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calcific aortic stenosis

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https://www.readbyqxmd.com/read/29325642/nhlbi-working-group-recommendations-to-reduce-lipoprotein-a-mediated-risk%C3%A2-of%C3%A2-cardiovascular-disease-and-aortic%C3%A2-stenosis
#1
REVIEW
Sotirios Tsimikas, Sergio Fazio, Keith C Ferdinand, Henry N Ginsberg, Marlys L Koschinsky, Santica M Marcovina, Patrick M Moriarty, Daniel J Rader, Alan T Remaley, Gissette Reyes-Soffer, Raul D Santos, George Thanassoulis, Joseph L Witztum, Simhan Danthi, Michelle Olive, Lijuan Liu
Pathophysiological, epidemiological, and genetic studies provide strong evidence that lipoprotein(a) [Lp(a)] is a causal mediator of cardiovascular disease (CVD) and calcific aortic valve disease (CAVD). Specific therapies to address Lp(a)-mediated CVD and CAVD are in clinical development. Due to knowledge gaps, the National Heart, Lung, and Blood Institute organized a working group that identified challenges in fully understanding the role of Lp(a) in CVD/CAVD. These included the lack of research funding, inadequate experimental models, lack of globally standardized Lp(a) assays, and inadequate understanding of the mechanisms underlying current drug therapies on Lp(a) levels...
January 16, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29290898/first-in-man-implantation-of-the-retrievable-and-repositionable-venusa-plus-valve
#2
Xian-Bao Liu, Yu-Xin He, Chun-Hui Liu, Li-Han Wang, Feng Gao, Lei Yu, Ai-Qiang Dong, Min-Jian Kong, Ji-Fang Chen, Yong Xu, Qi-Jing Zhou, Min Yan, Jian-An Wang
BACKGROUND: No retrievable and repositionable second generation transcatheter aortic valve is available in China. Here, we report the first-in-man implantation of the retrievable and repositionable VenusA-Plus valve. METHODS: A 76-year-old patient with symptomatic severe aortic stenosis and high surgical risk (STS 13.8%) was recommended for transcatheter aortic valve replacement (TAVR) by heart valve team. Type 0 bicuspid aortic valve with asymmetric calcification was identified by dual source computed tomography, and the unfavorable anatomies increased the possibility of malposition and paravalvular leakage during TAVR...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29279525/planimetry-of-the-orifice-area-in-aortic-valve-stenosis-using-phase-contrast-cardiac-magnetic-resonance-imaging
#3
Hajime Abe, Nobuo Iguchi, Yuko Utanohara, Kaori Takada, Yasuki Hen, Haruhiko Machida, Norihiko Takeda, Tetsuya Sumiyoshi
Manual planimetry is a well-established method using transesophageal echocardiography (TEE) to assess the severity of aortic stenosis (AS). TEE, however, is a less than optimal approach in patients with calcified valves. Even when using cine-cardiac magnetic resonance (CMR), it is often difficult to evaluate the true border of the aortic orifice because of jet turbulence. With phase-contrast sequences of CMR, high flow signals at the aortic orifice can be clearly visualized, even in cases with severe calcification and jet turbulence...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29276909/-management-of-patients-with-isolated-aortic-stenosis-considering-negative-prognostic-factors
#4
I G Nikitin, G E Gendlin, E I Emelina, A I Kovaleva
BACKGROUND: Aortic stenosis (AS) is the most common valve defect in developed countries; its prevalence increases with age of the population. The most frequent cause for isolated AS in adults is calcification of normal tricuspid or congenital bicuspid aortic valve (AV). The only effective treatment of AS is aortic valve replacement (AVR). Major negative prognostic factors include low LV ejection fraction (EF), age older than 70, female gender, and comorbidities such as renal dysfunction, chronic obstructive pulmonary disease, and neural disorders...
2017: Kardiologiia
https://www.readbyqxmd.com/read/29258732/using-a-regent-aortic-valve-in-a-small-annulus-mitral-position-is-a-viable-option
#5
Yaron D Barac, Brittany Zwischenberger, Jacob N Schroder, Mani A Daneshmand, Jack Haney, Jeff Gaca, Andrew Wang, Carmelo A Milano, Donald D Glower
BACKGROUND: Outcome of mitral valve replacement in extreme scenarios of small mitral annulus using the Regent mechanical aortic valve is not well documented. METHODS: Records were examined in 31 consecutive patients undergoing mitral valve replacement using the aortic Regent valve due to a small mitral annulus. RESULTS: Mean age was 60±14 years. Mitral stenosis or mitral annulus calcification was present in 30/31(97%) patients. Concurrent procedures were performed in 17/31(55%) patients...
