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mitral regurgitation guidelines

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https://www.readbyqxmd.com/read/28075037/gauging-the-response-to-cardiac-resynchronization-therapy-the-important-interplay-between-predictor-variables-and-definition-of-a-favorable-outcome
#1
Milan Petrovic, Marija Petrovic, Goran Milasinovic, Bosiljka Vujisic Tesic, Danijela Trifunovic, Olga Petrovic, Ivana Nedeljkovic, Ivana Petrovic, Marko Banovic, Marija Boricic-Kostic, Jelena Petrovic, Ross Arena, Dejana Popovic
AIMS: Selection of patients who are viable candidates for cardiac resynchronization therapy (CRT), prediction of the response to CRT as well as an optimal definition of a favorable response, all require further exploration. The purpose of this study was to evaluate the interplay between the prediction of the response to CRT and the definition of a favorable outcome. METHODS: Seventy patients who received CRT were included. All patients met current guideline criteria for CRT...
January 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/28054393/degenerative-valvular-disease-in-the-cavalier-king-charles-spaniel-results-of-the-uk-breed-scheme-1991-2010
#2
S Swift, A Baldin, P Cripps
BACKGROUND: Cavalier King Charles spaniels (CKCSs) are predisposed to degenerative mitral valve disease (DMVD) and studies have indicated a genetic cause. ANIMALS: A total of 8,860 CKCSs were examined at shows or private clinics from 1991 to 2010. OBJECTIVES: To analyze the effects of a breed scheme for CKCS on the age at which a murmur consistent with DMVD was first detected. METHODS: The presence or absence of a murmur consistent with mitral regurgitation was noted and age a murmur was first detected recorded...
January 5, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28007240/the-society-of-thoracic-surgeons-2017-clinical-practice-guidelines-for-the-surgical-treatment-of-atrial-fibrillation
#3
Vinay Badhwar, J Scott Rankin, Ralph J Damiano, A Marc Gillinov, Faisal G Bakaeen, James R Edgerton, Jonathan M Philpott, Patrick M McCarthy, Steven F Bolling, Harold G Roberts, Vinod H Thourani, Rakesh M Suri, Richard J Shemin, Scott Firestone, Niv Ad
Surgical ablation for atrial fibrillation (AF) can be performed without additional risk of operative mortality or major morbidity, and is recommended at the time of concomitant mitral operations to restore sinus rhythm. (Class I, Level A) Surgical ablation for AF can be performed without additional operative risk of mortality or major morbidity, and is recommended at the time of concomitant isolated aortic valve replacement, isolated coronary artery bypass graft surgery, and aortic valve replacement plus coronary artery bypass graft operations to restore sinus rhythm...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28004413/direct-oral-anticoagulant-use-in-nonvalvular-atrial-fibrillation-with-valvular-heart-disease-a-systematic-review
#4
REVIEW
Ryan E Owens, Rajesh Kabra, Carrie S Oliphant
Direct oral anticoagulants (DOACs) are indicated for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), which, according to the American College of Cardiology/American Heart Association/Heart Rhythm Society atrial fibrillation (AF) guidelines, excludes patients with rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair. However, the data regarding use of DOACs in AF patients with other types of valvular heart disease (VHD) are unclear. We aimed to summarize and evaluate the literature regarding the safety and efficacy of DOAC use in NVAF patients with other types of VHD...
December 22, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27899396/twenty-year-outcome-after-mitral-repair-versus-replacement-for-severe-degenerative-mitral-regurgitation-analysis-of-a-large-prospective-multicenter-international-registry
#5
Siham Lazam, Jean-Louis Vanoverschelde, Christophe Tribouilloy, Francesco Grigioni, Rakesh M Suri, Jean-Francois Avierinos, Christophe de Meester, Andrea Barbieri, Dan Rusinaru, Antonio Russo, Agnès A Pasquet, Hector I Michelena, Marianne Huebner, Joseph Maalouf, Marie-Annick Clavel, Catherine Szymanski, Maurice E Enriquez-Sarano
BACKGROUND: -Mitral valve (MV) repair is preferred over replacement in clinical guidelines and is an important determinant of the indication for surgery in degenerative mitral regurgitation (MR). Yet, the level of evidence supporting current recommendations is low, and recent data cast doubts on its validity in the current era. Accordingly, the aim of the present study was to analyze very long-term outcome after MV repair and replacement for degenerative MR with a flail leaflet. METHODS: -MIDA is a multicenter registry enrolling patients with degenerative MR with a flail leaflet in 6 tertiary European and US centers...
