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Asymptomatic aortic stenosis

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https://www.readbyqxmd.com/read/28317490/speculative-considerations-about-some-cardiology-enigmas
#1
Paulo Roberto Barbosa Evora, Andre Schmidt, Livia Arcêncio, José Antonio Marin-Neto
Write a review text or point-of-view that takes into account the interests, if not of all, but of most readers of a scientific journal is an arduous task. The editorial can be grounded in published articles, even in a single article of undeniable importance and, it can also represent a trend of specialty. Therefore, especially for the sake of the reader's motivation, the present text was freely designed to discuss some cardiology enigmas in the context of the heart valve and coronary artery disease (CAD). Concerning the CAD five well-known enigmas will be considered: 1) The absence of arteriosclerosis in intramyocardial coronary arteries; 2) The unique and always confirmed superior evolution of the left internal thoracic artery as a coronary graft; 3) The prophylactic left internal thoracic artery graft in mildly-stenosed coronary lesions, and; 4) The high incidence of perioperative atrial fibrillation (AF) in patients with CAD, and; 5) The handling of disease-free saphenous vein graft at the time of reoperation...
March 17, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28300680/evaluation-by-mri-of-silent-brain-infarcts-in-pre-and-post-operative-asymptomatic-carotid-surgery
#2
Remy Pascot, Anne Daoudal, Alain Cardon, Gilles Godet, Antoine Lucas, Elodie Clochard, Jean-Yves Gauvrit, Yann Le Teurnier, Adrien Kaladji
OBJECTIVE: To report the prevalence of Silent Brain Infarcts (SBI) at MRI before and after surgery for asymptomatic high grade carotid stenosis. DESIGN: Single-center retrospective observational study METHODS: Asymptomatic patients who underwent carotid endarterectomy between October 2012 and October 2014 were included. The preoperative assessment included a Doppler and a CT scan dating less than 3 months. A neurological examination was performed during the anesthesia consultation and in the 15 days before surgery...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28291817/specific-changes-in-circulating-cytokines-and-growth-factors-induced-by-exercise-stress-testing-in-asymptomatic-aortic-valve-stenosis
#3
Renata Kolasa-Trela, Malgorzata Konieczynska, Marta Bazanek, Anetta Undas
BACKGROUND: We evaluated exercise-induced changes in the profile of circulating cytokines and growth factors in patients with AS. METHODS: We studied 32 consecutive asymptomatic moderate-to-severe AS patients and 32 age and sex-matched controls. Plasma levels of interleukin (IL)-6, IL-10, hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), and transforming growth factor (TGF)-β were measured at 4 time points, i.e. at rest, at peak bicycle exercise, one hour and 24 hours after a symptom-limited exercise...
2017: PloS One
https://www.readbyqxmd.com/read/28290210/changing-concept-in-treatment-of-asymptomatic-severe-aortic-stenosis-and-normal-ejection-fraction-time-for-biomarkers-reappraisal
#4
Marko D Banovic
The uncertainty of whether/how to treat asymptomatic patients with isolated severe aortic stenosis and normal left ventricular ejection fraction is one of the most topical in cardiovascular medicine. Recently, the AVATAR trial: first ever randomized trial in the setting of aortic stenosis has been started in an attempt to adequately address this 'burning issue'. In light of this fact it is important to identify biomarkers which might help in risk stratification of these patients, not only in the referring physician's office during a routine exam, but also for preoperative patients scheduled for surgical replacement/transcatheter aortic valve implantation...
March 14, 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/28256378/high-sensitivity-troponin-and-valvular-heart-disease
#5
REVIEW
Cian P McCarthy, Eoin Donnellan, Dermot Phelan, Brian P Griffin, Maurice Enriquez- Sarano, John W McEvoy
Blood-based biomarkers have been extensively studied in a range of cardiovascular diseases and have established utility in routine clinical care, most notably in the diagnosis of acute coronary syndrome (e.g., troponin) and the management of heart failure (e.g., brain-natriuretic peptide). The role of biomarkers is less well established in the management of valvular heart disease (VHD), in which the optimal timing of surgical intervention is often challenging. One promising biomarker that has been the subject of a number of recent VHD research studies is high sensitivity troponin (hs-cTn)...
