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Asymptomatic aortic stenosis

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https://www.readbyqxmd.com/read/29776957/sudden-death-in-patients-with-severe-aortic-stenosis-observations-from-the-current-as-registry
#1
Tomohiko Taniguchi, Takeshi Morimoto, Hiroki Shiomi, Kenji Ando, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Takao Kato, Katsuhisa Ishii, Kazuya Nagao, Yoshihisa Nakagawa, Mamoru Toyofuku, Naritatsu Saito, Kenji Minatoya, Takeshi Kimura
BACKGROUND: The annual incidence of sudden death has been reported to be low (<1%/year) in asymptomatic patients with severe aortic stenosis (AS), and there is a paucity of data on the risk factors of sudden death in patients with severe AS. METHODS AND RESULTS: We evaluated the incidence and risk factors of sudden death during the median follow-up period of 1334 days in the Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis (CURRENT AS) registry enrolling 3815 consecutive patients with severe AS between 2003 and 2011...
May 18, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29772320/predictive-factors-of-silent-brain-infarcts-after-asymptomatic-carotid-endarteriectomy
#2
Rémy Pascot, Benjamin Parat, Yann Le Teurnier, Gilles Godet, Jean-Yves Gauvrit, Yann Gouëffic, Eric Steinmetz, Alain Cardon, Adrien Kaladji
BACKGROUND: The optimization of medical treatment regularly challenges the role of carotid surgery for asymptomatic patients. Current research seeks to determine which of these patients will benefit most from surgery. The goal of this study was to identify in a multi-center study, using MRI, the risk factors for postoperative silent cerebral ischemic lesions after carotid surgery for asymptomatic stenosis METHODS: The multicenter, retrospective study included patients with asymptomatic severe carotid stenosis suitable for surgical treatment and who did not have a history of cerebral ischemia...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29755794/time-of-anderson-fabry-disease-detection-and-cardiovascular-presentation
#3
K Selthofer-Relatic
Background: Anderson-Fabry disease is an X-linked inherited disease, which manifests in a different manner depending on gender and genotype. Making a working diagnosis of Anderson-Fabry disease is difficult because of several reasons: (a) that it is a multiorgan disease with wide variety of phenotypes, (b) different timelines of presentation, (c) gender differences, and (d) possible coexistence with other comorbidities. Late-onset/cardiac type of presentation with minimal involvement of other organs can additionally make diagnosis difficult...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29743995/percutaneous-repair-of-mitral-regurgitation
#4
REVIEW
Colin M Barker
Mitral regurgitation (MR) affects more than 2 million people in the United States annually and is the second leading cause of heart valve disease after aortic stenosis. Surgical intervention is the currently accepted treatment of choice in patients with either symptomatic degenerative MR or asymptomatic MR with pulmonary hypertension, atrial fibrillation, or left ventricular dysfunction. Based on robust evidence from clinical trials, the MitraClip Transcatheter Mitral Valve Repair system (Abbott Vascular) was approved in the United States for commercial use in 2013...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29721704/workup-and-management-of-patients-with-paradoxical-low-flow-low-gradient-aortic-stenosis
#5
REVIEW
Mohamed-Salah Annabi, Marine Clisson, Marie-Annick Clavel, Philippe Pibarot
About 60% of patients with paradoxical low-flow, low-gradient (PLF-LG) aortic stenosis (AS) have a severe disease that justifies aortic valve replacement (AVR). The first step in patients with symptomatic PLF AS should be to rule out measurement errors and treat hypertension. The second step is to distinguish pseudo-severe from true severe AS (TSAS). The third step is to select the optimal treatment modality at the right time. Regarding the second step, projected aortic valve area calculated using stress echocardiography is superior to traditional severity criteria (AVA < 1...
May 2, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29719036/clinical-context-and-detection-of-the-murmur-of-advanced-aortic-stenosis
#6
Ajoe John Kattoor, Anusha Shanbhag, Annette Abraham, Srikanth Vallurupalli
OBJECTIVES: Auscultation is an important clue to the presence of aortic stenosis (AS). We sought to assess the effect of symptom status, prior knowledge of diagnosis, and other patient factors on murmur detection. METHODS: Patients with moderate-to-severe AS by echocardiography at a single center between June 2015 and June 2016 were included. Five consecutive patient encounters (inpatient and outpatient) within 12 months before the echocardiogram were analyzed. RESULTS: Ninety-five patients (418 different clinician encounters) were studied...
