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valvular heart disease guidelines

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https://www.readbyqxmd.com/read/27858232/pulmonary-hypertension-in-heart-failure-patients-pathophysiology-and-prognostic-implications
#1
REVIEW
Marco Guazzi, Valentina Labate
Pulmonary hypertension (PH) due to left heart disease (LHD), i.e., group 2 PH, is the most common reason for increased pressures in the pulmonary circuit. Although recent guidelines incorporate congenital heart disease in this classification, left-sided heart diseases of diastolic and systolic origin including valvular etiology are the vast majority. In these patients, an increased left-sided filling pressure triggers a multistage hemodynamic evolution that ends into right ventricular failure through an initial passive increase in pulmonary artery pressure complicated over time by pulmonary vasoconstriction, endothelial dysfunction, and remodeling of the small-resistance pulmonary arteries...
November 17, 2016: Current Heart Failure Reports
https://www.readbyqxmd.com/read/27842711/-radiation-related-heart-toxicity-update-in-women
#2
S Marlière, E Vautrin, C Saunier, A Chaikh, I Gabelle-Flandin
Breast cancer is a common diagnosis in women and thus women are at risk of radiation-induced heart disease, in particular during radiotherapy for left breast cancer and when the internal mammary chain is included. Rates of major cardiac events increase with younger age at the time of irradiation, diagnosis before 1990s, higher radiation doses, coexisting cardiovascular risk factors and adjuvant cardiotoxic chemotherapy. Radiation-induced heart disease comprises a spectrum of cardiac pathologies, including pericardial disease, cardiomyopathy, coronary artery disease and valvular disease...
December 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27822623/-esc-and-aha-guidelines-2015-on-endocarditis-in-competition-or-synchrony
#3
Bernhard Maisch
In the 2015 guidelines of the European Society of Cardiology (ESC) and the American Heart Association (AHA) on infective endocarditis, the diagnostics are based on the modified Duke criteria. The diagnosis can be confirmed by a combination of micro-organisms demonstrated in culture or in situ, with the detection of valvular lesions or abscess formation by an imaging modality using echocardiography, positron emission tomography computed tomography (PET/CT), cardio-CT or nuclear medical methods. The management should be further improved by an interdisciplinary endocarditis team in a specifically designated reference center...
December 2016: Herz
https://www.readbyqxmd.com/read/27821538/cardiac-mortality-among-200%C3%A2-000-five-year-survivors-of-cancer-diagnosed-at-15-to-39-years-of-age-the-teenage-and-young-adult-cancer-survivor-study
#4
Katherine E Henson, Raoul C Reulen, David L Winter, Chloe J Bright, Miranda M Fidler, Clare Frobisher, Joyeeta Guha, Kwok F Wong, Julie Kelly, Angela B Edgar, Martin G McCabe, Jeremy Whelan, David J Cutter, Sarah C Darby, Mike M Hawkins
BACKGROUND: Survivors of teenage and young adult cancer are acknowledged as understudied. Little is known about their long-term adverse health risks, particularly of cardiac disease that is increased in other cancer populations where cardiotoxic treatments have been used. METHODS: The Teenage and Young Adult Cancer Survivor Study cohort comprises 200 945 5-year survivors of cancer diagnosed at 15 to 39 years of age in England and Wales from 1971 to 2006, and followed to 2014...