January 16, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28248915/-phacing-a-new-cause-of-carotid-artery-dissection
#6
Caterina Kulyk, Filippo Farina, Anna Palmieri, Federica Viaro, Francesco Causin, Anna M Laverda, Claudio Baracchini
INTRODUCTION: Cervical arterial dissection (CAD) is a frequent and preventable cause of ischemic stroke in young patients. Several arguments suggest that genetic and developmental disorders could play an important role as part of a multifactorial predisposition of sporadic CAD.We present 2 cases of young patients with CAD in association with cutaneous lesions and nonatherosclerotic multivessel arteriopathy. CASE REPORTS: Our first patient was a 17-year-old white girl with sudden onset of weakness in her right upper limb...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28204448/comparison-of-exercise-testing-and-cmr-measured-myocardial-perfusion-reserve-for-predicting-outcome-in-asymptomatic-aortic-stenosis-the-prognostic-importance-of-microvascular-dysfunction-in-aortic-stenosis-primid-as-study
#7
Anvesha Singh, John P Greenwood, Colin Berry, Dana K Dawson, Kai Hogrefe, Damian J Kelly, Vijay Dhakshinamurthy, Chim C Lang, Jeffrey P Khoo, David Sprigings, Richard P Steeds, Michael Jerosch-Herold, Stefan Neubauer, Bernard Prendergast, Bryan Williams, Ruiqi Zhang, Ian Hudson, Iain B Squire, Ian Ford, Nilesh J Samani, Gerry P McCann
No abstract text is available yet for this article.
February 13, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28179592/five-year-clinical-outcome-of-asymptomatic-vs-symptomatic-severe-aortic-stenosis-after-aortic-valve-replacement
#8
Shinichi Shirai, Tomohiko Taniguchi, Takeshi Morimoto, Kenji Ando, Kengo Korai, Kenji Minakata, Michiya Hanyu, Fumio Yamazaki, Tadaaki Koyama, Tatsuhiko Komiya, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Tsukasa Inada, Eri Minamino-Muta, Takao Kato, Moriaki Inoko, Katsuhisa Ishii, Naritatsu Saito, Kazuo Yamanaka, Noboru Nishiwaki, Hiroyuki Nakajima, Toshihiko Saga, Shogo Nakayama, Genichi Sakaguchi, Atsushi Iwakura, Kotaro Shiraga, Koji Ueyama, Keiichi Fujiwara, Senri Miwa, Junichiro Nishizawa, Mitsuru Kitano, Hitoshi Kitayama, Ryuzo Sakata, Takeshi Kimura
BACKGROUND: There is discordance regarding the effect of symptom status before aortic valve replacement (AVR) on long-term outcome after AVR in severe aortic stenosis (AS).Methods and Results:The CURRENT AS registry is a multicenter retrospective registry enrolling 3,815 consecutive patients with severe AS. Among 1,196 patients managed with the initial AVR strategy, long-term clinical outcomes were compared between the symptomatic patients (n=905), and asymptomatic patients (n=291)...
February 9, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28167498/myocardial-oxygen-consumption-and-efficiency-in-aortic-valve-stenosis-patients-with-and-without-heart-failure
#9
Nils Henrik Stubkjær Hansson, Jens Sörensen, Hendrik Johannes Harms, Won Yong Kim, Roni Nielsen, Lars P Tolbod, Jørgen Frøkiær, Kirsten Bouchelouche, Karen Kaae Dodt, Inger Sihm, Steen Hvitfeldt Poulsen, Henrik Wiggers
BACKGROUND: Myocardial oxygen consumption (MVO2) and its coupling to contractile work are fundamentals of cardiac function and may be involved causally in the transition from compensated left ventricular hypertrophy to failure. Nevertheless, these processes have not been studied previously in patients with aortic valve stenosis (AS). METHODS AND RESULTS: Participants underwent (11)C-acetate positron emission tomography, cardiovascular magnetic resonance, and echocardiography to measure MVO2 and myocardial external efficiency (MEE) defined as the ratio of left ventricular stroke work and the energy equivalent of MVO2...