April 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29701358/carotid-stenosis-in-cardiac-surgery-patients
#7
Pedro Pinto Sousa, Gabriela Teixeira, João Gonçalves, Carlos Veiga, Pedro Sá Pinto, Pedro Brandão, Alexandra Canedo, Luis Vouga, Rui Almeida
INTRODUCTION: Ischemic stroke is a potential perioperative complication after an open heart surgery (OHS). Whether a carotid stenosis or occlusion is associated with an increased risk of perioperative stroke in patients or just a risk factor has been a concern of intense debate in the literature. METHODS: We retrospectively analyzed patients submitted to OHS between January and December2016 with known asymptomatic carotid disease. The data from 85 consecutive patients undergoing coronary artery bypass grafting, valve replacement, or both was collected...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29650708/outcomes-in-asymptomatic-severe-aortic-stenosis-with-preserved-ejection-fraction-undergoing-rest-and-treadmill-stress-echocardiography
#8
Chetan P Huded, Ahmad Masri, Kenya Kusunose, Andrew L Goodman, Richard A Grimm, A Marc Gillinov, Douglas R Johnston, L Leonardo Rodriguez, Zoran B Popovic, Lars G Svensson, Brian P Griffin, Milind Y Desai
BACKGROUND: In asymptomatic patients with severe aortic stenosis and preserved left ventricular ejection fraction, we sought to assess the incremental prognostic value of resting valvuloarterial impedence (Zva) and left ventricular global longitudinal strain (LV-GLS) to treadmill stress echocardiography. METHODS AND RESULTS: We studied 504 such patients (66±12 years, 78% men, 32% with coronary artery disease who underwent treadmill stress echocardiography between 2001 and 2012...
April 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29602140/effect-of-simvastatin-and-ezetimibe-on-supar-levels-and-outcomes
#9
Gethin W Hodges, Casper N Bang, Julie L Forman, Michael H Olsen, Kurt Boman, Simon Ray, Y Antero Kesäniemi, Jesper Eugen-Olsen, Anders M Greve, Jørgen L Jeppesen, Kristian Wachtell
BACKGROUND AND AIMS: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory marker associated with cardiovascular disease. Statins lower both low-density lipoprotein (LDL)-cholesterol and C-reactive protein (CRP), resulting in improved outcomes. However, whether lipid-lowering therapy also lowers suPAR levels is unknown. METHODS: We investigated whether treatment with Simvastatin 40 mg and Ezetimibe 10 mg lowered plasma suPAR levels in 1838 patients with mild-moderate, asymptomatic aortic stenosis, included in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study, using a pattern mixture model...
March 16, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29596567/malignant-disease-as-a-comorbidity-in-patients-with-severe-aortic-stenosis-clinical-presentation-outcomes-and-management
#10
Eri Minamino-Muta, Takao Kato, Takeshi Morimoto, Tomohiko Taniguchi, Kenji Nakatsuma, Yuki Kimura, Moriaki Inoko, Shinichi Shirai, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Makoto Miyake, Chisato Izumi, Hirokazu Mitsuoka, Yutaka Hirano, Tomoki Sasa, Kazuya Nagao, Tsukasa Inada, Ryusuke Nishikawa, Yasuyo Takeuchi, Shintaro Yamagami, Keiichiro Yamane, Kanae Su, Akihiro Komasa, Katsuhisa Ishii, Yugo Yamashita, Yoshihiro Kato, Kensuke Takabayashi, Naritatsu Saito, Kenji Minatoya, Takeshi Kimura
Aim: To investigate the effect of malignancy on the outcomes of patients with severe aortic stenosis (AS) and the management strategy for AS with malignancy. Methods: Using data of 3815 patients with severe AS in a retrospective multicenter registry (CURRENT AS registry), we compared 3-year clinical outcomes among three groups based on malignancy status: with malignancy currently under treatment including best supportive care (malignancy group), with a history of malignancy without any current treatment (past history group), or without history of malignancy (no malignancy group)...