November 15, 2016: Circulation
https://www.readbyqxmd.com/read/27773405/cardiovascular-risk-profile-and-management-of-atrial-fibrillation-in-india-real-world-data-from-realiseaf-survey
#5
C Narasimhan, Jagmohan Singh Verma, A G Ravi Kishore, Balbir Singh, Sameer Dani, Kamaldeep Chawala, Azizul Haque, Aftab Khan, Mohan Nair, Amit Vora, V Rajasekhar, Joy M Thomas, Anoop Gupta, Ajay Naik, V S Prakash, Lisa Naditch, P Gabriel Steg
BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia with high risk for many cardiovascular (CV) complications. Adherence to recommended management guidelines is important to avoid complications. In India, there is little knowledge on how AF is managed in real world. METHODS: This is a cross-sectional study of patients in India enrolled in RealiseAF survey between February 2010 and March 2010 with a diagnosis of AF within the last 12 months...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27666180/anticoagulation-after-heart-valve-replacement-or-transcatheter-valve-implantation
#6
Anthony P Carnicelli, Patrick T O'Gara, Robert P Giugliano
Valvular heart disease is prevalent and represents a significant contributor to cardiac morbidity and mortality. Several options for valve replacement exist, including surgical replacement and transcatheter valve implantation. Prosthetic valves lead to increased risk of thromboembolic disease; therefore, antithrombotic therapy after valve replacement is indicated. For patients with mechanical prostheses, indefinite vitamin K antagonist and antiplatelet therapy are the mainstays of treatment. There is no consensus regarding optimal antithrombotic therapy after bioprosthetic valve replacement, although vitamin K antagonist therapy of varying duration in addition to antiplatelet therapy is recommended by guidelines...
August 13, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27642299/myocardial-infarction-and-aortic-root-mycotic-aneurysm-complicating-aortic-valve-endocarditis-utility-of-cardiac-ct
#7
Aimee E Moores, Michael S Cahill, Todd C Villines
Aortic mycotic aneurysms are a rare but life-threatening potential complication of infective endocarditis. Rapid deterioration of the vascular wall in highly focal areas makes these pseudoaneurysms particularly prone to rupture, resulting in uncontrolled aortic hemorrhage. While computed tomography angiography (CTA) is the imaging modality of choice for the evaluation of mycotic aneurysms, it is not routinely performed in patients with known or suspected infective endocarditis (IE). However, current valvular heart disease guidelines support the use of cardiac CTA in cases of IE and suspected perivalvular extension when there is inadequate or ambiguous visualization on echocardiography...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27607083/adherence-to-the-current-guidelines-for-bradycardic-pacing-in-the-octogenarian-and-nonagenarian-populations
#8
Vivienne Kim, James Pemberton, Fiona Riddell, Khang-Li Looi
AIM: A significant proportion of single-chamber ventricular pacemakers are implanted in octogenarian and nonagenarian patients. We aimed to assess whether the current pacing guideline is adhered for these populations. METHODS: We retrospectively identified patients ≥80 years of age, who received their first pacemaker from July 2010 to June 2013. RESULTS: A total of 356 patients were identified. Mean age was 86.1 years and 82.6 years for single and dual-chamber pacemakers respectively (p<0...
2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27571182/a-follow-up-study-of-the-prevalence-of-valvular-heart-abnormalities-in-hyperprolactinemic-patients-treated-with-cabergoline
#9
W M Drake, C E Stiles, J S Bevan, N Karavitaki, P J Trainer, D A Rees, T I Richardson, S E Baldeweg, N Stojanovic, R D Murray, A A Toogood, N M Martin, B Vaidya, T S Han, R P Steeds, F C Baldeweg, U E Sheikh, N Kyriakakis, S Parasuraman, L Taylor, N Butt, S Anyiam
: CONTEXT Uncertainty exists whether the long-term use of ergot-derived dopamine agonist (DA) drugs for the treatment of hyperprolactinemia may be associated with clinically significant valvular heart disease; and whether current regulatory authority guidelines for echocardiographic screening are clinically appropriate. OBJECTIVE: To provide follow-up echocardiographic data on a previously described cohort of patients treated with DA for lactotrope pituitary tumors; and to explore possible associations between structural and functional valve abnormalities with the cumulative dose of drug used...
August 29, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27544900/integration-of-flow-gradient-patterns-into%C3%A2-clinical-decision-making-for-patients-with-suspected-severe-aortic-stenosis-and-preserved-lvef-a-systematic-review-of-evidence-and-meta-analysis
#10
Chirag Bavishi, Kiruthika Balasundaram, Edgar Argulian
OBJECTIVES: This study was designed to evaluate the evidence base for the 2014 American Heart Association/American College of Cardiology (AHA/ACC) guidelines for severe aortic stenosis (SAS) and preserved left ventricular ejection fraction by comparing the natural history of the disease in subgroups of low-gradient (LG) aortic stenosis patients with high-gradient (HG) patients. BACKGROUND: The 2014 AHA/ACC valvular disease guidelines recommend estimation of stroke volume index by echocardiography in patients with suspected LG SAS and preserved left ventricular ejection fraction...