December 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29258711/mechanisms-of-aortic-stenosis
#6
REVIEW
Hirokuni Akahori, Takeshi Tsujino, Tohru Masuyama, Masaharu Ishihara
The pathobiology of degenerative aortic valve stenosis (AS) is complex and involves multiple features such as fibrosis, inflammation, oxidative stress, angiogenesis, hemorrhage, and osteogenic differentiation. We summarize the mechanism of valve calcification and angiogenesis which is necessary for calcifying processes. A promising therapeutic target is nuclear factor (NF)-κB which activates bone morphogenetic protein (BMP)2 via interleukin-6. BMP2 activates Wnt signaling via msh homeobox 2 causing osteogenic differentiation...
December 16, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29244962/expression-of-the-frizzled-receptors-and-their-co-receptors-in-calcified-human-aortic-valves
#7
Ateeque Siddique, Bin Yu, Kashif Khan, Ryan Buyting, Hamood Al-Kindi, Hossny Alaws, Eric Rhéaume, Jean-Claude Tardif, Renzo Cecere, Adel Schwertani
The cellular mechanisms that induce calcific aortic stenosis are yet to be unravelled. Wnt signaling is increasingly being considered as a major player in the disease process. However, the presence of Wnt Frizzled receptors (Fzd) and co-receptors LRP5 and 6 in normal and diseased human aortic valves remains to be elucidated. Immunohistochemistry and qPCR were used to determine Fzd receptor expression in normal and calcified human aortic valve tissue, as well as human aortic valve interstitial cells (HAVICs) isolated from calcified and normal human aortic valves...
December 15, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/29242201/familial-aggregation-of-aortic-valvular-stenosis-a-nationwide-study-of-sibling-risk
#8
Andreas Martinsson, Xinjun Li, Bengt Zöller, Pontus Andell, Charlotte Andersson, Kristina Sundquist, J Gustav Smith
BACKGROUND: Aortic valvular stenosis (AS) is the most common cause of cardiac valvular replacement surgery. During the last century, the pathogenesis of AS has undergone transitions in developed countries, from rheumatic heart disease to a degenerative calcific pathogenesis. Although a familial component has been described for a subset of cases with a bicuspid valve, data are limited on the overall familial aggregation of this disease. METHODS AND RESULTS: Contemporary information on 6 117 263 Swedish siblings, of which 13 442 had a clinical diagnosis of AS, was collected from the nationwide Swedish Multi-Generation Register and the National Patient Register...
December 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/29234617/transcatheter-mitral-valve-implantation-in-open-heart-surgery-an-off-label-technique
#9
Jacopo Alfonsi, Giacomo Murana, Anna Corsini, Carlo Savini, Roberto Di Bartolomeo, Davide Pacini
Extensive mitral annulus calcifications are considered a contraindication for valve surgery. We describe the case of a 76-year-old female with severe mitral and aortic stenosis associated with extensive calcifications of the heart. The patient underwent an open mitroaortic valve replacement using transcatheter aortic valve implantation with an Edwards SAPIEN XT valve (Edwards Lifesciences Corp., Irvine, CA, USA) in the mitral position. The aortic valve was replaced using a stentless valve prosthesis (LivaNova SOLO; LivaNova PLC, London, UK)...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29198984/relation-of-an-echocardiographic-based-cardiac-calcium-score-to-mitral-stenosis-severity-and-coronary-artery-disease-in-patients-with-severe-aortic-stenosis
#10
Siyuan P Sheng, Lucius A Howell, Melissa C Caughey, Michael Yeung, John P Vavalle
Patients with calcific aortic stenosis (AS) often have diffuse cardiac calcification involving the mitral valve apparatus and coronary arteries. We examined the association between global cardiac calcification quantified by a previously validated echocardiographic calcium score (eCS) with the severity of mitral stenosis (MS) and coronary artery disease (CAD) in patients with a clinical diagnosis of severe calcific AS. In this sample of 147 patients (mean age 81 ± 9 years, 50% male), 81 patients (55%) were determined by echocardiography to have some degree of MS...
