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Asymptomatic aortic stenosis

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https://www.readbyqxmd.com/read/28715078/polish-stress-echocardiography-registry-pol-stress-registry-a-multicenter-study-stress-echo-in-poland-numbers-settings-results-and-complications
#1
Edyta Płońska-Gościniak, Jarosław D Kasprzak, Szymon Olędzki, Jolanta Rzucidło-Resil, Piotr Gościniak, Tomasz Kukulski, Katarzyna Mizia-Stec, Wojciech Kosmala, Dariusz Kosior, Marta Marcinkiewicz-Siemion, Barbara Brzezińska, Beata Zaborska, Marcin Fijałkowski, Iwona Świątkiewicz, Andrzej Szyszka, Jan Błażejewski, Wojciech Witkiewicz, Zbigniew Gąsior, Danuta Sorysz, Agnieszka Olszanecka
BACKGROUND: Stress echocardiography (SE) is widely used in Europe. No collective data have been available on the use of SE in Poland until now. AIM: To evaluate the number of SE investigations performed in Poland, their settings, complications and results. METHODS: In this retrospective survey, referral cardiology centers in Poland were asked to fill in a questionnaire regarding SE examinations performed from May 01, 2014 to May 01, 2015. RESULTS: The study included data from 17 university hospitals and large community hospitals which performed 4611 SE examinations, including 4408 tests in patients investigated for coronary artery disease (CAD) and 203 tests to evaluate valvular heart disease (VHD)...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28705379/prognostic-usefulness-of-cardiopulmonary-exercise-testing-for-managing-patients-with-severe-aortic-stenosis
#2
Van D Le, Gunnar V Jensen, Lars Kjøller-Hansen
The approach to managing asymptomatic or questionably symptomatic patients for aortic stenosis is difficult. We aimed to determine whether cardiopulmonary exercise testing (CPET) is prognostically useful in such patients. Patients judged asymptomatic or questionably symptomatic for aortic stenosis with aortic valve area index <0.6 cm(2)/m(2) and left ventricular ejection fraction ≥0.50 were managed conservatively provided they had either (group 1) normal peak oxygen consumption and peak oxygen pulse (>83% and >95% of the predicted values, respectively) or (group 2) subnormal peak oxygen consumption or peak oxygen pulse but with CPET data pointing to pathologies other than hemodynamic compromise from aortic stenosis...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28698175/echocardiographic-aortic-valve-calcification-and-outcomes-in-women-and-men-with-aortic-stenosis
#3
Henrik K Thomassen, Giovanni Cioffi, Eva Gerdts, Eigir Einarsen, Helga Bergljot Midtbø, Constantino Mancusi, Dana Cramariuc
OBJECTIVE: Sex differences in risk factors of aortic valve calcification (AVC) by echocardiography have not been reported from a large prospective study in aortic stenosis (AS). METHODS: AVC was assessed using a prognostically validated visual score and grouped into none/mild or moderate/severe AVC in 1725 men and women with asymptomatic AS in the Simvastatin Ezetimibe in Aortic Stenosis study. The severity of AS was assessed by the energy loss index (ELI) taking pressure recovery in the aortic root into account...
July 11, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28684044/influence-of-metabolic-syndrome-and-diabetes-on-progression-of-calcific-aortic-valve-stenosis
#4
Ariane Testuz, Virginia Nguyen, Tiffany Mathieu, Caroline Kerneis, Dimitri Arangalage, Naozumi Kubota, Isabelle Codogno, Sarah Tubiana, Candice Estellat, Claire Cimadevilla, Alec Vahanian, David Messika-Zeitoun
BACKGROUND: Determinants of the progression of aortic stenosis (AS) remained unclear. Metabolic syndrome (MetS) and diabetes are suspected to play an active role but literature is scarce and results conflicting. We sought to assess their impact in an ongoing prospective cohort of asymptomatic patients with at least mild AS. METHODS: We enrolled 203 patients (73±9years, 75% men) with at least 2years of follow-up. Risk-factors assessment was performed at baseline...