November 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27488309/a-prospective-study-investigating-the-causes-of-warfarin-under-utilization-in-chinese-patients
#11
Shujuan Zhao, Hongwei Zhao, Xianpei Wang, Chuanyu Gao, Yuhua Qin, Haixia Cai, Boya Chen, Jingjing Cao
Background Warfarin is efficacious for ischemic stroke prevention in intermediate- to high-risk patients with atrial fibrillation; thus, warfarin is the recommended treatment according to evidence-based guidelines. Objective This prospective study evaluated the reasons for under-utilization of warfarin in Chinese patients with non-valvular atrial fibrillation (NVAF). Setting The People's Hospital of Henan Province of Zhengzhou City, which is a 3900-bed tertiary-care teaching institution. Methods We extracted data from an existing patient database...
October 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27394924/vitamin-k-and-non-vitamin-k-antagonist-oral-anticoagulants-for-non-valvular-atrial-fibrillation-in-real-life
#12
Michela Giustozzi, Maria Cristina Vedovati, Paolo Verdecchia, Lucia Pierpaoli, Melina Verso, Serenella Conti, Federica Cianella, Emanuela Marchesini, Esmeralda Filippucci, Giancarlo Agnelli, Cecilia Becattini
BACKGROUND: Current guidelines recommend vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in patients with non-valvular atrial fibrillation (AF). METHODS: We compared the clinical features of consecutive in- and out-patients with non-valvular AF newly-treated with NOACs or on treatment with VKAs. RESULTS: Overall, 1314 patients newly-treated with NOACs and 1024 on treatment with VKAs were included in the study...
September 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27382238/pregnancy-at-65-risks-and-complications
#13
Shailja Verma, Krishna Agarwal, Gauri Gandhi
A 65-year-old postmenopausal pregnant woman was referred with antepartum hemorrhage at 29 weeks of gestation. Postadmission diagnosed with chronic hypertension, gestational diabetes mellitus, valvular heart disease, and placenta previa. Her pregnancy was terminated by cesarean delivery at 32 weeks as she had a bout of bleeding per vaginum. Most of the placenta was adherent with no plane of cleavage; therefore, cesarean hysterectomy was performed. Baby birth weight was 1650 g and was shifted to nursery for observation and mother needed Intensive Care Unit care postcesarean...
April 2016: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/27347228/stroke-prevention-in-atrial-fibrillation-and-valvular-heart-disease
#14
Saad Ahmad, Heath Wilt
There is a clinically staggering burden of disease stemming from cerebrovascular events, of which a majority are ischemic in nature and many are precipitated by atrial fibrillation (AF). AF can occur in isolation or in association with myocardial or structural heart disease. In the latter case, and when considering health at an international level, congenital and acquired valve-related diseases are frequent contributors to the current pandemic of AF and its clinical impact. Guidelines crafted by the American Heart Association, American College of Cardiology, European Society of Cardiology and Heart Rhythm Society underscore the use of vitamin K antagonists (VKAs) among patients with valvular heart disease, particularly in the presence of concomitant AF, to reduce the risk of ischemic stroke of cardioembolic origin; however, the non-VKAs, also referred to as direct, target-specific or new oral anticoagulants (NOACs), have not been actively studied in this particular population...
2016: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/27326236/a-mechanical-heart-valve-is-the-best-choice
#15
Iqbal H Jaffer, Richard P Whitlock
The choice of prosthesis type in patients with valvular heart disease should always be individualised. The treating heart team must weigh the concerns surrounding durability of bioprosthetic valves compared with mechanical valves and the need for lifelong anticoagulation required with mechanical valves. In general, guidelines recommend that patients under the age of 60 would benefit from a mechanical valve, and those over 70 would benefit from a bioprosthetic valve. We would argue, in this context, that the most appropriate choice for this patient would be undertaking a mitral valve replacement with a mechanical prosthesis...
