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Asymptomatic aortic stenosis

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https://www.readbyqxmd.com/read/29124471/clinical-outcome-and-functional-characteristics-of-patients-with-asymptomatic-low-flow-low-gradient-severe-aortic-stenosis-with-preserved-ejection-fraction-are-closer-to-high-gradient-severe-than-to-moderate-aortic-stenosis
#1
Mohammad Kavianipour, Amir Farkhooy, Frank A Flachskampf
Asymptomatic "paradoxic" severe low-flow low-gradient aortic stenosis with preserved ejection fraction (PAS) constitutes a challenging condition where the optimal management and follow-up remain elusive. We evaluated the clinical outcome in patients with PAS as compared to asymptomatic patients with moderate (MAS) or classical severe aortic stenosis (CAS). Consecutive asymptomatic moderate or severe aortic stenosis patients without concomitant other heart or lung disease (n = 121) were invited. Participants (n = 74) were assigned to three subgroups with regard to degree of aortic stenosis: MAS (n = 25), CAS (n = 22) and PAS (n = 27)...
November 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29089282/safety-and-efficacy-of-the-new-micromesh-covered-stent-cguard-in-patients-undergoing-carotid-artery-stenting-early-experience-from-a-single-centre
#2
Renato Casana, Valerio Tolva, Andrea Odero, Chiara Malloggi, Aldo Paolucci, Fabio Triulzi, Vincenzo Silani
OBJECTIVE/BACKGROUND: Plaque protrusion through stent struts represents one of the principal causes of cerebral embolisation during carotid artery stenting (CAS) and the stent healing period. The aim of this study was to evaluate the safety (technical success) and efficacy (clinical success) of the CGuard stent system - a new nitinol stent covered by a closed-cell polyethylene terephthalate mesh designed to prevent embolic events. METHODS: Eighty-two consecutive patients who underwent CAS with CGuard from June 2015 were included in this study...
October 28, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29042031/relation-of-the-mitral-annular-plane-systolic-excursion-to-risk-for-intervention-in-initially-asymptomatic-patients-with-aortic-stenosis-and-preserved-systolic-function
#3
Jason D Matos, Joshua E Kiss, Andrew H Locke, Randal I Goldberg, Kenneth Mukamal, Warren J Manning
Aortic valve intervention (AVI) in patients with a severe aortic stenosis (AS) and a preserved left ventricular ejection fraction (LVEF) is controversial. Mitral annular plane systolic excursion (MAPSE) is an easily acquired metric of left ventricular longitudinal shortening. We sought to investigate if an asymptomatic decrease in MAPSE preceded the need for AVI in asymptomatic patients with AS and a preserved LVEF. In this retrospective cohort study, we identified 205 consecutive patients (56% male, 73 ± 11 years) with at least a moderate AS and a normal LVEF who underwent a serial outpatient transthoracic echocardiography (TTE) from 2006 to 2013...
December 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29021260/risk-stratification-of-severe-aortic-stenosis-with-preserved-left-ventricular-ejection-fraction-using-peak-aortic-jet-velocity-an-outcome-study
#4
Yohann Bohbot, Dan Rusinaru, Quentin Delpierre, Sylvestre Marechaux, Christophe Tribouilloy
BACKGROUND: Current guidelines consider aortic valve replacement reasonable in asymptomatic patients with very severe aortic stenosis (AS); however, the definition of very severe AS based on peak aortic jet velocity (Vmax) remains unclear with a 5-m/s cutoff in US guidelines and 5.5 m/s in European guidelines. Because ≈20% of patients with severe AS and preserved left ventricular ejection fraction have Vmax in this range, we aimed to assess the relationship between Vmax and mortality and determine the best threshold to define very severe AS...
