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aortic regurgitation guidelines

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https://www.readbyqxmd.com/read/28535761/the-emerging-role-of-cardiovascular-magnetic-resonance-in-the-evaluation-of-hypertensive-heart-disease
#1
REVIEW
Sophie Mavrogeni, Vasiliki Katsi, Vasiliki Vartela, Michel Noutsias, George Markousis-Mavrogenis, Genovefa Kolovou, Athanasios Manolis
BACKGROUND: Arterial hypertension is the commonest cause of cardiovascular death. It may lead to hypertensive heart disease (HHD), including heart failure (HF), ischemic heart disease (IHD) and left ventricular hypertrophy (LVH). MAIN BODY: According to the 2007 ESH/ESC guidelines, the recommended imaging technique is echocardiography (echo), when a more sensitive detection of LVH than that provided by ECG, is needed. Cardiovascular Magnetic Resonance (CMR), a non-invasive, non-radiating technique, offers the following advantages, beyond echo: a) more reliable and reproducible measurements of cardiac parameters such as volumes, ejection fraction and cardiac mass b) more accurate differentiation of LVH etiology by providing information about tissue characterisation c) more accurate evaluation of myocardial ischemia, specifically if small vessels disease is present d) technique of choice for diagnosis of renovascular, aortic tree/branches lesions and quantification of aortic valve regurgitation e) technique of choice for treatment evaluation in clinical trials...
May 23, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28450039/characterization-of-chronic-aortic-and-mitral-regurgitation-undergoing-valve-surgery-using-cardiovascular-magnetic-resonance
#2
Christian L Polte, Sinsia A Gao, Åse A Johnsson, Kerstin M Lagerstrand, Odd Bech-Hanssen
Grading of chronic aortic regurgitation (AR) and mitral regurgitation (MR) by cardiovascular magnetic resonance (CMR) is currently based on thresholds, which are neither modality nor quantification method specific. Accordingly, this study sought to identify CMR-specific and quantification method-specific thresholds for regurgitant volumes (RVols), RVol indexes, and regurgitant fractions (RFs), which denote severe chronic AR or MR with an indication for surgery. The study comprised patients with moderate and severe chronic AR (n = 38) and MR (n = 40)...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28370410/echocardiographic-assessment-of-pediatric-semilunar-valve-disease
#3
REVIEW
Massimiliano Cantinotti, Raffaele Giordano, Michele Emdin, Nadia Assanta, Maura Crocetti, Marco Marotta, Giorgio Iervasi, Leo Lopez, Shelby Kutty
We reviewed echocardiography literature for the assessment and management of semilunar valve disease in children. A search was performed within the National Library of Medicine using the keywords aortic stenosis (AS), aortic regurgitation, pulmonary stenosis (PS), and pulmonary regurgitation in children. The search was further refined adding the keywords-pediatric, neonates, echocardiographic definition, classification, evaluation. Thirty-eight studies were included. For stenotic lesions, there were sufficient consistencies between Doppler and invasive gradients (especially for PS), while other quantitative parameters used in adults showed significant limitations when applied to children...
March 31, 2017: Echocardiography
https://www.readbyqxmd.com/read/28336789/percutaneous-therapy-for-tricuspid-regurgitation-a-new-frontier-for-interventional-cardiology
#4
EDITORIAL
Samir Kapadia, Amar Krishnaswamy, E Murat Tuzcu
No abstract text is available yet for this article.
May 9, 2017: Circulation
https://www.readbyqxmd.com/read/28329360/early-surgery-versus-conventional-treatment-for-asymptomatic-severe-aortic-regurgitation-with-normal-ejection-fraction-and-left-ventricular-dilatation
#5
Yin Wang, Weiwei Jiang, Junwei Liu, Geng Li, Yi Liu, Xingjian Hu, Nianguo Dong
OBJECTIVES: The management of patients with asymptomatic severe aortic regurgitation (AR) remains controversial. The aim of the present study was to assess and compare the clinical results between early surgery and conventional treatment for asymptomatic severe AR in patients with normal left ventricular (LV) systolic function and LV dilatation. METHODS: This retrospective cohort study included 230 consecutive patients with severe AR with left ventricular ejection function (LVEF ≥50%) and left ventricular end-diastolic dimension (LVEDD >70 mm) from 2003 to 2014...