February 6, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28163283/safety-and-efficacy-of-simultaneous-biplane-mode-of-3-dimensional-transesophageal-echocardiography-guided-antegrade-multiple-inflation-balloon-aortic-valvuloplasty-in-patients-with-severe-aortic-stenosis
#10
Kazuki Mizutani, Masahiko Hara, Hirotoshi Ishikawa, Shinsuke Nishimura, Asahiro Ito, Shinichi Iwata, Yosuke Takahashi, Kenichi Sugioka, Takashi Murakami, Toshihiko Shibata, Minoru Yoshiyama
BACKGROUND: Balloon aortic valvuloplasty (BAV) is resurging as a bridge treatment in patients with severe aortic stenosis (AS) with a dissemination of transcatheter aortic valve implantation. However, the significantly high periprocedural mortality and complication rates still limit the indications of BAV. Further efforts are needed to improve the safety and efficacy of BAV.Methods and Results:We retrospectively investigated the safety and efficacy of simultaneous biplane mode of 3-dimensional transesophageal echocardiography (biplane-TEE) guided antegrade transseptal multiple-inflation BAV, with gradual upsizing of the balloon, by enrolling 20 consecutive AS patients who underwent BAV...
February 4, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28132685/comparison-of-frequency-of-ischemic-cardiovascular-events-in-patients-with-aortic-stenosis-with-versus-without-asymmetric-septal-hypertrophy-from-the-seas-trial
#11
Eigir Einarsen, Dana Cramariuc, Mai T Lønnebakken, Kurt Boman, Christa Gohlke-Bärwolf, John B Chambers, Eva Gerdts
Asymmetric interventricular septum hypertrophy (ASH) has been associated with increased perioperative morbidity and mortality in patients with severe, symptomatic aortic valve stenosis (AS). Less is known about the prognostic impact of ASH during progression of AS. Clinical, echocardiographic, and outcome data from 1,691 patients with initially asymptomatic, mostly moderate AS, participating in the Simvastatin Ezetimibe in Aortic Stenosis (SEAS) study was used. ASH was considered present if interventricular septum/posterior wall thickness ratio in end-diastole ≥1...
April 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28130437/heartbeat-intervention-for-asymptomatic-severe-aortic-stenosis
#12
Catherine M Otto
No abstract text is available yet for this article.
February 15, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28115002/left-innominate-vein-stenosis-in-an-asymptomatic-population-a-retrospective-analysis-of-212-cases
#13
Xiangjiang Guo, Yaxue Shi, Hui Xie, Lan Zhang, Guanhua Xue, Leyi Gu, Changning Hao, Shuofei Yang, Kejia Kan
BACKGROUND: Although left innominate vein (LIV) stenosis has been demonstrated to be attributed to compression by adjacent anatomical structures, most of the studies are focusing on hemodialysis patients with clinical symptoms compatible with LIV stenosis. The goal of this study was to retrospectively investigate the incidence of LIV stenosis and its influencing factors in an asymptomatic, non-hemodialysis population, which has rarely been performed. METHODS: From Jan 2013 to Dec 2014, 212 consecutive cases undergoing a chest multi-detector computed tomography (MDCT) angiography were enrolled...
January 23, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28095921/papillary-fibroelastoma-of-the-aortic-valve-presenting-with-chronic-angina-and-acute-stroke-a-case-report
#14
Fan Zhang, Ziqiang Zhu, Gautham K Upadhya, Jiankun Tong, Vlad Gotlieb, Abdullah Khan, Rakesh P Gupta
BACKGROUND: Papillary fibroelastomas are rare, benign cardiac tumors that are often found on cardiac valvular surfaces. Most are incidental discoveries during surgery or autopsy. The clinical presentation of fibroelastoma varies widely, ranging from clinically asymptomatic to severe thromboembolic events. CASE PRESENTATION: We report a case of 65-year-old white man diagnosed with scattered, bilateral acute cerebral hemisphere infarcts with a history of chronic angina...
