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Asymptomatic aortic stenosis

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https://www.readbyqxmd.com/read/28644073/nt-probnp-in-patients-with-asymptomatic-severe-aortic-stenosis-relation-to-coronary-microvascular-function
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28507251/stress-testing-in-asymptomatic-aortic-stenosis
#14
REVIEW
Björn Redfors, Philippe Pibarot, Linda D Gillam, Daniel Burkhoff, Jeroen J Bax, Brian R Lindman, Robert O Bonow, Patrick T O'Gara, Martin B Leon, Philippe Généreux
Aortic stenosis is 1 of the most common heart valve diseases among adults. When symptoms develop, prognosis is poor, and current guidelines recommend prompt aortic valve replacement. Depending of the severity of the aortic stenosis and the presence of concomitant heart disease and medical comorbidities, stress testing represents a reasonable strategy to help better risk stratify asymptomatic patients. The present report provides a comprehensive review of the current available data on stress testing in aortic stenosis and subsequently summarizes its potential for guiding the optimal timing of aortic valve replacement...
May 16, 2017: Circulation
https://www.readbyqxmd.com/read/28476777/disease-stage-dependent-changes-in-cardiac-contractile-performance-and-oxygen-utilization-underlie-reduced-myocardial-efficiency-in-human-inherited-hypertrophic-cardiomyopathy
#15
Ahmet Güçlü, Paul Knaapen, Hendrik J Harms, Rahana Y Parbhudayal, Michelle Michels, Adriaan A Lammertsma, Albert C van Rossum, Tjeerd Germans, Jolanda van der Velden
BACKGROUND: Reduced myocardial efficiency represents a target for therapy in hypertrophic cardiomyopathy although therapeutic benefit may depend on disease stage. Here, we determined disease stage-dependent changes in myocardial efficiency and effects of myectomy surgery. METHODS AND RESULTS: Myocardial external efficiency (MEE) was determined in 27 asymptomatic mutation carriers (genotype positive/phenotype negative), 10 patients with hypertrophic obstructive cardiomyopathy (HOCM), 10 patients with aortic valve stenosis, and 14 healthy individuals using [(11)C]-acetate positron emission tomography and cardiovascular magnetic resonance imaging...
May 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28441821/-assessment-of-undiagnosed-critical-congenital-heart-disease-before-discharge-from-the-maternity-hospital
#16
Q M Zhao, F Liu, L Wu, M Ye, B Jia, X J Ma, G Y Huang
Objective: Undiagnosed critical congenital heart disease (CCHD) was assessed before discharge from maternity hospital.Basic information was provided for screening CCHD in the early neonatal stage.Chi-squared test was used for comparison of categorical variables(detection rate of different types of CCHD). Method: A retrospective cohort study was conducted in neonates with CCHD who were admitted to Children's Hospital of Fudan University between 1 January 2012 and 31 December 2015. For comparing with the previously reported undiagnosed rate of CCHD at discharge, CCHD was defined as all duct dependent congenital heart disease (DDCHD) and any cyanotic CHD that required early surgery...
April 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28431770/aortic-stenosis-and-non-cardiac-surgery-a-systematic-review-and-meta-analysis
#17
Chun Shing Kwok, Rodrigo Bagur, Muhammad Rashid, Ronit Lavi, Mario Cibelli, Mark A de Belder, Neil Moat, David Hildick-Smith, Peter Ludman, Mamas A Mamas
BACKGROUND: Aortic stenosis (AS) poses a perioperative management dilemma to physicians looking after patients who require non-cardiac surgery. The objective of this review is to investigate mortality and adverse cardiovascular events in patients with and without AS who underwent non-cardiac surgery. METHODS: We searched MEDLINE and EMBASE for studies that evaluated mortality and adverse cardiovascular events in patients with and without AS who underwent non-cardiac surgery...
August 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28429500/electrocardiographic-appearance-of-aortic-stenosis-before-and-after-aortic-valve-replacement
#18
Ivana I Vranic
BACKGROUND: So far, the specific appearance of QRS complex, ST-segment, and T wave was observed in aortic stenosis (AS). S-wave dynamic change in leads V1 -V3 was not reported in AS. METHODS: In a single-center, prospective study, we included a total number of 1.175 patients who underwent surgical aortic valve replacement (AVR). We conducted 3-year gathering of patients with symptomatic and asymptomatic severe AS, and separated them by hemodynamic stability into groups A and B, through EFLV (of more or less than 50%), AVA (of more or less than 0...
April 21, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28415097/p544the-importance-of-contractile-reserve-when-assessing-asymptomatic-patients-with-aortic-stenosis
#19
J J Van Zalen, S Badiani, L Hart, A Marshall, N Patel, G Lloyd
Asymptomatic patients may exhibit symptoms during objective exercise testing, but whether symptoms are due to the obstructively of the valve (typified by the mean gradient) or underlying ventricular function remains unknown. While the mean gradient is an easy parameter to measure no consensus about the measurement of contractile reserve exists. Longitudinal abnormalities may occur in the presence of a normal ejection fraction and the augmentation of these parameters is poorly described. To obtain an objective regarding patients exercise ability is best determined using cardiopulmonary exercise testing...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28395958/relationship-between-exercise-pressure-gradient-and-haemodynamic-progression-of-aortic-stenosis
#20
Anne Ringle, Franck Levy, Pierre-Vladimir Ennezat, Caroline Le Goffic, Anne-Laure Castel, François Delelis, Aymeric Menet, Dorothée Malaquin, Pierre Graux, André Vincentelli, Christophe Tribouilloy, Sylvestre Maréchaux
BACKGROUND AND AIMS: We hypothesized that large exercise-induced increases in aortic mean pressure gradient can predict haemodynamic progression during follow-up in asymptomatic patients with aortic stenosis. METHODS: We retrospectively identified patients with asymptomatic moderate or severe aortic stenosis (aortic valve area<1.5cm(2) or<1cm(2)) and normal ejection fraction, who underwent an exercise stress echocardiography at baseline with a normal exercise test and a resting echocardiography during follow-up...
April 7, 2017: Archives of Cardiovascular Diseases
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