March 27, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29593834/oral-anticoagulant-therapy-for-early-post-tavi-thrombosis
#11
Neil Ruparelia
While transcatheter aortic valve implantation (TAVI) is now the accepted treatment option of choice for patients presenting with severe symptomatic aortic stenosis who are deemed to be inoperable or of high surgical risk, there have been concerns regarding the risk of early valve failure and durability. One potential limitation is the occurrence of early post-TAVI thrombosis. Whilst the incidence of obstructive transcatheter heart valve (THV) thrombosis is <1 %, with technological advances in imaging, it is increasingly apparent that the overall true incidence is likely to be much higher with between 7-40 % of patients observed to have appearances strongly suggestive of asymptomatic subclinical THV thrombosis...
January 2018: Interventional Cardiology
https://www.readbyqxmd.com/read/29591724/two-year-outcomes-of-the-nellix-endovascular-aneurysm-sealing-system-for-treatment-of-abdominal-aortic-aneurysms
#12
Aleksandra C Zoethout, Johannes T Boersen, Jan M M Heyligers, Jean-Paul P M de Vries, Clark J A M Zeebregts, Michel M P J Reijnen
PURPOSE: To analyze the 2-year outcomes of endovascular aneurysm sealing (EVAS) according to 2 versions of the instructions for use (IFU). METHODS: A retrospective study was conducted involving 355 consecutive patients treated with the first-generation EVAS device from April 2013 to December 31, 2015, at 3 high-volume centers. Out of 355 patients treated with EVAS, 264 were elective asymptomatic infrarenal EVAS procedures suitable for analysis. In this cohort, 168 (63...
March 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29561453/prognostic-value-of-area-of-calcified-aortic-valve-by-2-dimensional-echocardiography-in-asymptomatic-severe-aortic-stenosis-patients-with-preserved-left-ventricular-ejection-fraction
#13
Victor Chien-Chia Wu, Masaaki Takeuchi, Yasufumi Nagata, Masaki Izumo, Yoshihiro J Akashi, Fen-Chiung Lin, Yutaka Otsuji
We hypothesized that area of calcified aortic valve (ACAV) measured by 2D echocardiography (2DE) can predict future cardiovascular events in asymptomatic severe aortic stenosis (AS).Multidetector computed tomography determined aortic valve calcification load is strongly associated with AS severity but has risks for radiation exposure. Quantification of ACAV by transthoracic 2DE is simple and convenient but its clinical utility has not been extensively studied.We measured ACAV in 124 asymptomatic severe AS patients (80 ± 9 years, 45 males) with preserved left ventricular ejection fraction...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29547988/impact-of-low-stroke-volume-on-mortality-in-patients-with-severe-aortic-stenosis-and-preserved-left-ventricular-ejection-fraction
#14
Dan Rusinaru, Yohann Bohbot, Anne Ringle, Sylvestre Maréchaux, Momar Diouf, Christophe Tribouilloy
Aims: In patients with severe aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF), low flow (LF) is currently defined using Doppler-echocardiography by a stroke volume index (SVi)<35 mL/m2. However, the relationship between LF and outcome remains unclear as data on normal reference values defining LF are scarce, and previous studies did not explore the risk associated with other SVi cut-points. We analysed the relationship between LF and mortality in severe AS to establish prognostic LF values associated with mortality risk...
March 13, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29525246/evaluation-and-management-of-aortic-stenosis-for-the-emergency-clinician-an-evidence-based-review-of-the-literature
#15
Michael Gottlieb, Brit Long, Alex Koyfman
INTRODUCTION: Aortic stenosis is a common condition among older adults that can be associated with dangerous outcomes, due to both the disease itself and its influence on other conditions. OBJECTIVE: This review provides an evidence-based summary of the current emergency department (ED) evaluation and management of aortic stenosis. DISCUSSION: Aortic stenosis refers to significant narrowing of the aortic valve and can be caused by calcific disease, congenital causes, or rheumatic valvular disease...
