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calcific aortic stenosis

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https://www.readbyqxmd.com/read/28547872/cerebral-white-matter-lesion-burden-is-associated-with-the-degree-of-aortic-valve-calcification-and-predicts-peri-procedural-cerebrovascular-events-in-patients-undergoing-transcatheter-aortic-valve-implantation-tavi
#1
Jonas Doerner, Patrick A Kupczyk, Marius Wilsing, Julian A Luetkens, Klaus Storm, Rolf Fimmers, Tilman Hickethier, Lars Eichhorn, Claas P Naehle, Hans H Schild, Nikos Werner, Georg Nickenig, Alexander Ghanem
OBJECTIVES: To investigate the impact of aortic valve calcification and brain morphology on acute peri-procedural cerebrovascular events (CVEs) in patients undergoing transcatheter aortic valve implantation (TAVI). BACKGROUND: Aortic valve calcification and stenosis can be assessed with echocardiography. Cerebral magnetic resonance imaging (MRI) depicts and quantifies morphological signs of hypoperfusion and vascular embolism, which is of special interest in patients with severe aortic stenosis...
May 26, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28543102/low-flow-low-gradient-aortic-stenosis-still-a-diagnostic-and-therapeutic-challenge
#2
REVIEW
Anja Vogelgesang, Gerd Hasenfuss, Claudius Jacobshagen
Aortic stenosis (AS) is the most frequently observed valvular heart disease. During the symptomatic stage, the rate of death increases dramatically, so that a precise diagnostic approach is taken to guide therapeutic options. Of patients with severe AS, 30% to 50% present with low-flow/low-gradient AS (LF/LGAS) status. This review focuses on LF/LGAS and the best diagnostic and therapeutic management in either classic LF/LGAS with reduced left ventricular ejection fraction (LVEF) or paradoxical LF/LGAS with preserved LVEF...
May 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28540072/standard-imaging-techniques-in-transcatheter-aortic-valve-replacement
#3
REVIEW
Arash Salemi, Berhane M Worku
Transcatheter aortic valve replacement (TAVR) has become a widely accepted therapeutic option for patients with severe, symptomatic aortic stenosis at intermediate, high, or extreme risk for conventional surgery as determined through a heart team approach. Two valve prostheses are currently available and the Food and Drug Administration (FDA) approved in the United States for TAVR: the self-expandable Medtronic CoreValve (Medtronic, Inc., Minneapolis, MN, USA) and the balloon-expandable Edwards Sapien Valve (Edwards Lifesciences, Irvine CA, USA)...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28533099/surgical-aortic-valve-replacement-following-early-sapien-xt-valve-failure-a-first
#4
Tanveer Ahmad, Prakash Ludhani, Ronen Gurvitch, John Goldblatt, James Tatoulis
BACKGROUND: Early degeneration of prosthetic aortic valve in transcatheter aortic valve replacement (TAVR) is a rare complication. METHOD: We report the case of a 75-year-old woman who presented with severe calcific stenosis of Edwards SAPIEN-XT valve implanted only four years previously. She is a Jehovah's Witness and has background of Sjogren's syndrome with secondary cryoglobulinaemic vasculitis. She was not a suitable candidate for valve-in-valve TAVR in view of early prosthetic valve failure by calcification...
May 9, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28500739/feasibility-and-safety-of-transfemoral-sheathless-portico-aortic-valve-implantation-preliminary-results-in-a-single-center-experience
#5
Maurizio Taramasso, Andrea Denegri, Shingo Kuwata, Hans Rickli, Philipp K Haager, Gabor Sütsch, Hector Rodriguez Cetina Biefer, Jan Kottwitz, Fabian Nietlispach, Francesco Maisano
BACKGROUND: Feasibility of transfemoral (TF) transcathteter aortic valve replacement (TAVR) is limited by the smallest diameter, the calcification and tortuosity of the iliofemoral access vessels. The use of the Portico system without delivery sheath results in significantly lower profile delivery system compared to standard technique. We herein report our single center experience, feasibility and safety of such an approach. METHODS: The Portico valve was implanted sheathless in 81 high-risk patients with severe aortic stenosis utilizing percutaneous femoral access...