February 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329331/natural-history-of-moderately-dilated-tubular-ascending-aorta-implications-for-determining-the-optimal-imaging-interval
#6
Kay-Hyun Park, Suryeun Chung, Dong Jung Kim, Jun Sung Kim, Cheong Lim
OBJECTIVES: For a moderately dilated ascending aorta (diameter 35-54 mm), current guidelines recommend continuous annual or semi-annual examinations with computed tomography or magnetic resonance imaging. However, few data have shown the yield and benefit of such a protocol. This study aimed to investigate the fate of a moderately dilated ascending aorta and thereby determine the adequate imaging interval. METHODS: In our institutional database, we identified adult patients having an ascending aortic diameter ≥40 mm in contrast-enhanced computed tomography and follow-up imaging(s) after ≥1 year...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28259111/evidence-based-surgery-of-aortic-regurgitation-results-of-a-questionnaire-in-german-speaking-countries
#7
Christian Dinges, Johannes Steindl, Wolfgang Hitzl, Tobias Kiesslich, Rainald Seitelberger
Background evidence-based medicine (EBM) approaches have reached broad acceptance, both in conservative and surgical disciplines. The aim of this study is to clarify the role of EBM in a rare condition of aortic regurgitation (AR) with surgical indication. Methods A purpose-built Internet-based questionnaire was sent to 607 cardiovascular surgeons in Germany, Austria, and Switzerland. A virtual 64-year-old patient's medical history was presented, including two ultrasound images and one computed tomography scan, showing a 58-mm aortic root aneurysm and a severe trileaflet regurgitant aortic valve...
March 4, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28224928/impact-of-right-ventricular-function-on-outcome-of-severe-aortic-stenosis-patients-undergoing-transcatheter-aortic-valve-replacement
#8
Edward Koifman, Romain Didier, Nirav Patel, Zack Jerusalem, Sarkis Kiramijyan, Itsik Ben-Dor, Smita I Negi, Zuyue Wang, Steven A Goldstein, Michael J Lipinski, Rebecca Torguson, Jiaxiang Gai, Augusto D Pichard, Lowell F Satler, Ron Waksman, Federico M Asch
BACKGROUND: Right ventricular (RV) dysfunction was shown to be associated with adverse outcomes in a variety of cardiac patients and is considered a risk factor for adverse outcome according to the updated Valve Academic Research Consortium criteria. OBJECTIVE: Our goal was to assess the impact of RV function at baseline on 1-year mortality among patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). METHODS: All patients with severe AS treated with TAVR from May 2007 to March 2015 at our center were included in the present study, and baseline and procedural characteristics were recorded for each patient...
February 2017: American Heart Journal
https://www.readbyqxmd.com/read/28131996/cohort-profile-prevalence-of-valvular-heart-disease-in-community-patients-with-suspected-heart-failure-in-uk
#9
Anna Marciniak, Keli Glover, Rajan Sharma
PURPOSE: The aim of this study was to evaluate the proportion of suspected heart failure patients with significant valvular heart disease. Early diagnosis of valve disease is essential as delay can limit treatment and negatively affect prognosis for undiagnosed patients. The prevalence of unsuspected valve disease in the community is uncertain. PARTICIPANTS: We prospectively evaluated 79 043 patients, between 2001 and 2011, who were referred to a community open access echocardiography service for suspected heart failure...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28104211/balloon-post-dilation-following-implantation-of-a-self-expanding-transcatheter-aortic-valve%C3%A2-bioprosthesis
#10
J Kevin Harrison, G Chad Hughes, Michael J Reardon, Robert Stoler, Paul Grayburn, Robert Hebeler, David Liu, Yanping Chang, Jeffrey J Popma
OBJECTIVES: This study sought to explore the impact of balloon post-dilation (BPD) on outcomes in the CoreValve US Clinical Trials. BACKGROUND: BPD following transcatheter aortic valve replacement (TAVR) has been used in selected cases to optimize hemodynamic results. METHODS: Procedural details of 3,532 patients were examined to determine whether BPD was performed after self-expanding TAVR. "Best practice" guidelines recommended BPD for treatment of suboptimal intraprocedural valve function, primarily manifested by moderate or severe residual aortic regurgitation (AR)...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28100277/stress-echo-2020-the-international-stress-echo-study-in-ischemic-and-non-ischemic-heart-disease