March 7, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29404717/pulse-oximetry-findings-in-newborns-with-antenatally-diagnosed-congenital-heart-disease
#16
Isabel E Mawson, Pratusha L Babu, John M Simpson, Grenville F Fox
A retrospective review of admission preductal oxygen saturations of neonates with antenatally diagnosed critical congenital heart disease (CCHD) was performed to investigate the differences in newborn pulse oximetry (Pulsox) by specific CCHD diagnosis. Saturations were recorded at median of < 1 h (range < 1-9 h) after delivery. Data was stratified by CCHD diagnosis and analysed according to the three different admission Pulsox thresholds, ≤ 90, ≤ 92 and ≤ 95%. Of the 276 neonates studied, 208 were clinically well at admission, with no co-morbidities, gestation > 34 weeks and birth weight > 1...
May 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29396865/comparison-between-characteristics-of-severe-and-very-severe-aortic-stenosis
#17
Hidekazu Tanaka, Yong-Jin Kim, Seung-Ji Park, Seung Woo Park, Takeshi Hozumi, Chisato Izumi, Lieng His Ling, Cheuk-Man Yu, Shota Fukuda, Yutaka Otsuji, Jae-Kwan Song, Dae-Won Sohn
OBJECTIVES: Patients with very severe aortic stenosis (AS) have extremely poor clinical outcomes even if they are asymptomatic compared to those with severe AS, but the clinical and echocardiographic characteristics of patients with very severe AS remain unclear. METHODS: The Asian Valve Registry is a prospective, multicenter, multinational registry for the study and identification of the incidence, natural course, clinical outcomes, and prognostic factors for patients with significant AS at 9 centers in Asian countries...
April 2018: Echocardiography
https://www.readbyqxmd.com/read/29387432/supar-predicts-postoperative-complications-and-mortality-in-patients-with-asymptomatic-aortic-stenosis
#18
Gethin W Hodges, Casper N Bang, Jesper Eugen-Olsen, Michael H Olsen, Kurt Boman, Simon Ray, Antero Y Kesäniemi, Jørgen L Jeppesen, Kristian Wachtell
Background: We evaluated whether early measurement of soluble urokinase plasminogen activator receptor (suPAR) could predict future risk of postoperative complications in initially asymptomatic patients with mild-moderate aortic stenosis (AS) undergoing aortic valve replacement (AVR) surgery. Methods: Baseline plasma suPAR levels were available in 411 patients who underwent AVR surgery during follow-up in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study...
2018: Open Heart
https://www.readbyqxmd.com/read/29361285/effect-modifications-of-lipid-lowering-therapy-on-progression-of-aortic-stenosis-from-the-simvastatin-and-ezetimibe-in-aortic-stenosis-seas-study
#19
Anders M Greve, Casper N Bang, Kurt Boman, Kenneth Egstrup, Julie L Forman, Y Antero Kesäniemi, Simon Ray, Terje R Pedersen, Patricia Best, Nalini M Rajamannan, Kristian Wachtell
Observational studies indicate that low-density lipoprotein (LDL) cholesterol acts as a primary contributor to an active process leading to aortic stenosis (AS) development. However, randomized clinical trials have failed to demonstrate an effect of lipid lowering on impeding AS progression. This study explored if pretreatment LDL levels and AS severity altered the efficacy of lipid-lowering therapy. The study goal was evaluated in the analysis of surviving patients with baseline data in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) trial of 1,873 asymptomatic patients with mild-to-moderate AS...
March 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29359271/molecular-imaging-of-calcific-aortic-valve-disease
#20
Jae-Joon Jung, Farid Jadbabaie, Mehran M Sadeghi
Calcific aortic valve disease (CAVD) can progress to symptomatic aortic stenosis in a subset of patients. The severity of aortic stenosis and the extent of valvular calcification can be evaluated readily by echocardiography, CT, and MRI using well-established imaging protocols. However, these techniques fail to address optimally other important aspects of CAVD, including the propensity for disease progression, risk of complications in asymptomatic patients, and the effect of therapeutic interventions on valvular biology...
January 22, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
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