November 29, 2016: Circulation
https://www.readbyqxmd.com/read/27738076/asymmetrical-left-atrial-remodelling-in-atrial-fibrillation-relation-with-diastolic-dysfunction-and-long-term-ablation-outcomes
#6
Sotirios Nedios, Emmanuel Koutalas, Philipp Sommer, Arash Arya, Sascha Rolf, Daniela Husser, Andreas Bollmann, Gerhard Hindricks, Ole-Alexander Breithardt
AIMS: The association between anatomical left atrial (LA) remodelling and ventricular diastolic dysfunction (DD) in atrial fibrillation (AF) patients is not well studied. We aimed to examine the effect of DD on anatomic LA remodelling and their relation with ablation outcomes. METHODS AND RESULTS: In 104 patients (58 ± 10 years, 69% male) referred for AF ablation, LA volume (LAV) was determined by computed tomography. A cutting plane, between the pulmonary vein (PV) ostia and the appendage and parallel to the posterior wall, divided LAV into anterior- (LA-A) and posterior-LA parts...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27667378/the-role-of-medical-therapy-in-moderate-to-severe-degenerative-mitral-regurgitation
#7
Leandro Slipczuk, Asim M Rafique, Carlos D Davila, Roy Beigel, Gregg S Pressman, Robert J Siegel
Mitral regurgitation (MR) is a common valvular disorder that has important health and economic consequences. Standardized guidelines exist regarding when and in whom to perform mitral valve surgery, but little information is available regarding medical treatment of MR. Many patients with moderate or severe MR do not meet criteria for surgery or are deemed to be at high risk for surgical therapy. We reviewed the available published data on medical therapy in the treatment of patients with primary MR. b-blockers and renin-angiotensin-aldosterone system inhibitors had the strongest supporting evidence for providing beneficial effects...
2016: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27639377/total-average-diastolic-longitudinal-displacement-by-colour-tissue-doppler-imaging-as-an-assessment-of-diastolic-function
#8
Martina Chantal de Knegt, Tor Biering-Sørensen, Peter Søgaard, Jacob Sivertsen, Jan Skov Jensen, Rasmus Møgelvang
BACKGROUND: The current method for a non-invasive assessment of diastolic dysfunction is complex with the use of algorithms of many different echocardiographic parameters. Total average diastolic longitudinal displacement (LD), determined by colour tissue Doppler imaging (TDI) via the measurement of LD during early diastole and atrial contraction, can potentially be used as a simple and reliable alternative. METHODS: In 206 patients, using GE Healthcare Vivid E7 and 9 and Echopac BT11 software, we determined both diastolic LD, measured in the septal and lateral walls in the apical 4-chamber view by TDI, and the degree of diastolic dysfunction, based on current guidelines...
September 17, 2016: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/27548683/identification-of-the-asymptomatic-patient-with-severe-mitral-regurgitation-discrepancy-between-research-and-clinical-practice
#9
Rosemarijn Jansen, Jolanda Kluin, Simon G Ray, Maarten Jan M Cramer, Willem J L Suyker, Steven A J Chamuleau
Organic mitral regurgitation (MR) is a common disorder, and due to the increase in population and its aging, the occurrence of MR is steadily increasing. Current guideline recommendations on the management of asymptomatic severe MR are conflicting and based solely on registries or non-randomized trials in expert heart valve clinics, resulting in a lack of evidence for the best treatment strategy. In this review we will evaluate the latest evidence on diagnostic approaches and treatment strategies for asymptomatic patients without a clear indication for surgical intervention...
August 19, 2016: Cardiology in Review
https://www.readbyqxmd.com/read/27490591/aortic-and-mitral-valve-disease-and-left-ventricular-dysfunction-in-children
#10
Kevin O Maher, James S Tweddell
OBJECTIVES: In this review, we will discuss aortic stenosis, aortic regurgitation, mitral regurgitation, and mitral stenosis. We will review the etiology, anatomy, pathophysiology, presentation, and treatment of aortic and mitral valve disease. Age and lesion specific treatments are outlined based on the severity of valve disease with an aim at long-term preservation of left ventricular function. DATA SOURCE: MEDLINE and PubMed. CONCLUSIONS: Mitral and aortic valve disease leads to unique hemodynamic burdens that can impact left ventricular function, quality of life, and longevity...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27467174/functional-mitral-regurgitation-in-patients-with-heart-failure-and-depressed-ejection-fraction
#11
Aeshita Dwivedi, Alan Vainrib, Muhamed Saric
PURPOSE OF REVIEW: Functional mitral regurgitation (FMR) is a common complication of left ventricular dysfunction. It is now recognized as an important clinical entity and an independent predictor of poor prognosis in cardiomyopathy patients. In this review, we provide a comprehensive summary of the pathophysiology, latest imaging modalities, and diagnostic criteria for FMR. Additionally, we discuss the recent literature on the continuously evolving surgical and percutaneous treatment options...