October 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29197602/continuous-flow-perfused-cadaver-model-for-endovascular-training-research-and-development
#11
Amrita Sarkar, Richa Kalsi, Joseph D Ayers, Charles B Drucker, Vaidehi Kaushal, William Sutton, Robert S Crawford
BACKGROUND: Endovascular simulation employing computer, animal, and static models are common and useful adjuncts for teaching endovascular procedures and developing novel, complex endovascular techniques. Unfortunately, these models lack realistic haptic feedback and thus do not faithfully replicate many of the technical challenges associated with clinical endovascular procedures (e.g., arterial calcification, rigidity, and stenosis). We sought to develop a realistic and reproducible perfused cadaver model for endovascular training, device development and research...
November 29, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29194051/blood-tissue-and-imaging-biomarkers-in-calcific-aortic-valve-stenosis-past-present-and-future
#12
Mylène Shen, Lionel Tastet, Jutta Bergler-Klein, Philippe Pibarot, Marie-Annick Clavel
PURPOSE OF REVIEW: Calcific aortic valve stenosis is the most prevalent valvular heart disease in the high-income countries. To this date, no medical therapy has been proven to prevent or to stop the progression of aortic valve stenosis. The physiopathology of aortic valve stenosis is highly complex and involves several signalling pathways, as well as genetic related factors, which delay the elaboration of effective pharmacotherapies. Moreover, it is difficult to predict accurately the progression of the valve stenosis and finding the optimal timing for aortic valve replacement remains challenging...
November 30, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29176317/downregulated-microrna-195-in-the-bicuspid-aortic-valve-promotes-calcification-of-valve-interstitial-cells-via-targeting-smad7
#13
Junjie Du, Rui Zheng, Feng Xiao, Shuai Zhang, Keshuai He, Junjie Zhang, Yongfeng Shao
BACKGROUND/AIMS: Aortic stenosis caused by leaflet calcification in the bicuspid aortic valve (BAV) is more accelerative than that in the tricuspid aortic valve (TAV). MicroRNA-195 (miR-195) is downregulated more in stenotic than in insufficient BAVs, but its expression in BAVs compared with TAVs is unclear. We aimed to investigate the roles of miR-195 and its calcification-related target SMAD7 in stenotic BAVs compared with those in TAVs. METHODS: Twenty-one stenotic BAV and 29 TAV samples were collected from surgical patients and examined for the expression of miR-195 and SMAD7 by RT-PCR...
November 24, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29158034/different-notch-signaling-in-cells-from-calcified-bicuspid-and-tricuspid-aortic-valves
#14
A Kostina, A Shishkova, E Ignatieva, O Irtyuga, M Bogdanova, K Levchuk, A Golovkin, E Zhiduleva, V Uspenskiy, O Moiseeva, G Faggian, J Vaage, A Kostareva, A Rutkovskiy, A Malashicheva
AIMS: Calcific aortic valve disease is the most common heart valve disease in the Western world. Bicuspid and tricuspid aortic valve calcifications are traditionally considered together although the dynamics of the disease progression is different between the two groups of patients. Notch signaling is critical for bicuspid valve development and NOTCH1 mutations are associated with bicuspid valve and calcification. We hypothesized that Notch-dependent mechanisms of valve mineralization might be different in the two groups...
November 17, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/29157538/mast-cells-in-calcific-aortic-stenosis
#15
Ivo Šteiner, Václav Stejskal, Pavel Žáček
In developed countries, calcific aortic stenosis (CAS) has become the most common acquired valvular disease and reason for aortic valve replacement. It is considered a form of atherosclerosis and, like the latter, of inflammatory origin, with presence in the calcified aortic valves of blood vessels, lymphatics, lymphocytes, plasma cells, histiocytes, and sometimes also of metaplastic bone tissue. This study is aimed at examining the presence of CD117 - positive mast cells in CAS. In 56 examined calcified aortic valves excised by cardiac surgery, mast cells were constantly present as a part of the polymorphous cellular infiltrate; in individual cases, their numbers were 1-90 (median 24)...
