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aortic regurgitation guidelines

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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
#1
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...
November 21, 2016: 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
#2
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
#3
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])...
September 23, 2016: 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
#4
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
#5
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...
October 6, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27597299/-ascending-aortic-aneurysm-update-to-existing-guidelines
#6
Daniel Grinberg, Matteo Pozzi, Fadi Farhat, Jean-François Obadia
The initial aorta (aortic valve, ring, sinuses and ascending aorta) constitutes an inseparable anatomical-functional entity. The "normal" diameter grows with age and body surface area. Two potential risks: aortic regurgitation (chronic complication) and aortic dissection (acute complication) The aortic diameter is the main factor of aortic dissection. Issues of the recommendations: set thresholds to indicate prophylactic surgery (avoid complication) Betablockers are indicated, especially in cases of hypertension or proven familial dystrophy...
September 2, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27550231/bicuspid-aortic-valve-a-review-with-recommendations-for-genetic-counseling
#7
REVIEW
Samantha L Freeze, Benjamin J Landis, Stephanie M Ware, Benjamin M Helm
Bicuspid aortic valve (BAV) is the most common congenital heart defect and falls in the spectrum of left-sided heart defects, also known as left ventricular outflow tract obstructive (LVOTO) defects. BAV is often identified in otherwise healthy, asymptomatic individuals, but it is associated with serious long term health risks including progressive aortic valve disease (stenosis or regurgitation) and thoracic aortic aneurysm and dissection. BAV and other LVOTO defects have high heritability. Although recommendations for cardiac screening of BAV in at-risk relatives exist, there are no standard guidelines for providing genetic counseling to patients and families with BAV...
December 2016: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/27490591/aortic-and-mitral-valve-disease-and-left-ventricular-dysfunction-in-children
#8
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/27429910/the-role-of-cardiovascular-magnetic-resonance-in-the-assessment-of-severe-aortic-stenosis-and-in-post-procedural-evaluation-following-transcatheter-aortic-valve-implantation-and-surgical-aortic-valve-replacement
#9
REVIEW
Tarique Al Musa, Sven Plein, John P Greenwood
Degenerative aortic stenosis (AS) is the most common valvular disease in the western world with a prevalence expected to double within the next 50 years. International guidelines advocate the use of cardiovascular magnetic resonance (CMR) as an investigative tool, both to guide diagnosis and to direct optimal treatment. CMR is the reference standard for quantifying both left and right ventricular volumes and mass, which is essential to assess the impact of AS upon global cardiac function. Given the ability to image any structure in any plane, CMR offers many other diagnostic strengths including full visualisation of valvular morphology, direct planimetry of orifice area, the quantification of stenotic jets and in particular, accurate quantification of valvular regurgitation...
June 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/27356759/mechanical-aortic-valve-without-anticoagulation-for-33%C3%A2-years-in-a-yemeni-man-a-case-report
#10
Khadija Aman
BACKGROUND: Mechanical prosthetic heart valves have been used for many decades to replace damaged native valves. Guidelines mandate the use of anticoagulant therapy in patients with mechanical prosthetic valves of any type, irrespective of the position in the heart. The rationale for this is to prevent valve thrombosis and thromboembolic complications without increasing the risk of excess bleeding. We report a case involving a patient with a functioning aortic mechanical valve without any anticoagulation therapy for 33 years...
2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27206941/characterization-of-the-unique-chinese-w483x%C3%A2-mutation-in-the-low-density-lipoprotein-receptor-gene-in-young-patients-with-homozygous-familial-hypercholesterolemia
#11
Long Jiang, Li-Yuan Sun, Xiao-Dong Pan, Pan-Pan Chen, Ling Tang, Wei Wang, Li-Min Zhao, Shi-Wei Yang, Lu-Ya Wang
BACKGROUND: Recent guidelines suggest that more attention should be focused on children with homozygous familial hypercholesterolemia (HoFH). China may have 3.8 million potential FH patients, but there are limited data focused on HoFH children. OBJECTIVE: We systematically analyzed the characteristic phenotype and the relationship between the genotype and the phenotype in HoFH children with the unique Chinese W483X mutation in the low-density lipoprotein (LDL)-receptor gene...