October 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28982541/six-minute-walking-test-and-long-term-prognosis-in-patients-with-asymptomatic-aortic-valve-stenosis
#5
Per Ejlstrup Sigvardsen, Linnea Hornbech Larsen, Helle Gervig Carstensen, Jørgen Tobias Kühl, Rasmus Møgelvang, Christian Hassager, Lars Køber, Klaus Fuglsang Kofoed
BACKGROUND: Management of asymptomatic patients with aortic valve stenosis is challenging due to the elusive relationship between symptomatic status and hemodynamic parameters in addition to the occurrence of cardiovascular death. The 6-minute walking test (6MWT) reflects overall hemodynamic function and could contribute to risk assessment in such patients. METHODS AND RESULTS: One hundred sixteen asymptomatic patients (peak velocity>2.5m/s and left ventricular ejection fraction >50% assessed by echocardiographic screening; 85 males; aged 72±8years) underwent clinical workup, transthoracic echocardiography and a 6MWT...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28977565/transcarotid-transcatheter-aortic-valve-implantation-multicentre-experience-in-france
#6
Thierry Folliguet, Nicolas Laurent, Maxime Bertram, Konstantinos Zannis, Mazen Elfarra, Fabrice Vanhuyse, Pablo Maureira, Thomas Modine
OBJECTIVES: Transcatheter aortic valve implantation is a well-recognized treatment option for high-risk patients with aortic stenosis. The femoral approach is possible in 80% of cases and remains the access of choice. When this approach is not feasible, other alternative routes have been proposed such as transapical, transaortic and subclavian. Transcarotid aortic valve implantation has been proposed as another direct vascular access. Its use is relatively new and still under evaluation...
August 4, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28956773/metoprolol-reduces-hemodynamic-and-metabolic-overload-in-asymptomatic-aortic-valve-stenosis-patients-a-randomized-trial
#7
RANDOMIZED CONTROLLED TRIAL
Nils Henrik Hansson, Jens Sörensen, Hendrik Johannes Harms, Won Yong Kim, Roni Nielsen, Lars Poulsen Tolbod, Jørgen Frøkiær, Kirsten Bouchelouche, Karen Kaae Dodt, Inger Sihm, Steen Hvitfeldt Poulsen, Henrik Wiggers
BACKGROUND: Currently, no pharmacological treatment can modify the natural history of aortic valve stenosis (AS). This underlines the critical need to explore novel treatment strategies, which could postpone or prevent the need for aortic valve replacement in patients with asymptomatic AS. The objectives of this study were to investigate whether metoprolol reduce the hemodynamic and metabolic burden imposed by AS. METHODS AND RESULTS: In a double-blinded design, 40 patients with moderate-severe asymptomatic AS (aortic valve area, 0...
October 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28950334/ascending-aorta-dilatation-rates-in-patients-with-tricuspid-and-bicuspid-aortic-stenosis-the-cofrasa-generac-study
#8
Caroline Kerneis, Nicoletta Pasi, Dimitri Arangalage, Virginia Nguyen, Tiffany Mathieu, Constance Verdonk, Isabelle Codogno, Phalla Ou, Xavier Duval, Sarah Tubiana, Claire Cimadevilla, Alec Vahanian, And David Messika-Zeitoun
Background: Ascending aorta (AA) dilatation is common in aortic valve stenosis (AS) but data regarding AA progression, its determinants and impact of valve anatomy [bicuspid (BAV), or tricuspid (TAV)] are scarce. Methods and Results: Asymptomatic AS patients enrolled in a prospective cohort (COFRASA/GENERAC) with at least 2 years of follow-up were considered in the present analysis. A transthoracic echocardiography (TTE) and a computed tomography (CT) scan were performed at inclusion and yearly thereafter...
July 25, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28947308/relation-of-left-atrial-size-cardiac-morphology-and-clinical-outcome-in-asymptomatic-aortic-stenosis
#9
Nicolaj Lyhne Christensen, Jordi Sanchez Dahl, Rasmus Carter-Storch, Rine Bakkestrøm, Redi Pecini, Flemming Hald Steffensen, Eva Vad Søndergaard, Lars Melgaard Videbæk, Jacob Eifer Møller
Left atrial (LA) dilation in asymptomatic severe aortic stenosis (AS) may be an indicator of advanced disease. We aimed to investigate the association between LA volume index and left ventricular (LV) morphology assessed with cardiac magnetic resonance imaging (cMRI), and to assess the association with cardiac events. Ninety-two asymptomatic patients with aortic valve area <1 cm(2), aortic peak jet velocity >3.5 m/s, and ejection fraction ≥50% were prospectively enrolled and divided according to echocardiographic-derived LA volume index  <35 ml/m(2)...
