidelines advocate an integrative approach, although no recommendation is provided on how to do so. An easy-to-use index will be helpful for standardized and reproducible MR grading. METHODS: Eleven echocardiographic parameters were retrospectively evaluated in 145 patients with moderate or severe MR...
September 2017: Echocardiography
https://www.readbyqxmd.com/read/28820545/assessment-and-management-of-acute-severe-mitral-regurgitation-in-the-intensive-care-unit
#18
Marina Leitman, Vladimir Tyomkin, Ehud Raanani, Ram Sharony, Ludmila Tzatskin, Eli Peleg, Alex Blatt, Zvi Vered
BACKGROUND: Acute severe mitral regurgitation (MR) is a serious medical condition. Whilst clear guidelines exist regarding the management of chronic MR, acute severe MR is usually treated on an individual basis. Currently, few data exist regarding acute MR in the era of primary coronary interventions (PCI). The present study included patients admitted to the Department of Cardiology during recent years with acute severe MR of different etiologies, and an analysis of these data in the light of previous investigations...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28805026/correlation-of-6-min-walk-test-with-left-ventricular-function-and-quality-of-life-in-heart-failure-due-to-chagas-disease
#19
Mayara C Chambela, Mauro F F Mediano, Roberto R Ferreira, André M Japiassú, Mariana C Waghabi, Gilberto M S da Silva, Roberto M Saraiva
OBJECTIVES: To evaluate the correlation of the total distance walked during the six-minute walk test (6MWT) with left ventricular function and quality of life in patients with Chagas Disease (ChD) complicated by heart failure. METHODS: This is a cross-sectional study of adult patients with ChD and heart failure diagnosed based on Framingham criteria. 6MWT was performed following international guidelines. New York Heart Association functional class, brain natriuretic peptide (BNP) serum levels, echocardiographic parameters and quality of life (SF-36 and MLHFQ questionnaires) were determined and their correlation with the distance covered at the 6MWT was tested...
October 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28689751/postprocedural-changes-of-tricuspid-regurgitation-after-mitraclip-therapy-for-mitral-regurgitation
#20
MULTICENTER STUDY
Kentaro Toyama, Kengo Ayabe, Saibal Kar, Shunsuke Kubo, Toshinori Minamishima, Florian Rader, Takahiro Shiota, Toshihiko Nishioka, Robert J Siegel
The effect of percutaneous mitral valve repair using the MitraClip system on tricuspid regurgitation (TR) has not been well investigated. We retrospectively analyzed 102 consecutive patients who underwent the successful MitraClip procedure, and who also had a preprocedural and 1-year follow-up transthoracic echocardiography. TR severity was graded by standard guideline-recommended criteria. At 1 year after the MitraClip procedure, the degree of TR regressed (at least 1 grade) in 23% of the patients, was unchanged in 62% of the patients, and progressed in 16% of the patients...
September 1, 2017: American Journal of Cardiology
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