May 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/26743732/right-ventricular-function-and-prognosis-in-patients-with-low-flow-low-gradient-severe-aortic-stenosis
#12
João L Cavalcante, Shasank Rijal, Andrew D Althouse, Antonia Delgado-Montero, William E Katz, John T Schindler, Frederick Crock, Matthew E Harinstein, Forozan Navid, Thomas G Gleason, Joon S Lee
BACKGROUND: Patients with low left ventricular ejection fractions and low-flow, low-gradient aortic stenosis (AS) represent a challenging cohort with high morbidity and mortality. The prevalence and clinical impact of right ventricular dysfunction (RVD) on risk stratification and prognosis in these patients is unknown. METHODS: A retrospective analysis was performed of 65 patients with low-flow, low-gradient AS who underwent low-dose dobutamine stress echocardiography to determine AS severity and to ascertain flow reserve status (≥20% stroke volume increase)...
April 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/26718321/aortic-valve-replacement-for-severe-aortic-regurgitation-in-asymptomatic-patients-with-normal-ejection-fraction-and-severe-left-ventricular-dilatation
#13
Yin Wang, Jiawei Shi, Fei Li, Yongjun Wang, Nianguo Dong
OBJECTIVES: According to current guidelines, aortic valve surgery is a Class II indication for asymptomatic patients with severe aortic regurgitation (AR) accompanied by left ventricular (LV) ejection fraction (LVEF) ≥ 50% and left ventricular end-diastolic dimension (LVEDD) >70 mm. This study aims to assess the postoperative outcomes of asymptomatic patients with severe AR accompanied by LVEF ≥ 50% and LVEDD >70 mm after aortic valve replacement (AVR) and to identify prognostic indicators of the surgery, especially in terms of LV ejection fraction and degree of LV dilatation...
April 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/26715655/infective-endocarditis-prophylaxis-current-practice-trend-among-paediatric-cardiologists-are-we-following-the-2007-guidelines
#14
Ronak J Naik, Neil R Patel, Ming Wang, Nishant C Shah
BACKGROUND: In 2007, the American Heart Association modified the infective endocarditis prophylaxis guidelines by limiting the use of antibiotics in patients with cardiac conditions associated with the highest risk of adverse outcomes after infective endocarditis. Our objective was to evaluate current practice for infective endocarditis prophylaxis among paediatric cardiologists. METHODS: A web-based survey focussing on current practice, describing the use of antibiotics for infective endocarditis prophylaxis in various congenital and acquired heart diseases, was distributed via e-mail to paediatric cardiologists...
August 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/26714887/the-beneficial-effects-of-tavi-in-mitral-insufficiency
#15
MULTICENTER STUDY
Marco Fabio Costantino, Ernesta Dores, Pasquale Innelli, Antonella Matera, Vincenza Santillo, Roberto Violini, Rosario Fiorilli, GianGiuseppe Cappabianca, Nicola Marraudino, Eugenio Picano, Giandomenico Tarsia
BACKGROUND: Previous studies have suggested that concomitant mitral regurgitation (MR) is a risk factor for acute transcatheter aortic valve implantation (TAVI) failure, but may improve afterwards. Aim of this study was to assess the prevalence, clinical meaning and modifications of MR in patients undergoing TAVI. METHODS: In a retrospective, two-center (Potenza-San Carlo and Roma- San Camillo) study, from January 2010 to June 2014 we enrolled 165 consecutive patients (age =80 ± 5 years, 74 males, Ejection Fraction 51 ± 9 %) referred for TAVI with either Medtronic Core-ReValving System (in 114 patients, 69%) or balloon-expandable Edwards SAPIEN/SAPIEN XT (in 51 patients, 31%)...