September 2016: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27464577/disruption-of-desmin-mitochondrial-architecture-in-patients-with-regurgitant-mitral-valves-and-preserved-ventricular-function
#12
Mustafa I Ahmed, Jason L Guichard, Namakkal S Rajasekaran, Shama Ahmad, Nithya Mariappan, Silvio Litovsky, Himanshu Gupta, Steven G Lloyd, Thomas S Denney, Pamela Cox Powell, Inmaculada Aban, James F Collawn, James E Davies, David C McGiffin, Louis J Dell'Italia
OBJECTIVE: Recent studies have demonstrated improved outcomes in patients receiving early surgery for degenerative mitral regurgitation (MR) rather than adhering to conventional guidelines for surgical intervention. However, studies providing a mechanistic basis for these findings are limited. METHODS: Left ventricular (LV) myocardium from 22 patients undergoing mitral valve repair for American Heart Association class I indications was evaluated for desmin, the voltage-dependent anion channel, α-B-crystallin, and α, β-unsaturated aldehyde 4-hydroxynonenal by fluorescence microscopy...
October 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27372607/echocardiographic-prevalence-of-rheumatic-heart-disease-in-brazilian-schoolchildren-data-from-the-provar-study
#13
Bruno R Nascimento, Andrea Z Beaton, Maria Carmo P Nunes, Adriana C Diamantino, Gabriel A L Carmo, Kaciane K B Oliveira, Cassio M Oliveira, Zilda Maria A Meira, Sandra Regina T Castilho, Eduardo L V Lopes, Iara M Castro, Vitória M L R Rezende, Graziela Chequer, Taylor Landay, Allison Tompsett, Antônio Luiz P Ribeiro, Craig Sable
BACKGROUND: Accurate estimates of Rheumatic Heart Disease (RHD) burden are needed to justify improved integration of RHD prevention and screening into the public health systems, but data from Latin America are still sparse. OBJECTIVE: To determine the prevalence of RHD among socioeconomically disadvantaged youth (5-18years) in Brazil and examine risk factors for the disease. METHODS: The PROVAR program utilizes non-expert screeners, telemedicine, and handheld and standard portable echocardiography to conduct echocardiographic screening in socioeconomically disadvantaged schools in Minas Gerais, Brazil...
September 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27349588/-aftercare-of-patients-after-mitraclip%C3%A2-implantation
#14
A Schlitt, E Lubos, M Guha, C Hegeler-Molkewehrum, M Sudau, H Schmidt
Many patients with moderate to severe mitral regurgitation cannot be subjected to surgical therapy due to their multimorbidity. For these patients, MitraClip® implantation is a therapeutic alternative.The aim of this article is to present recommendations for treatment after a MitraClip® procedure. For this purpose, a selective literature review has been carried out based on the current literature, notably on national and international guidelines.After a MitraClip® procedure, rehabilitation is indicated because of the underlying heart failure as well as the treatment of a heart valve...
June 27, 2016: Herz
https://www.readbyqxmd.com/read/27199056/papillary-muscle-approximation-versus-restrictive-annuloplasty-alone-for-severe%C3%A2-ischemic-mitral-regurgitation
#15
Francesco Nappi, Mario Lusini, Cristiano Spadaccio, Antonio Nenna, Elvio Covino, Christophe Acar, Massimo Chello
BACKGROUND: Guidelines recommend surgery for patients with severe ischemic mitral regurgitation (MR). Nonrandomized studies suggest that subvalvular repair is associated with longer survival, but randomized studies are lacking. OBJECTIVES: This study sought to investigate the benefit of papillary muscle surgery on long-term clinical outcomes of patients with ischemic MR. METHODS: Ninety-six patients with severe ischemic MR were randomized to either undersizing restrictive mitral annuloplasty (RA) or papillary muscle approximation with undersizing restrictive mitral annuloplasty (PMA) associated with complete surgical myocardial revascularization...