January 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28062138/determinants-and-prognostic-value-of-b-type-natriuretic-peptide-in-patients-with-aortic-valve-stenosis
#15
Virginia Nguyen, Claire Cimadevilla, Dimitri Arangalage, Monique Dehoux, Isabelle Codogno, Xavier Duval, Sarah Tubiana, Alec Vahanian, David Messika-Zeitoun
BACKGROUND: The prognostic value of N-terminal fragment of pro B-type natriuretic peptide (Nt-proBNP) in aortic stenosis (AS) is still being debated. We sought to evaluate the determinants of Nt-proBNP in AS and its prognostic value in asymptomatic patients. METHODS: Patients with pure isolated at least mild degenerative AS enrolled in our prospective cohort (2006-2013) constituted our population. Clinical and biological measurements as well as echocardiographic evaluations were performed at study entry for all patients...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28060855/determinants-and-prognostic-significance-of-symptomatic-status-in-patients-with-moderately-dysfunctional-bicuspid-aortic-valves
#16
Soo Youn Lee, Chi Young Shim, Geu-Ru Hong, In Jeong Cho, Hyuk-Jae Chang, Jong-Won Ha, Namsik Chung
BACKGROUND: We aimed to identify the clinical and echocardiographic determinants of symptoms and their prognostic implications in patients with moderately dysfunctional bicuspid aortic valves (BAVs). METHODS: Among 1,019 subjects in the BAV registry treated in a single tertiary care center, the records of 127 patients (85 men, age 58±13 years) with moderately dysfunctional BAVs were comprehensively reviewed. The patients were divided into two groups based on symptom status: asymptomatic (n = 80) vs...
2017: PloS One
https://www.readbyqxmd.com/read/27989081/value-of-combined-circumferential-and-longitudinal-left-ventricular-systolic-dysfunction-to-predict-adverse-outcome-in-patients-with-asymptomatic-aortic-stenosis
#17
Giovanni Cioffi, Carmine Mazzone, Giulia Barbati, Andrea Rossi, Stefano Nistri, Federica Ognibeni, Luigi Tarantini, Andrea Di Lenarda, Pompilio Faggiano, Giovanni Pulignano, Carlo Stefenelli, Giovanni de Simone
No abstract text is available yet for this article.
January 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27931592/the-rationale-for-performance-of-coronary%C3%A2-angiography-and-stenting-before-transcatheter-aortic-valve-replacement-from-the-interventional-section-leadership-council-of-the-american-college-of-cardiology
#18
REVIEW
Stephen Ramee, Saif Anwaruddin, Gautam Kumar, Robert N Piana, Vasilis Babaliaros, Tanveer Rab, Lloyd W Klein
Transcatheter aortic valve replacement (TAVR) is an effective, nonsurgical treatment option for patients with severe aortic stenosis. The optimal treatment strategy for treating concomitant coronary artery disease (CAD) has not been tested prospectively in a randomized clinical trial. Nevertheless, it is standard practice in the United States to perform coronary angiography and percutaneous coronary intervention for significant CAD at least 1 month before TAVR. All existing clinical trials were designed using this strategy...
December 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27922809/impact-of-coronary-artery-disease-on-postoperative-outcomes-in-patients-undergoing-transcatheter-aortic-valve-replacement-tavr-is-preoperative-coronary-revascularization-necessary
#19
Dhaval Chauhan, Mohammad Thawabi, Nicky Haik, Bruce J Haik, Chunguang Chen, Marc Cohen, Mark Russo
BACKGROUND: There remains much controversy on impact of preoperative coronary artery disease (CAD) and necessity of preoperative coronary revascularization on postoperative outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). METHODS: Data were collected retrospectively for 364 consecutive patients undergoing TAVR at Newark Beth Israel Medical Center, New Jersey, from May 15, 2012 to September 17, 2015. Preoperative CAD burden was calculated by three different measures of CAD: SYNTAX score, Duke Myocardial Jeopardy score (DMJS), and number of diseased coronary arteries...
December 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27916346/cardiopulmonary-exercise-testing-is-a-better-outcome-predictor-than-exercise-echocardiography-in-asymptomatic-aortic-stenosis
#20
Olivia Domanski, Marjorie Richardson, Augustin Coisne, Anne-Sophie Polge, Stephanie Mouton, François Godart, Jean Louis Edmé, Regis Matran, Patrizio Lancellotti, David Montaigne
BACKGROUND: Objective assessment of maximal aerobic capacity using peak oxygen consumption (peak VO2) can be helpful in the management of patients with asymptomatic aortic stenosis (AS). The relationship between peak VO2 and AS severity criteria derived from rest and supine exercise echocardiography (SEE) has never been explored. OBJECTIVES: We aimed to determine whether low peak VO2 (<85% of predicted value) is associated with severity parameters in SEE, and poor clinical outcome...
January 15, 2017: International Journal of Cardiology
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