#11
MULTICENTER STUDY
Eugenio Picano, Quirino Ciampi, Rodolfo Citro, Antonello D'Andrea, Maria Chiara Scali, Lauro Cortigiani, Iacopo Olivotto, Fabio Mori, Maurizio Galderisi, Marco Fabio Costantino, Lorenza Pratali, Giovanni Di Salvo, Eduardo Bossone, Francesco Ferrara, Luna Gargani, Fausto Rigo, Nicola Gaibazzi, Giuseppe Limongelli, Giuseppe Pacileo, Maria Grazia Andreassi, Bruno Pinamonti, Laura Massa, Marco A R Torres, Marcelo H Miglioranza, Clarissa Borguezan Daros, José Luis de Castro E Silva Pretto, Branko Beleslin, Ana Djordjevic-Dikic, Albert Varga, Attila Palinkas, Gergely Agoston, Dario Gregori, Paolo Trambaiolo, Sergio Severino, Ayana Arystan, Marco Paterni, Clara Carpeggiani, Paolo Colonna
BACKGROUND: Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS: In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information...
January 18, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28025268/hypertrophic-cardiomyopathy-with-aortic-dilation-a-novel-observation
#12
Rayan Yousefzai, Anushree Agarwal, M Fuad Jan, Chi Cho, Michael Anigbogu, Kambiz Shetabi, Maharaj Singh, Michelle Bush, Shannon Treiber, Steven Port, Khawaja Afzal Ammar, Timothy E Paterick, Renuka Jain, Bijoy K Khandheria, A Jamil Tajik
AIMS: Our goal was to identify the prevalence of aortic dilation in patients with hypertrophic cardiomyopathy (HCM), the most prevalent (0.2%) heritable, genetic cardiovascular disease. Aortic dilation also represents a spectrum of familial inheritance. However, data regarding the prevalence of aortic dilation in HCM patients is lacking. METHODS AND RESULTS: This is an observational retrospective study of all patients referred to our HCM centre. Aortic dilation was defined based on recent American Society of Echocardiography and European Association of Cardiovascular Imaging published guidelines...
December 26, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28009949/a-patient-with-quadricuspid-aortic-valve-and-ischemic-stroke
#13
Maximillian Krisper, Clemens Köhncke, Felicitas Escher, Daniel A Morris, Carsten Tschöpe, Burkert Pieske
Quadricuspid aortic valve (QAV) is a rare congenital cardiac defect. Aortic regurgitation is the predominant hemodynamically relevant abnormality in patients with QAV, and the main reason for patients requiring valve surgery. Calcific valve disease of the left heart valves is classified as 'low embolic risk' according to current guidelines. However, it remains an important risk factor of cardiovascular events, including ischemic stroke. A 71-year-old woman presented with new-onset aphasia and hemiparesis of the right side of her body...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28007240/the-society-of-thoracic-surgeons-2017-clinical-practice-guidelines-for-the-surgical-treatment-of-atrial-fibrillation
#14
REVIEW
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
#15
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/27873174/prognostic-value-of-exercise-left-ventricular-end-systolic-volume-index-in-patients-with-asymptomatic-aortic-regurgitation-an-exercise-echocardiography-study
#16
Yukio Sato, Masaki Izumo, Kengo Suzuki, Seisyou Kou, Kihei Yoneyama, Maya Tsukahara, Kanako Teramoto, Keisuke Minami, Shingo Kuwata, Ryo Kamijima, Kei Mizukoshi, Akio Hayashi, Sachihiko Nobuoka, Eiji Ohtaki, Tomoo Harada, Yoshihiro J Akashi
BACKGROUND: Surgical timing of chronic aortic regurgitation (AR) remains a matter of debate because of limited data. This study assessed the prognostic value of exercise echocardiography in asymptomatic AR. METHODS: This prospective study included 60 consecutive asymptomatic patients with isolated moderate or severe AR (mean regurgitant volume 56.7 ± 11.8 ml) and preserved ejection fraction who underwent exercise echocardiography. The clinical outcomes were defined by the presence of major adverse cardiovascular events (MACE) and the indication for aortic valve replacement (AVR) with class I or IIa classification in the current guidelines...