June 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28671805/valvular-heart-disease-in-adults-management-of-native-valve-disease
#5
Xin Zhang, Steven M Hollenberg
Patients with valvular heart disease (VHD) should be treated for diabetes, hypertension, and hyperlipidemia. They also should receive therapy for left ventricular dysfunction, undergo interval echocardiography, and participate in aerobic exercise. Valve replacement should be considered for patients with aortic stenosis (AS) and syncope, presyncope, heart failure, angina, or severe AS with left ventricular dysfunction. Valve replacement is performed with open or transcatheter procedures; the latter are preferred for patients with high surgical risk...
June 2017: FP Essentials
https://www.readbyqxmd.com/read/28671804/valvular-heart-disease-in-adults-etiologies-classification-and-diagnosis
#6
Steven M Hollenberg
The prevalence of valvular heart disease (VHD) in the United States was estimated to be approximately 2.5% in the 1990s. The prevalence currently is thought to be increasing because of more accurate diagnostic methods and aging of the population. Mitral regurgitation (MR) is the most common valve defect, followed by aortic stenosis (AS) and aortic regurgitation (AR). Degenerative disease is the most common etiology of MR, AS, and AR, though these forms of VHD also can be caused by congenital valve defects, systemic inflammatory diseases, endocarditis, and many other conditions...
June 2017: FP Essentials
https://www.readbyqxmd.com/read/28655164/role-of-diastolic-function-indices-in-the-risk-stratification-of-patients-with-mixed-aortic-valve-disease
#7
Alexander C Egbe, Arooj R Khan, Amber Boler, Sameh M Said, Jeffrey B Geske, William R Miranda, Emmanuel Akintoye, Heidi M Connolly, Carole A Warnes, Jae K Oh
Aims: Determine the role of diastolic function indices in pre-operative and post-operative risk stratification in patients with moderate mixed aortic valve disease (MAVD). Methods and results: A retrospective study was conducted of asymptomatic patients with moderate MAVD (a combination of moderate aortic stenosis and moderate aortic regurgitation) and an ejection fraction of 50% or more who were followed up at Mayo Clinic from 1 January 2004, to 31 December 2013...
June 23, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28644073/nt-probnp-in-patients-with-asymptomatic-severe-aortic-stenosis-relation-to-coronary-microvascular-function
#8
Marko D Banovic
No abstract text is available yet for this article.
June 23, 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/28624411/incremental-prognostic-utility-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-patients-with-significant-chronic-aortic-regurgitation-and-preserved-left-ventricular-ejection-fraction
#9
Alaa Alashi, Amgad Mentias, Amjad Abdallah, Ke Feng, A Marc Gillinov, L Leonardo Rodriguez, Douglas R Johnston, Lars G Svensson, Zoran B Popovic, Brian P Griffin, Milind Y Desai
OBJECTIVES: We sought to examine the prognostic utility of left ventricular (LV) global longitudinal strain (GLS) in asymptomatic patients with ≥III+ aortic regurgitation (AR), an indexed LV end-systolic dimension of <2.5 cm/m(2), and preserved left ventricular ejection fraction (LVEF). BACKGROUND: Management of asymptomatic patients with severe chronic AR and preserved LVEF is challenging and is typically based on LV dimensions. METHODS: We studied 1,063 such patients (53 ± 16 years; 77% men) seen between 2003 and 2010 (excluding those with symptoms, obstructive coronary artery disease, acute AR/dissection, aortic/mitral stenosis, more than moderate mitral regurgitation, and previous cardiac surgery)...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28623117/open-heart-surgery-does-not-increase-the-incidence-of-ipsilateral-ischemic-stroke-in-patients-with-asymptomatic-severe-carotid-stenosis
#10
John E Castaldo, Hussam A Yacoub, Yuebing Li, Hope Kincaid, Donna Jenny
BACKGROUND AND PURPOSE: We evaluated the incidence of perioperative stroke following the institution's 2007 practice change of discontinuing combined carotid endarterectomy and open heart surgery (OHS) for patients with severe carotid stenosis. METHODS: In this retrospective cohort study, we compared 113 patients undergoing coronary artery bypass grafting, aortic valve replacement, or both from 2007 to 2011 with data collected from 2001 to 2006 from a similar group of patients...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28616342/bicuspid-aortic-valve-syndrome-a-multidisciplinary-approach-for-a-complex-entity