November 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28893390/periodic-repolarization-dynamics-in-patients-with-moderate-to-severe-aortic-stenosis
#10
Konstantinos D Rizas, Christine S Zuern, A Bauer
BACKGROUND: Periodic repolarization dynamics (PRD) refers to low-frequency oscillations of cardiac repolarization, most likely related to phasic sympathetic activation. Increased PRD is a validated predictor of mortality after myocardial infarction and in ischemic heart disease, but has not been tested in aortic valve stenosis (AS). Here, we assessed PRD in patients with AS and tested its correlation with clinical and hemodynamic parameters as well as markers of heart rate variability (HRV)...
August 9, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28879059/pulmonary-hypertension-and-cardiac-hypertrophy-in-children-recipients-of-orthotopic-living-related-liver-transplantation
#11
Magd A Kotb, Inas Abd El Satar, Ahmed M Badr, Nancy H Anis, Hoda Abd El Rahman Ismail, Alaa F Hamza, Hesham M Abdelkader
Surgical stress, liberation of cytokines associated with re-perfusion injury, and long standing use of immune suppressive medications in children recipients of orthotopic living related liver transplantation (OLRLT) pose cardiovascular risk. Reported cardiovascular adverse effects vary from left ventricular wall thickening, hypertrophic cardiomyopathy to resting ECG abnormalities, asymptomatic ST depression following increased heart rate and ventricular arrhythmias. Twenty-five consecutive children recipients of OLRLT were assessed by conventional 2-D, M-mode echocardiography and Doppler...
November 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28877303/association-of-guideline-adherence-for-serial-evaluations-with-survival-and-adverse-clinical-events-in-patients-with-asymptomatic-severe-aortic-stenosis
#12
Aisha Ahmed, Paul Sorajja, Ross F Garberich, R Saeid Farivar, Kevin M Harris, Mario Gössl
Importance: For patients with asymptomatic severe aortic stenosis and normal left ventricular function, current practice guidelines empirically recommend serial evaluations every 6 to 12 months. The benefit of this clinical monitoring is unknown. Objective: To determine the association of guideline adherence with clinical outcomes in patients with asymptomatic severe aortic stenosis. Design, Setting, and Participants: This retrospective cohort study involved 300 patients with asymptomatic severe aortic stenosis who were seen in the ambulatory Minneapolis Heart Institute at Abbott Northwestern Hospital...
October 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28864136/severe-aortic-stenosis-patients-with-preserved-ejection-fraction-according-to-flow-and-gradient-classification-prevalence-and-outcomes
#13
Ariana González Gómez, Covadonga Fernández-Golfín, Juan Manuel Monteagudo, Carlos Izurieta, Rocío Hinojar, Ana García, Eduardo Casas, José Julio Jiménez-Nacher, José Luis Moya, Soledad Ruiz, José Luis Zamorano
BACKGROUND: Clinicians often encounter patients with apparently discordant echocardiographic findings, severe aortic stenosis (SAS) defined by aortic valve area (AVA) despite a low mean gradient. A new classification according to flow state and pressure gradient has been proposed. We sought to assess the prevalence, characteristics and outcomes of patients with asymptomatic SAS with preserved left-ventricular ejection fraction (LVEF) according to flow and gradient. METHODS AND RESULTS: In total 442 patients with SAS (AVAi<0...
December 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28857529/-surgical-treatment-of-tracheal-stenosis-a-11-year-report-in-a-pediatric-hospital
#14
M Boglione, A Reusmann, M Cadario, C Giuseppucci, H Botto, M Nieto, M Barrenechea
OBJECTIVES: To report our experience in the surgical treatment of patients having acquired and congenital tracheal stenosis. MATERIAL AND METHODS: Fifty eight patients with tracheal stenosis were surgically treated between July 2005 and May 2016, 29 were females and 29 were males. Thirty patients had acquired stenosis and 28 had congenital stenosis. RESULTS: Five to 12 rings were resected (median 5) in 26 patients, in 2 cartilage was grafted in the anterior wall, in another carinostomy was performed, and in the remaining, the trachea was replaced using an aortic cryopreserved graft...