July 23, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/29151260/the-first-case-of-locked-in-leaflet-after-transcatheter-aortic-valve-replacement-in-a-patient-with-bicuspid-aortic-stenosis
#16
Nao Shibata, Kensuke Matsumoto, Takayoshi Toba, Shumpei Mori, Shinsuke Shimoyama, Hidekazu Tanaka, Toshiro Shinke, Ken-Ichi Hirata
This case report is about an 85-year-old woman with bicuspid aortic stenosis (AS). Although preoperative multimodality imaging showed challenging anatomical aspects, transcatheter aortic valve replacement (TAVR) was selected to be performed as a less invasive alternative treatment approach, owing to her comorbidity. Postoperative transesophageal echocardiography and multidetector-row computed tomography revealed the presence of "locked-in leaflet" caused by stent distortion due to pinching by calcified native leaflets, with nodular calcification preventing the full expansion of the valve, which resulted in moderate perivalvular leakage...
November 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/29147686/lipoprotein-a-associated-molecules-are-prominent-components-in-plasma-and-valve-leaflets-in-calcific-aortic-valve-stenosis
#17
Michael Torzewski, Amir Ravandi, Calvin Yeang, Andrea Edel, Rahul Bhindi, Stefan Kath, Laura Twardowski, Jens Schmid, Xiaohong Yang, Ulrich F W Franke, Joseph L Witztum, Sotirios Tsimikas
The LPA gene is the only monogenetic risk factor for calcific aortic valve stenosis (CAVS). Oxidized phospholipids (OxPL) and lysophosphatidic acid generated by autotaxin (ATX) from OxPL are pro-inflammatory. Aortic valve leaflets were categorized pathologically from Both ATX-apoB and ATX-apo(a) were measureable in plasma. Lp(a), autotaxin, OxPL and MDA epitopes progressively increased in immunostaining (p<0.001 for all). Six species of OxPL and LysoPA were identified following extraction from valve leaflets...
June 2017: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/29136138/calcific-aortic-valve-stenosis-hard-disease-in-the-heart-a-biomolecular-approach-towards-diagnosis-and-treatment
#18
Frederique E C M Peeters, Steven J R Meex, Marc R Dweck, Elena Aikawa, Harry J G M Crijns, Leon J Schurgers, Bas L J H Kietselaer
Calcific aortic valve stenosis (CAVS) is common in the ageing population and set to become an increasing economic and health burden. Once present, it inevitably progresses and has a poor prognosis in symptomatic patients. No medical therapies are proven to be effective in holding or reducing disease progression. Therefore, aortic valve replacement remains the only available treatment option. Improved knowledge of the mechanisms underlying disease progression has provided us with insights that CAVS is not a passive disease...
November 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29130612/caliber-and-fitness-of-the-axillary-artery-as-a-conduit-for-large-bore-cardiovascular-procedures
#19
Daniel M Arnett, James C Lee, Michael A Harms, Kathleen E Kearney, Mario Ramos, Bryn M Smith, Emily C Anderson, Rajiv Tayal, James M McCabe
OBJECTIVES: We sought to describe the caliber and vascular health of the subclavian and axillary arteries as related to their potential utilization in complex cardiovascular procedures. BACKGROUND: Patients referred for advanced catheter-based therapies frequently have lower extremity peripheral vascular disease that may prohibit the use of large bore arterial catheters. Utilization of the upper extremity peripheral vasculature is rarely considered as an alternative access strategy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29121522/effects-of-vitamin-k-antagonist-on-aortic-valve-degeneration-in-non-valvular-atrial-fibrillation-patients-prospective-4-year-observational-study
#20
Kazuhiro Yamamoto, Yukihiro Koretsune, Takashi Akasaka, Akira Kisanuki, Nobuyuki Ohte, Takashi Takenaka, Masaaki Takeuchi, Kiyoshi Yoshida, Kazunori Iwade, Yuji Okuyama, Yutaka Hirano, Yasuharu Takeda, Yasumasa Tsukamoto, Yoshiharu Kinugasa, Satoshi Nakatani, Takashi Sakamoto, Katsuomi Iwakura, Takashi Sozu, Tohru Masuyama
BACKGROUND: The prevalence of atrial fibrillation (AF) is high in elder subjects. Our previous observational study suggested that vitamin K antagonist (VKA) promotes aortic valve degeneration, a principal cause of aortic stenosis in the elderly, and that angiotensin receptor blocker (ARB) attenuates its progression. This study aimed to prospectively investigate these observations in non-valvular AF patients. METHODS: Of enrolled 430 patients with calcification on no or one aortic valve leaflet, all of the planned 4-year follow-up data were obtained in 122 non-valvular AF patients treated with warfarin (warfarin group) and 101 patients with cardiovascular diseases and without AF and prescription of warfarin (non-warfarin group)...
November 6, 2017: Thrombosis Research
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