#11
REVIEW
María Martín, Rebeca Lorca, José Rozado, Rubén Alvarez-Cabo, Juan Calvo, Isaac Pascual, Helena Cigarrán, Isabel Rodríguez, César Morís
Bicuspid aortic valve (BAV) or bicuspid aortopathy is the most common congenital heart disease. It can be clinically silent and it is often identified as an incidental finding in otherwise healthy, asymptomatic patients. However, it can be dysfunctioning at birth, even requiring neonatal intervention, or, in time, lead to aortic stenosis, aortic insufficiency, and endocarditis, and also be associated with aortic aneurysm and aortic dissection. Given its prevalence and significant complications, it is estimated that BAV is responsible for more deaths and morbidity than the combined effects of all the other congenital heart defects...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28606674/transcatheter-aortic-valve-implantation-in-patients-with-an-extremely-small-native-aortic-annulus-the-ocean-tavi-registry
#12
Fumiaki Yashima, Masanori Yamamoto, Makoto Tanaka, Ryo Yanagisawa, Takahide Arai, Hideyuki Shimizu, Keiichi Fukuda, Yusuke Watanabe, Toru Naganuma, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Kentaro Hayashida
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been reported to be advantageous over surgical aortic valve replacement owing to the low incidence of prosthesis-patient mismatch (PPM) and large effective orifice area (EOA). However, data on TAVI for extremely small annuli are limited. The present study aimed to compare post-procedural hemodynamics and morphology between 20-mm and 23-mm Sapien XT (SXT) transcatheter heart valves (THVs) with extremely small annuli (<314mm(2))...
August 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28599829/noninvasive-coronary-flow-reserve-predicts-response-to-exercise-in-asymptomatic-severe-aortic-stenosis
#13
Patrick Meimoun, Daniel Czitrom, Jérome Clerc, Jean Christophe Seghezzi, Sonia Martis, Alain Berrebi, Frederic Elmkies
BACKGROUND: In patients with asymptomatic aortic stenosis (AS), exercise stress echocardiography (ESE) provides additional prognostic information beyond baseline. The coronary flow velocity reserve (CFVR) is impaired in AS, but its link with exertion is unknown in this setting. The aim of this study was to test the hypothesis that CFVR could predict exercise capacity and abnormal exercise test results in AS. METHODS: Noninvasive CFVR and symptom-limited semisupine ESE were prospectively performed the same day in 43 patients with asymptomatic isolated severe AS (mean age, 68...
June 6, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28593422/treatment-of-asymptomatic-aortic-valve-stenosis-watchful-waiting-or-early-intervention
#14
J Ledwoch, H Thiele
There is ongoing debate about the optimal management of severe asymptomatic aortic stenosis (AS). Thus far, current guidelines recommend a watchful waiting strategy for the majority of asymptomatic patients. However, data on the prognosis of asymptomatic AS are inconsistent. Some reports claim an increased risk of complications and even mortality in this subset of patients when treated conservatively. Several factors are considered to contribute to the impaired outcome of asymptomatic patients, such as progressive myocardial damage or sudden cardiac death, during the watchful waiting period...
June 7, 2017: Herz
https://www.readbyqxmd.com/read/28582434/asymptomatic-aortic-stenosis-an-assessment-of-patients-and-of-their-general-practitioners-knowledge-after-an-indexed-specialized-assessment-in-community-practice
#15
Raphaëlle-Ashley Guerbaii, Gabriel Fustier, Pierre-Vladimir Ennezat, Anne Ringle, Camille Trouillet, Pierre Graux, André Vincentelli, Christophe Tribouilloy, Sylvestre Maréchaux
BACKGROUND: Clinical and echocardiography follow-up is recommended in patients with aortic stenosis to detect symptom onset, thus a watchful waiting approach has to be safe and effective. For both AS patients and their general practitioners, evaluation of valvular heart disease (VHD) knowledge, after the indexed specialized assessment has never been measured. AIMS: To evaluate the knowledge of clinical symptoms of aortic stenosis by both patients and their general practitioner...