June 2017: Journal of Echocardiography
https://www.readbyqxmd.com/read/27860152/n-terminal-pro-brain-natriuretic-peptide-is-a-useful-marker-to-identify-latent-heart-failure-patients-in-older-adults-in-a-rural-outpatient-clinic
#17
Kosuke Hamagawa, Toru Kubo, Kotaro Nishimura, Yuichi Baba, Takayoshi Hirota, Naohito Yamasaki, Hiroaki Kitaoka
AIM: Although measurement of natriuretic peptides including N-terminal pro-brain natriuretic peptide (NT-proBNP) has been recommended for identifying heart failure (HF) patients, the prevalence of elderly patients with latent HF who are attending an outpatient clinic is unknown. METHODS: We measured NT-proBNP levels in 393 patients (aged 75 ± 9 years) in a rural outpatient clinic. Patients with a diagnosis of heart disease were excluded. The patients were divided into two groups by the values of NT-proBNP: high NT-proBNP group (>400 pg/mL) and low NT-proBNP group (≤400 pg/mL) according to Japanese guidelines...
November 17, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27847162/patient-specific-computational-fluid-dynamics-assessment-of-aortic-hemodynamics-in-a-spectrum-of-aortic-valve-pathologies
#18
Pouya Youssefi, Alberto Gomez, Taigang He, Lisa Anderson, Nick Bunce, Rajan Sharma, C Alberto Figueroa, Marjan Jahangiri
OBJECTIVES: The complexity of aortic disease is not fully exposed by aortic dimensions alone, and morbidity or mortality can occur before intervention thresholds are met. Patient-specific computational fluid dynamics (CFD) were used to assess the effect of different aortic valve morphologies on velocity profiles, flow patterns, helicity, wall shear stress (WSS), and oscillatory shear index (OSI) in the thoracic aorta. METHODS: A total of 45 subjects were divided into 5 groups: volunteers, aortic regurgitation-tricuspid aortic valve (AR-TAV), aortic stenosis-tricuspid aortic valve (AS-TAV), aortic stenosis-bicuspid aortic valve right-left cusp fusion (BAV[RL]), and aortic stenosis-right-non cusp fusion (AS-BAV[RN])...
January 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27761871/the-crucial-role-of-cardiac-imaging-in-transcatheter-aortic-valve-replacement-tavr-pre-and-post-procedural-assessment
#19
Saif Al-Najafi, Frank Sanchez, Stamatios Lerakis
Transcatheter valve interventions have emerged as one of the most important developments in structural heart disease over the past 20 years. Initially, these interventions were directed at patients with severe aortic stenosis and high surgical risk; however, their applications have extended to involve other native valves' pathologies, degenerated prosthetic valves, as well as patients of lower surgical risk. In this article, we discuss the importance of cardiac imaging in transcatheter aortic valve replacement (TAVR) by exploring the current practices, guidelines, and recommendations with the supporting data...
December 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27732925/echocardiographic-pulmonary-hypertension-probability-is-associated-with-clinical-outcomes-after-transcatheter-aortic-valve-implantation
#20
V J Nijenhuis, M P Huitema, V M M Vorselaars, M J Swaans, T de Kroon, J A S van der Heyden, B J W M Rensing, R Heijmen, J M Ten Berg, M C Post
AIMS: Pulmonary hypertension (PH) is associated with mortality after transcatheter aortic valve implantation (TAVI). However, diagnosis based on tricuspid regurgitant velocity (TRV) is often inaccurate and unreliable. The updated PH guidelines introduced a PH probability grading implementing additional PH signs on transthoracic echocardiography (TTE), from which we aimed to analyse its effects on clinical outcomes in patients undergoing TAVI. METHODS AND RESULTS: We included 591 consecutive patients (mean age 80...
December 15, 2016: International Journal of Cardiology
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