May 24, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27133325/clinical-profile-and-30-day-outcome-of-women-with-acute-coronary-syndrome-as-a-first-manifestation-of-ischemic-heart-disease-a-single-center-observational-study
#16
Veena Nanjappa, Gopi Aniyathodiyil, R Keshava
BACKGROUND: Gender disparity, with respect to women receiving less medical therapy, undergoing fewer invasive procedures, and experiencing worse outcome than men, has been noted in various observational and randomized trials, though guidelines on acute coronary syndrome (ACS) are gender-neutral. Indian data with focus on women with ACS are lacking. AIM: This study was undertaken to give us an insight on the clinical presentation, risk factors, and in-hospital outcome of ACS in women and at 30 days...
March 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27131928/operative-outcomes-with-myxomatous-mitral-valve-repair-experience-with-586-patients
#17
L Bassin, B Weiss, G Cranney, D Gimpel, P Gilhooly, R Smith, Z Akhunji, P Grant, H Wolfenden
INTRODUCTION: American Heart Association (AHA) guidelines recommend mitral valve repair for myxomatous mitral regurgitation whenever possible to prevent LV dysfunction and early mortality. Here we review our early operative outcomes with mitral valve repair for myxomatous mitral regurgitation. METHODS: We collected data from 586 consecutive patients that underwent mitral repair for myxomatous disease at the Prince Henry and Prince of Wales Hospitals Sydney between 1997 and 2012...
August 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27084054/efficacy-of-a-standardized-computer-based-training-curriculum-to-teach-echocardiographic-identification-of-rheumatic-heart-disease-to-nonexpert-users
#18
Andrea Beaton, Bruno R Nascimento, Adriana C Diamantino, Gabriel T R Pereira, Eduardo L V Lopes, Cassio O Miri, Kaciane K O Bruno, Graziela Chequer, Camila G Ferreira, Luciana C X Lafeta, Hedda Richards, Lindsay Perlman, Catherine L Webb, Antonio L P Ribeiro, Craig Sable, Maria do Carmo P Nunes
The ability to integrate echocardiographic for rheumatic heart disease (RHD) into RHD prevention programs is limited because of lack of financial and expert human resources in endemic areas. Task shifting to nonexperts is promising; but investigations into workforce composition and training schemes are needed. The objective of this study was to test nonexperts' ability to interpret RHD screening echocardiograms after a brief, standardized, computer-based training course. Six nonexperts completed a 3-week curriculum on image interpretation...
June 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27056158/comprehensive-imaging-in-women-with%C3%A2-organic-mitral-regurgitation-implications-for-clinical-outcome
#19
Francesca Mantovani, Marie-Annick Clavel, Hector I Michelena, Rakesh M Suri, Hartzell V Schaff, Maurice Enriquez-Sarano
OBJECTIVES: The purpose of this study was to compare women and men with organic mitral regurgitation (MR) using pre- and post-operative comprehensive imaging and to analyze the effect on outcome. BACKGROUND: Management of organic MR has no sex-specific guideline recommendation, and sex differences on the basis of comprehensive imaging and links to outcome remain largely unknown. METHODS: Comprehensive imaging (MR cause, quantitation, ventricular and atrial measures, and post-operative reverse cardiac remodeling) was analyzed in 217 women and 447 men who underwent operations for organic MR from 1990 to 2000 with long-term follow-up analysis...
April 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27051543/staphylococcus-lugdunensis-endocarditis-in-a-35-year-old-woman-in-her-24th-week-of-pregnancy
#20
Mounir Khafaga, Karl-Patrik Kresoja, Berndt Urlesberger, Igor Knez, Philipp Klaritsch, David Benjamin Lumenta, Robert Krause, Dirk von Lewinski
Background. Infective endocarditis is associated with considerable morbidity and mortality. Guidelines addressing prophylaxis and management of infective endocarditis do not extensively deal with concomitant pregnancy, and case reports on infective endocarditis are scarce. This is the first published report of infective endocarditis by Staphylococcus lugdunensis in a pregnant woman. Case Presentation. We report a single case of a 35-year-old woman in her 24th week of pregnancy who was admitted to our intensive care unit with fever and suspected infectious endocarditis...
2016: Case Reports in Obstetrics and Gynecology
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