December 30, 2015: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/26649912/discordance-in-grading-methods-of-aortic-stenosis-by-pre-cardiopulmonary-bypass-transesophageal-echocardiography
#16
George Whitener, Jeff McKenzie, Igor Akushevich, William D White, Ishwori B Dhakal, Alina Nicoara, Madhav Swaminathan
BACKGROUND: Current guidelines define severe aortic valve stenosis (AS) as an aortic valve area (AVA) ≤1.0 cm by the continuity equation and mean gradient (ΔPm) ≥ 40 mm Hg. However, these measurements can be discordant when classifying AS severity. Approximately one-third of patients with normal ejection fraction and severe AS by AVA have nonsevere AS by ΔPm when measured by preoperative transthoracic echocardiography (TTE). Given the use of positive pressure ventilation and general anesthesia in the pre-cardiopulmonary bypass (pre-CPB) period, we hypothesized that discordance between ΔPm and AVA during pre-CPB transesophageal echocardiography (TEE) would be higher than previously reported by TTE...
April 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26625232/-aortic-regurgitation-update-2015
#17
REVIEW
Volker Rudolph, Stephan Baldus
Aortic regurgitation is the consequence of a heterogenous alterations to the aortic valve and ascending aorta, respectively. Due to the widespread use of transcatheter aortic valve implantation, paravalvular leakage has gained interest as a special subtype of aortic regurgitation. The present article summarizes the current state and recent developments in the diagnostics and therapy of the different forms of aortic regurgitation.
December 2015: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/26474984/baseline-mdct-findings-after-prosthetic-heart-valve-implantation-provide-important-complementary-information-to-echocardiography-for-follow-up-purposes
#18
Dominika Suchá, Steven A J Chamuleau, Petr Symersky, Matthijs F L Meijs, Renee B A van den Brink, Bas A J M de Mol, Willem P Th M Mali, Jesse Habets, Lex A van Herwerden, Ricardo P J Budde
OBJECTIVES: Recent studies have proposed additional multidetector-row CT (MDCT) for prosthetic heart valve (PHV) dysfunction. References to discriminate physiological from pathological conditions early after implantation are lacking. We present baseline MDCT findings of PHVs 6 weeks post implantation. METHODS: Patients were prospectively enrolled and TTE was performed according to clinical guidelines. 256-MDCT images were systematically assessed for leaflet excursions, image quality, valve-related artefacts, and pathological and additional findings...
April 2016: European Radiology
https://www.readbyqxmd.com/read/26455017/-moderate-or-severe-aquired-valvular-heart-disease-in-pregnancy-what-does-determine-the-management-experence-intuition-or-guidelines
#19
REVIEW
Lidia Greszata, Janina Stępińska
Epidemiology of acquired valvular heart diseases has changed significantly over last decades. Degenerative aortic valve stenosis is the most common acquired valvular disease with high prevalence in elderly population. Another common disorder is ischemic mitral regurgitation secondary to myocardial infarction. Both above-mentioned heart disorders are not typical for women in reproductive age. Rheumatic heart valve disease has become infrequent in Polish population. Mitral stenosis, the most prevalent of rheumatic valvular disorders, affects 5% of pregnant women with heart disease and rheumatic aortic stenosis is responsible for 0...
2015: Przegla̧d Lekarski
https://www.readbyqxmd.com/read/26438784/handheld-echocardiographic-screening-for-rheumatic-heart-disease-by-non-experts
#20
Michelle Ploutz, Jimmy C Lu, Janet Scheel, Catherine Webb, Greg J Ensing, Twalib Aliku, Peter Lwabi, Craig Sable, Andrea Beaton
OBJECTIVES: Handheld echocardiography (HAND) has good sensitivity and specificity for rheumatic heart disease (RHD) when performed by cardiologists. However, physician shortages in RHD-endemic areas demand less-skilled users to make RHD screening practical. We examine nurse performance and interpretation of HAND using a simplified approach for RHD screening. METHODS: Two nurses received training on HAND and a simplified screening approach. Consented students at two schools in Uganda were eligible for participation...
January 2016: Heart: Official Journal of the British Cardiac Society
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