May 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28478711/ct-angiography-of-peripheral-arterial-disease-by-256-slice-scanner-accuracy-advantages-and-disadvantages-compared-to-digital-subtraction-angiography
#6
Atul Mishra, Narendra Jain, Anand Bhagwat
BACKGROUND: Peripheral arterial occlusive disease (PAOD) may cause disabling claudication or critical limb ischemia. Multidetector computed tomography (CT) technology has evolved to the level of 256-slice CT scanners which has significantly improved the spatial and temporal resolution of the images. This has provided the capability of chasing the contrast bolus at a fast speed enabling angiographic imaging of long segments of the body. These images can be reconstructed in various planes and various modes for detailed analysis of the peripheral vascular diseases which helps in making treatment decision...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28472283/oxldl-derived-lysophosphatidic-acid-promotes-the-progression-of-aortic-valve-stenosis-through-a-lpar1-rhoa-nf-%C3%AE%C2%BAb-pathway
#7
Mohamed Jalloul Nsaibia, Marie-Chloé Boulanger, Rihab Bouchareb, Ghada Mkannez, Khai Le Quang, Fayez Hadji, Deborah Argaud, Abdellaziz Dahou, Yohan Bossé, Marlys L Koschinsky, Philippe Pibarot, Benoit J Arsenault, André Marette, Patrick Mathieu
AIMS: Oxidatively modified lipoproteins may promote the development/progression of calcific aortic valve stenosis (CAVS). Oxidative transformation of low-density lipoprotein (OxLDL) generates lysophosphatidic acid (LPA), a lipid mediator that accumulates in mineralized aortic valves. LPA activates at least 6 different G protein-coupled receptors, which may play a role in the pathophysiology of CAVS. We hypothesized that LPA derived from OxLDL may promote a NF-κB signature that drives osteogenesis in the aortic valve...
May 4, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28465973/aortic-stenosis-a-routine-diagnosis-with-a-rare-cause
#8
Afsoon Fazlinejad, Atooshe Rohani, Malihe Layeghian, Shahram Kargar, Mohammad Reza Arefifar
A 40-year-old male patient presented with dyspnea on exertion and palpitation from 2 months ago. Physical examination revealed normal vital sign and a systolic murmur grade 3/6 in aortic area. Echocardiography revealed unicuspid aortic valve with an eccentric orifice, calcification, and aortic valve area of 0.9 cm(2). This case report highlights the usefulness of three-dimensional echocardiography for the determination of number of aortic valve cusps, presence of raphe and morphology of valve.
July 2016: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28439213/a-clinical-perspective-on-the-utility-of-alpha-1-antichymotrypsin-for-the-early-diagnosis-of-calcific-aortic-stenosis
#9
Tatiana Martin-Rojas, Laura Mourino-Alvarez, Felix Gil-Dones, Fernando de la Cuesta, Esther Rosello-Lleti, Carlos M Laborde, Miguel Rivera, Luis Fernando Lopez-Almodovar, Juan Antonio Lopez, Finn Akerstrom, Luis R Padial, Maria G Barderas
BACKGROUND: Calcific aortic stenosis (CAS) is the most common heart valve disease in the elderly, representing an important economic and social burden in developed countries. Currently, there is no way to predict either the onset or progression of CAS, emphasizing the need to identify useful biomarkers for this condition. METHODS: We performed a multi-proteomic analysis on different kinds of samples from CAS patients and healthy donors: tissue, secretome and plasma...
2017: Clinical Proteomics
https://www.readbyqxmd.com/read/28433490/evaluating-health-of-emerging-economies-through-the-eyes-of-heart-valve-disease-in%C3%A2-the%C3%A2-transcatheter-era
#10
REVIEW
Sameer Arora, Cassandra J Ramm, Amol A Bahekar, John P Vavalle
China and India are the 2 fastest growing major world economies. However, they suffer from great differences in health policies, demographics, and rates of population growth. Whereas China has seen a steep decline in rheumatic heart disease (RHD) and a rise in life expectancy, India continues to suffer from a significant burden of RHD due to insufficient distribution of economic prosperity to health care, denser population, and ineffective application of World Health Organization RHD prevention guidelines. As China faces the burden of the world's largest geriatric population, focus has shifted to calcific aortic stenosis for which it prepares by expansions in the field of transcatheter aortic valve replacement...