2017: PloS One
https://www.readbyqxmd.com/read/28572283/impact-of-mean-transaortic-pressure-gradient-on-long-term-outcome-in-patients-with-severe-aortic-stenosis-and-preserved-left-ventricular-ejection-fraction
#16
Yohann Bohbot, Cedric Kowalski, Dan Rusinaru, Anne Ringle, Sylvestre Marechaux, Christophe Tribouilloy
BACKGROUND: Mean transaortic pressure gradient (MTPG) has never been validated as a predictor of mortality in patients with severe aortic stenosis. We sought to determine the value of MTPG to predict mortality in a large prospective cohort of severe aortic stenosis patients with preserved left ventricular ejection fraction and to investigate the cutoff of 60 mm Hg, proposed in American guidelines. METHODS AND RESULTS: A total of 1143 patients with severe aortic stenosis defined by aortic valve area ≤1 cm(2) and MTPG ≥40 mm Hg were included...
June 1, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28569053/pathology-of-balloon-expandable-transcatheter-aortic-valves
#17
Kazuyuki Yahagi, Elena Ladich, Robert Kutys, Hiroyoshi Mori, Lars G Svensson, Michael J Mack, Howard C Herrmann, Craig R Smith, Martin B Leon, Renu Virmani, Aloke V Finn
BACKGROUND: The Placement of AoRtic TraNscathetER Valves trials (PARTNER) showed favorable safety and efficacy versus medical or surgical therapy in inoperable, high, and intermediate surgical risk patients with severe aortic stenosis. However, the biological responses to transcatheter aortic valves have not been well characterized. OBJECTIVES: The aim of this study was to perform pathologic assessment of Edwards SAPIEN transcatheter aortic valves removed either at autopsy or surgically during the PARTNER I and II clinical trials...
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28560534/exercise-testing-and-stress-imaging-in-aortic-valve-disease
#18
REVIEW
Luc A Pierard, Raluca Dulgheru
Aortic valve disease and especially aortic stenosis (AS) is a growing cardiac pathology. Aortic valve replacement (AVR) is still the only treatment with proven benefit on survival in symptomatic patients and in patients with a left ventricular ejection fraction (LVEF) <50%. The benefit of prophylactic AVR in asymptomatic patients is still unproven. Once symptoms develop, the prognosis worsens. Exercise testing has emerged as a tool to unmask the "pseudo-asymptomatic" patients with AS (those without self-reporting symptoms), to link "exercise induced dyspnea" more confidently and more objectively to aortic valve disease and to allow for a safe "watchful waiting strategy" in "pseudo-symptomatic" patients (those with dyspnea unrelated to aortic valve disease)...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28559420/incremental-prognostic-use-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-minimally-symptomatic-patients-with-severe-bioprosthetic-aortic-stenosis-undergoing-redo-aortic-valve-replacement
#19
Peyman Naji, Shailee Shah, Lars G Svensson, A Marc Gillinov, Douglas R Johnston, L Leonardo Rodriguez, Richard A Grimm, Brian P Griffin, Milind Y Desai
BACKGROUND: With improved survival of patients undergoing primary bioprosthetic aortic valve replacement (AVR), reoperation to relieve severe prosthetic aortic stenosis (PAS) is increasing. Timing of redo surgery in asymptomatic/minimally symptomatic patients remains controversial. Left ventricular (LV) global longitudinal strain (GLS) is a marker of subclinical LV dysfunction. In asymptomatic/minimally symptomatic patients with severe PAS undergoing redo AVR, we sought to determine whether LV-GLS provides incremental prognostic use...
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28552098/cardiopulmonary-exercise-testing-in-aortic-stenosis
#20
Van Doan Tuyet Le
Patients with moderate to severe aortic stenosis (AVA <1.3 cm(2)) who were judged, by a referring cardiologist, as asymptomatic or equivocal symptomatic from the aortic stenosis were included in the study. Patients with left ventricular ejection fraction <50% were not included. Twenty-nine percent of the referred patients were judged asymptomatic and 71% equivocal symptomatic from their valve disease. The mean age was 72 years and 90% of the patients had an AVA-index <0.6 cm(2)/m(2). By clinical evaluation in the outpatient clinic, 48% were judged as having functional limitation corresponding to NYHA≥II...
May 2017: Danish Medical Journal
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