2016: Heart Asia
https://www.readbyqxmd.com/read/27325921/valvular-regurgitation-and-stenosis-when-is-surgery-required
#16
R Goel, P P Sengupta, F Mookadam, H P Chaliki, B K Khandheria, A J Tajik
Valvular heart disease is a growing public health problem, with an increasing prevalence due to an ageing population. Despite advances, the medical management of symptomatic valvular heart diseases remains suboptimal, necessitating surgical correction. The challenge remains in identifying an asymptomatic or mildly symptomatic patient who will benefit from timely surgery before irreversible changes in cardiac function have occurred. The potential risks of surgery versus watchful expectancy require careful decision-making...
2009: Heart Asia
https://www.readbyqxmd.com/read/27179545/cardiac-outcomes-in-survivors-of-pediatric-and-adult-cancers
#17
REVIEW
Paul C Nathan, Eitan Amir, Husam Abdel-Qadir
More than 80% of children and 60% of adults with cancer will become long-term survivors, emphasizing the importance of late effects of cancer therapy. Cardiotoxicity due to chemotherapy and radiation is a frequent cause of serious morbidity and premature mortality in survivors. Anthracyclines, a core component of many treatment regimens, have been implicated as a principal cause of irreversible cardiomyopathy. Approximately 60% of anthracycline-treated children will develop echocardiographic evidence of cardiac dysfunction, and 10% of those treated with high-dose anthracyclines will develop congestive heart failure within the 20 years after therapy...
July 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27173039/operationalizing-the-2014-acc-aha-guidelines-for-valvular-heart-disease-a-guide-for-clinicians
#18
REVIEW
Rick A Nishimura, Blase Carabello
The 2014 American College of Cardiology/American Heart Association guidelines for valvular heart disease were released to help guide the clinician in caring for patients with this ever more prevalent and complex group of diseases and have been instrumental in providing a foundation of knowledge for the management of patients with valvular heart disease. However, there are many caveats in applying the guidelines to individual patients. As clinicians, we wish to outline important aspects to be considered by other clinicians, including the integration of the echocardiogram with the history and physical examination, recognition of discordant data within an echocardiographic examination, and proper interpretation of the cutoff measurements applied to timing of intervention...
May 17, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27057292/atrial-fibrillation-and-hypertension-mechanistic-epidemiologic-and-treatment-parallels
#19
Adedotun A Ogunsua, Amir Y Shaikh, Mohamed Ahmed, David D McManus
Atrial fibrillation (AF) is an increasingly prevalent condition and the most common sustained arrhythmia encountered in ambulatory and hospital practice. Several clinical risk factors for AF include age, sex, valvular heart disease, obesity, sleep apnea, heart failure, and hypertension (HTN). Of all the risk factors, HTN is the most commonly encountered condition in patients with incident AF. Hypertension is associated with a 1.8-fold increase in the risk of developing new-onset AF and a 1.5-fold increase in the risk of progression to permanent AF...
October 2015: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/27038640/prognosis-of-low-normal-left-ventricular-ejection-fraction-in-an-asymptomatic-population-based-adult-cohort-the-multiethnic-study-of-atherosclerosis
#20
Joseph Yeboah, Carlos J Rodriguez, Waqas Qureshi, Songtao Liu, J Jeffrey Carr, Joao A Lima, W Gregory Hundley, David M Herrington
BACKGROUND: Reduced left ventricular systolic function predicts worse outcomes. However, the optimal threshold for "normal" left ventricular ejection fraction (LVEF) is uncertain. In general, LVEF ≥ 55% is considered to be "normal" by guidelines, with a low normal designation for LVEF being 50%-55%. We assessed the prognosis of participants with low normal LVEF in the Multiethnic Study of Atherosclerosis. All participants were asymptomatic and had no known clinical cardiovascular disease at baseline...
October 2016: Journal of Cardiac Failure
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