April 19, 2017: Global Heart
https://www.readbyqxmd.com/read/28431214/interferon-%C3%AE-released-by-activated-cd8-t-lymphocytes-impairs-the-calcium-resorption-potential-of-osteoclasts-in-calcified-human-aortic-valves
#11
Edit Nagy, Yang Lei, Eduardo Martínez-Martínez, Simon C Body, Florian Schlotter, Michael Creager, Alexander Assmann, Kamal Khabbaz, Peter Libby, Göran K Hansson, Elena Aikawa
In calcific aortic valve disease (CAVD), activated T lymphocytes localize with osteoclast regions; however, the functional consequences of this association remain unknown. We hypothesized that CD8(+) T cells modulate calcification in CAVD. CAVD valves (n = 52) dissected into noncalcified and calcified portions were subjected to mRNA extraction, real-time quantitative PCR, enzyme-linked immunosorbent assay, and immunohistochemical analyses. Compared with noncalcified portions, calcified regions exhibited elevated transcripts for CD8, interferon (IFN)-γ, CXCL9, Perforin 1, Granzyme B, and heat shock protein 60...
June 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28415102/p650influence-of-fetunin-a-level-on-progression-of-calcific-aortic-valve-stenosis-the-cofrasa-generac-study
#12
N Kubota, Dmz David Messika-Zeitoun
Background.: In recent years, pathophysiology of aortic stenosis (AS) has been considered as a possibly active inflammatory process, but its determinants remain unclear. Calcium tissue deposition observed in dilaysis patients have been linked to low level of Fetuin-A, a powerful inhibitor of ectopic calcification. It is thus suspected to play a role in development of aortic stenosis. Purpose.: To assess correlation between Fetuin-A level and AS progression in a prospective cohort of AS patients, COFRASA (clinicalTrial...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28412434/a-highly-predictive-risk-model-for-pacemaker-implantation-after-tavr
#13
Yoshio Maeno, Yigal Abramowitz, Hiroyuki Kawamori, Yoshio Kazuno, Shunsuke Kubo, Nobuyuki Takahashi, Geeteshwar Mangat, Kazuaki Okuyama, Mohammad Kashif, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, John Friedman, Daniel Berman, Raj R Makkar, Hasan Jilaihawi
OBJECTIVES: This study sought to develop a robust and definitive risk model for new permanent pacemaker implantation (PPMI) after SAPIEN 3 (third generation balloon expandable valve) (Edwards Lifesciences, Irvine, California) transcatheter aortic valve replacement (third generation balloon expandable valve TAVR), including calcification in the aortic-valvular complex (AVC). BACKGROUND: The association between calcium in the AVC and need for PPMI is poorly delineated after third generation balloon expandable valve TAVR...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28404735/pathophysiology-of-aortic-valve-stenosis-is-it-both-fibrocalcific-and-sex-specific
#14
REVIEW
Yoginee Sritharen, Maurice Enriquez-Sarano, Hartzell V Schaff, Grace Casaclang-Verzosa, Jordan D Miller
Our understanding of the fundamental biology and identification of efficacious therapeutic targets in aortic valve stenosis has lagged far behind the fields of atherosclerosis and heart failure. In this review, we highlight the most clinically relevant problems facing men and women with fibrocalcific aortic valve stenosis, discuss the fundamental biology underlying valve calcification and fibrosis, and identify key molecular points of intersection with sex hormone signaling.