April 20, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28844834/what-makes-new-ischemic-lesions-symptomatic-after-aortic-valve-replacement
#15
Ronen R Leker, Steven R Messé, Guray Erus, Michel Bilello, Molly Fanning, Michael Acker, Allie Massaro, Scott E Kasner, Thomas Floyd
BACKGROUND: Acute cerebral infarctions on diffusion-weighted magnetic resonance imaging (MRI) are common after cardiothoracic surgery. However, most are asymptomatic and we aimed to identify features associated with clinical stroke symptoms. METHODS: Patients over 65 years of age undergoing surgical aortic valve replacement (AVR) for calcific stenosis were prospectively recruited (N = 196). All patients underwent neurological evaluation preoperatively and on postoperative days 1, 3, and 7, and MRI on planned postoperative day 5...
August 24, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28827255/self-reported-health-status-treatment-decision-and-survival-in-asymptomatic-and-symptomatic-patients-with-aortic-stenosis-in-a-western-norway-population-undergoing-conservative-treatment-a-cross-sectional-study-with-18-months-follow-up
#16
Kjersti Oterhals, Rune Haaverstad, Jan Erik Nordrehaug, Geir Egil Eide, Tone M Norekvål
OBJECTIVES: To investigate symptoms and self-reported health of patients conservatively treated for aortic stenosis (AS) and to identify factors associated with treatment decision and patient outcomes. DESIGN: A cross-sectional survey with an 18-month follow-up. SETTING: One tertiary university hospital in Western Norway. PARTICIPANTS: In all, 1436 patients were diagnosed with AS between 2000 and 2012, and those 245 still under conservative treatment in 2013 were included in this study...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28814237/statins-in-aortic-stenosis
#17
Karl Norrington, Emmanuel Androulakis, Evangelos Oikonomou, Georgia Vogiatzi, Dimitris Tousoulis
Calcific aortic stenosis (AS) is the most common form of valvular heart disease in Europe and North America. It is a progressive disease with a prolonged period of asymptomatic latency which eventually leads to critical left ventricular outflow tract obstruction necessitating surgical replacement of the valve. Statins are lipid-lowering drugs with a robust evidence base demonstrating clinical benefit in atherosclerotic coronary artery disease. There has therefore been significant interest in the potential benefit of statins in AS...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28809945/correction-asymptomatic-aortic-stenosis-an-assessment-of-patients-and-of-their-general-practitioners-knowledge-after-an-indexed-specialized-assessment-in-community-practice
#18
Raphaëlle-Ashley Guerbaai, Gabriel Fustier, Pierre-Vladimir Ennezat, Anne Ringle, Camille Trouillet, Pierre Graux, André Vincentelli, Christophe Tribouilloy, Sylvestre Maréchaux
[This corrects the article DOI: 10.1371/journal.pone.0179988.].
2017: PloS One
https://www.readbyqxmd.com/read/28734915/asymptomatic-aortic-stenosis-from-flights-of-stairs-to-exercise-testing-to-exercise%C3%A2-echocardiography
#19
EDITORIAL
Michael S Lauer
No abstract text is available yet for this article.
July 13, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28734909/prognostic-value-of-exercise-stress-echocardiography-in-asymptomatic-patients-with-aortic-valve-stenosis
#20
Coppelia Goublaire, Maria Melissopoulou, David Lobo, Naozumi Kubota, Constance Verdonk, Claire Cimadevilla, Isabelle Codogno, Eric Brochet, Alec Vahanian, David Messika-Zeitoun
OBJECTIVES: This study sought to evaluate the prognostic value of mean pressure gradient (MPG) increase and peak systolic pulmonary artery pressure (SPAP) measured during exercise stress echocardiography in asymptomatic patients with aortic stenosis (AS). BACKGROUND: Exercise testing is recommended in asymptomatic AS patients, but the additional value of exercise-stress echocardiography, especially the prognostic value of MPG increase and peak SPAP, is still debated...
July 13, 2017: JACC. Cardiovascular Imaging
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