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valvular heart disease guidelines

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https://www.readbyqxmd.com/read/28229203/-real-time-3d-echocardiography-for-estimation-of-severity-in-valvular-heart-disease-impact-on-current-guidelines
#1
T Buck, L Bösche, B Plicht
Besides providing spatial anatomic information on heart valves, real-time three-dimensional echocardiography (3DE) combined with color Doppler has the potential to overcome the limitations of flow quantification inherent to conventional 2D color Doppler methods. Recent studies validated the application of color Doppler 3DE (cD-3DE) for the quantification of regurgitation flow based on the vena contracta area (VCA) and the proximal isovelocity surface area (PISA) methods. Particularly the assessment of VCA by cD-3DE led to a change of paradigm by understanding of the VCA as being strongly asymmetric in the majority of patients and etiologies...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28209729/edoxaban-for-the-prevention-of-thromboembolism-in-patients-with-atrialfibrillation-and-bioprosthetic-valves
#2
Anthony P Carnicelli, Raffaele De Caterina, Jonathan L Halperin, Giulia Renda, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott Antman, Robert P Giugliano
Atrial fibrillation (AF) and valvular heart disease (VHD) frequently coexist and independently increase mortality1. Bioprosthetic valve implantation (surgical or transcatheter), is a common, increasingly utilized treatment for VHD2. Patients with AF and bioprosthetic valves require anticoagulation to prevent thromboembolic events. Non-vitamin K oral anticoagulants (NOACs) are safe and efficacious alternatives to vitamin K antagonists for anticoagulation in AF. However, guidelines recommend against NOACs in patients with bioprosthetic valves, citing a lack of supporting data...
February 16, 2017: Circulation
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#3
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28182589/bicuspid-aortic-valve-aortopathy-mechanistic-and-clinical-insights-from-recent-studies
#4
David G Guzzardi, Subodh Verma, Paul W M Fedak
PURPOSE OF REVIEW: This focused review summarizes key insights from the past 12 months of basic science and clinical research on bicuspid aortic valve (BAV)-associated aortopathy. RECENT FINDINGS: Recent studies in BAV-associated aortopathy support a heterogeneous spectrum of disease with distinct phenotypes. Basic science studies provide further support for the concept of regional differences in the severity of aortopathy within the aorta of BAV patients. Clinical studies compared outcomes of BAV patients after isolated aortic valve replacement and showed that those with primarily valvular insufficiency as compared with stenosis may be at greater risk for important aortic events over time...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28182166/reducing-the-risk-of-stroke-in-elderly-patients-with-non-valvular-atrial-fibrillation-a-practical-guide-for-clinicians
#5
REVIEW
Joanne M Foody
Non-valvular atrial fibrillation (NVAF) significantly contributes to the burden of stroke, particularly in elderly patients. The challenge of optimizing anticoagulation therapy is balancing efficacy and bleeding risk, especially as the same patients at high risk of stroke also tend to be at high risk of bleeding. Treating the elderly patient with NVAF presents special challenges because of their heightened risk for both stroke and bleeding. Despite clinical trial data and evidence-based guidelines, surveys indicate that physicians underuse anticoagulation in older patients for reasons that include overemphasis of bleeding risk, particularly with the increased risk of falling, at the cost of thromboembolic risk...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28170357/on-x-valve-the-next-generation-aortic-valve
#6
Rahul Chaudhary, Jalaj Garg, Parasuram Krishnamoorthy, Neeraj Shah, Bruce A Feldman, Matthew W Martinez, Ronald Freudenberger
The On-X valve is a newer generation mechanical bileaflet valve. Its key features include the use of pure pyrolytic carbon (devoid of silicon), a length-to-diameter ratio similar to a native valve, an inlet flared orifice, a leaflet opening up to 90 degrees, a shorter leaflet closing angle, a 2-point leaflet contact, and an actuated pivot. These features have translated into increased strength, improved valve hemodynamics, reduced hemolysis, and thrombogenicity. The 2014 American Heart Association/American College of Cardiology guidelines for the management of patients with valvular heart disease recommend an international normalized ratio (INR) of 2...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28131996/cohort-profile-prevalence-of-valvular-heart-disease-in-community-patients-with-suspected-heart-failure-in-uk
#7
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/28087179/value-of-serum-n-terminal-b-type-natriuretic-peptide-in-asymptomatic-structural-heart-disease-in-taiwanese-population-comparisons-with-current-esc-guidelines
#8
Ta-Chuan Hung, Kuang-Te Wang, Chun-Ho Yun, Jen-Yuan Kuo, Charles Jia-Yin Hou, Chia-Yuan Liu, Tung-Hsin Wu, Hiram G Bezerra, Hsiao-Yang Cheng, Chung-Lieh Hung, Hung-I Yeh
BACKGROUND: The relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac structural or functional anomalies in pre-clinical, asymptomatic Asian populations has not been well identified. METHODS: From October 2005 to March 2008, we enrolled consecutive asymptomatic adults with preserved global left ventricular (LV) function (ejection fraction>50%) who underwent annual cardiovascular health survey. Circulating NT-proBNP was used to identify echo-defined cardiac structural/functional anomalies and compared to current recommended cut-off from the European Society of Heart Failure...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28076633/statins-for-aortic-valve-stenosis
#9
Luciana Thiago, Selma Rumiko Tsuji, Jonathan Nyong, Maria Eduarda Dos Santos Puga, Aécio Flávio Teixeira de Góis, Cristiane Rufino Macedo, Orsine Valente, Álvaro Nagib Atallah
BACKGROUND: Aortic valve stenosis is the most common type of valvular heart disease in the USA and Europe. Aortic valve stenosis is considered similar to atherosclerotic disease. Some studies have evaluated statins for aortic valve stenosis. OBJECTIVES: To evaluate the effectiveness and safety of statins in aortic valve stenosis. METHODS: Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, LILACS - IBECS, Web of Science and CINAHL Plus...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28045409/turkish-registry-for-diagnosis-and-treatment-of-acute-heart-failure-taktik-study
#10
Mehmet Eren, Mehdi Zoghi, Mustafa Tuncer, Yüksel Çavuşoğlu, Recep Demirbağ, Mahmut Şahin, Osman Akın Serdar, Ersel Onrat, Haşim Mutlu, Dursun Dursunoğlu, Mehmet Birhan Yılmaz, Ahmet Temizhan
OBJECTIVE: The goal of this study was to develop a national database of patients hospitalized in Turkey with acute heart failure (AHF) using evaluations of diagnostic and therapeutic approaches. METHODS: Patient data were collected using an Internet-based survey. A total of 588 patients were enrolled from 36 participating medical centers across the country. RESULTS: Mean age was 62±13 years and 38% of the patients were female. Ratio of de novo AHF to study cohort was 24%...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28004413/direct-oral-anticoagulant-use-in-nonvalvular-atrial-fibrillation-with-valvular-heart-disease-a-systematic-review
#11
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/27858232/pulmonary-hypertension-in-heart-failure-patients-pathophysiology-and-prognostic-implications
#12
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...
December 2016: Current Heart Failure Reports
https://www.readbyqxmd.com/read/27842711/-radiation-related-heart-toxicity-update-in-women
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
September 9, 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
#20
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
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