May 2017: Physiology
https://www.readbyqxmd.com/read/28396860/aortic-valve-replacement-for-moderate-aortic-stenosis-with-severe-calcification-and-left-ventricualr-dysfunction-a-case-report-and-review-of-the-literature
#15
Nikhil Narang, Roberto M Lang, Vladimir M Liarski, Valluvan Jeevanandam, Marion A Hofmann Bowman
A 55-year-old man with a history of erosive, seropositive rheumatoid arthritis (RA), and interstitial lung disease presented with shortness of breath. Echocardiography showed new-onset severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 15% and moderately increased mean aortic valve gradient of 20 mmHg in a trileaflet aortic valve with severe sclero-calcific degeneration. Coronary angiography revealed no significant obstructive coronary disease. Invasive hemodynamic studies and dobutamine stress echocardiography were consistent with moderate aortic stenosis...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28379513/five-year-echocardiographic-follow-up-after-tavi-structural-and-functional-changes-of-a-balloon-expandable-prosthetic-aortic-valve
#16
Manuela Muratori, Laura Fusini, Gloria Tamborini, Paola Gripari, Sarah Ghulam Ali, Massimo Mapelli, Franco Fabbiocchi, Piero Trabattoni, Maurizio Roberto, Marco Agrifoglio, Francesco Alamanni, Antonio L Bartorelli, Mauro Pepi
Aims: Scarce data are available on the long-term structural and functional changes of prosthetic valves after transcatheter aortic valve implantation (TAVI). The objective was to evaluate with echocardiography the long-term structural and functional changes of prosthetic valves after TAVI. Methods and results: Structural valve deterioration (SVD) was defined as leaflet thickening ≥3mm, presence of calcification and abnormal leaflet motion. Five-year echocardiographic follow-up was available in 96 out of 318 patients who underwent TAVI with a balloon-expandable device between April 2008 and December 2011...
March 30, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28369281/relation-between-calcium-burden-echocardiographic-stent-frame-eccentricity-and-paravalvular-leakage-after-corevalve-transcatheter-aortic-valve-implantation
#17
Luigi F M Di Martino, Osama I I Soliman, Lennart van Gils, Wim B Vletter, Nicolas M Van Mieghem, Ben Ren, Tjebbe W Galema, Carl Schultz, Peter P T de Jaegere, Matteo Di Biase, Marcel L Geleijnse
Aims: Paravalvular aortic leakage (PVL) after transcatheter aortic valve implantation (TAVI) is a complication with potentially severe consequences. The relation between native aortic root calcium burden, stent frame eccentricity and PVL was not studied before. Methods and results: Two-hundred-and-twenty-three consecutive patients with severe aortic stenosis who underwent TAVI with a Medtronic CoreValve System© and who had available pre-discharge transthoracic echocardiography were studied...
June 1, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28369223/severe-aortic-stenosis-with-low-aortic-valve-calcification-characteristics-and-outcome-following-transcatheter-aortic-valve-implantation
#18
Yigal Abramowitz, Hasan Jilaihawi, Philippe Pibarot, Tarun Chakravarty, Mohammad Kashif, Yoshio Kazuno, Yoshio Maeno, Hiroyuki Kawamori, Geeteshwar Mangat, John Friedman, Wen Cheng, Raj R Makkar
Aims: High aortic valve calcification (AVC) assessed with CT may be used to differentiate between severe and non-severe aortic stenosis (AS). Nonetheless, in some cases patients with low calcification are diagnosed with haemodynamically severe AS. The prevalence, mechanism of valve stenosis and implications for transcatheter aortic valve implantation (TAVI) of low AVC severe AS remain unclear. We assessed the clinical and haemodynamic characteristics and the outcome of patients with severe AS and low AVC that undergo TAVI...
June 1, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28364395/severe-and-asymptomatic-aortic-stenosis-management-challenge-knowing-that-we-do-not-really-know
#19
REVIEW
Lionel Tastet, Louis Simard, Marie-Annick Clavel
The clinical management of asymptomatic patients with severe aortic valve stenosis (AS) may be challenging. Indeed, there is substantial controversy over the optimal timing of intervention for these patients, as some advocate early intervention while others urge for a conservative management until symptom onset. In the meantime of randomized clinical trials aiming to compare both strategies of management, an integrative approach including several imaging modalities as well as biomarkers of the myocardial damage may help to improve the risk stratification of patients with asymptomatic severe AS and individualize strategy of treatment...
May 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28364394/transcatheter-mitral-valve-interventions-current-therapies-and-future-directions
#20
REVIEW
Ramon A Partida, Sammy Elmariah
Transcatheter interventions for the treatment of aortic valve stenosis have become commonplace since the advent of transcatheter aortic valve implantation. However, transcatheter mitral valve therapies have lagged in development due to the complexity of mitral valve anatomy. Transcatheter edge-to-edge leaflet repair using the MitraClip device provides an option for the treatment of severe primary mitral valve regurgitation in high or prohibitive surgical risk patients, and multiple novel approaches are evolving to replace or repair the mitral valve...
May 2017: Current Treatment Options in Cardiovascular Medicine
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