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Asymptomatic aortic stenosis

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https://www.readbyqxmd.com/read/27903539/outcome-implication-of-aortic-valve-area-normalized-to-body-size-in-asymptomatic-aortic-stenosis
#1
Christophe Tribouilloy, Yohann Bohbot, Sylvestre Maréchaux, Nicolas Debry, Quentin Delpierre, Marcel Peltier, Momar Diouf, Michel Slama, David Messika-Zeitoun, Dan Rusinaru
BACKGROUND: Current guidelines define severe aortic stenosis in patients with aortic valve area normalized to body surface area (AVA/BSA) <0.6 cm(2)/m(2); yet, this cutoff has never been validated. Moreover, it is not known whether AVA normalization to other body size indexes allows improved outcome prediction. We aim to test the value of AVA normalized to body size for outcome prediction in asymptomatic aortic stenosis. METHODS AND RESULTS: We included 289 patients with asymptomatic aortic stenosis, preserved ejection fraction, and AVA<1...
November 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27894069/association-between-left-atrial-dilatation-and-invasive-hemodynamics-at-rest-and-during-exercise-in-asymptomatic-aortic-stenosis
#2
Nicolaj Lyhne Christensen, Jordi Sanchez Dahl, Rasmus Carter-Storch, Rine Bakkestrøm, Kurt Jensen, Flemming Hald Steffensen, Eva Vad Søndergaard, Lars Videbæk, Jacob Eifer Møller
BACKGROUND: Transition from an asymptomatic to symptomatic state in severe aortic stenosis is often difficult to assess. Identification of a morphological sign of increased hemodynamic load may be important in asymptomatic aortic stenosis to identify patients at risk. METHODS AND RESULTS: Thirty-nine patients with asymptomatic severe aortic stenosis (aortic valve area <1 cm(2), peak jet velocity >3.5 m/s) underwent exercise testing with simultaneous invasive hemodynamic monitoring and Doppler echocardiography...
October 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27894060/combined-use-of-tissue-doppler-imaging-and-natriuretic-peptides-as-prognostic-marker-in-asymptomatic-aortic-stenosis
#3
Miquel Gomez Perez, Mireia Ble, Mercedes Cladellas, Lluis Molina, Joan Vila, Alexandra Mas-Stachurska, Laura Higueras-Ortega, Julio Marti-Almor
INTRODUCTION: Tissue Doppler imaging (TDI) and N-terminal-pro-Brain Natriuretic Peptide (NT-proBNP) provides useful non-invasive information about left ventricle filling pressures and both have demonstrated to be a prognostic marker in some valve disease as aortic stenosis (AS). OBJECTIVES: To assess the clinical value of combined TDI and NT-proBNP information in asymptomatic AS patients. MATERIAL AND METHODS: Prospective study of 350 initially asymptomatic moderate to severe AS patients with: Mean aortic valve area 0...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27865193/different-clinical-outcomes-in-patients-with-asymptomatic-severe-aortic-stenosis-according-to-the-stage-classification-does-the-aortic-valve-area-matter
#4
Takeshi Kitai, Tomohiko Taniguchi, Takeshi Morimoto, Toshiaki Toyota, Chisato Izumi, Shuichiro Kaji, Kitae Kim, Naritatsu Saito, Kazuya Nagao, Tsukasa Inada, Eri Minamino-Muta, Takao Kato, Moriaki Inoko, Katsuhisa Ishii, Tadaaki Koyama, Ryuzo Sakata, Yutaka Furukawa, Takeshi Kimura
BACKGROUND: The ACC/AHA guidelines introduced a new classification of severe aortic stenosis (AS) mainly based on maximum jet velocity (Vmax) and mean pressure gradient (mPG), but not on aortic valve area (AVA). However, prognostic value of this new classification has not yet been fully evaluated. METHODS AND RESULTS: We studied 1512 patients with asymptomatic severe AS enrolled in the CURRENT AS registry in whom surgery was not initially planned. Patients were divided into 2 groups: Group 1 (N=122) comprised patients who met the recommendation for surgery; high-gradient (HG)-AS (Vmax≥4...
November 11, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27860144/the-not-so-innocent-heart-murmur-a-five-year-experience
#5
Shaw-Hua Kueh, Thomas Pasley, Miriam Wheeler, James Pemberton
BACKGROUND: Auckland City Hospital (ACH) established a Heart Murmur Clinic (HMC) with the aim of providing prompt assessment of patients with asymptomatic systolic murmurs. This may lead to early intervention and improved outcomes if significant structural heart disease is detected and reassurance if no significant findings found. Similar clinics for children have proven beneficial; the benefit of a HMC in an adult population has been difficult to determine. OBJECTIVES: To review the clinical demographics and echocardiographic information of patients presenting to our HMC and to assess what proportion had significant structural heart disease and determine the common structural abnormalities in this population...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27821197/the-association-between-pro-arrhythmic-agents-and-aortic-stenosis-in-young-adults-is-it-sufficient-to-clarify-the-sudden-unexpected-deaths
#6
Bojana Radnic, Nemanja Radojevic, Jelena Vucinic, Natasa Duborija-Kovacevic
Most young patients with mild-to-moderate aortic stenosis show no symptoms, and sudden death appears only occasionally. We hypothesised that malignant ventricular arrhythmias could be responsible for the high incidence of sudden death in such patients. If multiple factors such as asymptomatic aortic stenosis in association with arrhythmia-provoking agents are involved, could it be sufficient to account for sudden unexpected death? In this study, eight cases of sudden death in young adults, with ages ranging from 22 to 36 years, who had never reported any symptoms that could be related to aortic stenosis, were investigated...
November 8, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27773728/clinical-presentation-management-follow-up-and-outcomes-of-isolated-celiac-and-superior-mesenteric-artery-dissections
#7
Sara L Zettervall, Eleonora G Karthaus, Peter A Soden, Dominique B Buck, Klaas H J Ultee, Marc L Schermerhorn, Mark C Wyers
OBJECTIVE: Isolated visceral artery dissections are rare entities with no current consensus guidelines for treatment and follow-up. This study aims to evaluate the presentation, management, outcomes, and follow-up practices for patients with isolated visceral artery dissections and to compare those with and without symptoms. METHODS: In this retrospective analysis, we identified all patients with isolated celiac artery and/or isolated superior mesenteric artery dissections at a single institution between September 2006 and December 2014...
October 20, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27753892/os-01-01-association-of-lp-pla2-mass-and-aysmptomatic-intracranial-and-extracranial-arterial-stenosis-in-hypertension-patients
#8
Yan Wang, Jin Zhang, Yuesheng Qian, Xiaofeng Tang, Huawei Ling, Kemin Chen, Pingjin Gao, Dingliang Zhu
OBJECTIVE: Intracranial arterial stenosis (ICAS) is a common cause of ischemic stroke in Asians, whereas whites tend to have more extracranial lesions. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been associated with ischemic stroke by a large amount of work. However, there are few studies focusing on the relationship of Lp-PLA2 and asymptomatic ICAS or extracranial arterial stenosis (ECAS). We hereby sought to explore the relationship of Lp-PLA2 and ICAS, ECAS and concurrent stenosis in stroke-free hypertensive patients in Chinese population...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27737738/risk-of-pregnancy-in-moderate-and-severe%C3%A2-aortic-stenosis-from-the-multinational-ropac-registry
#9
Stefan Orwat, Gerhard-Paul Diller, Iris M van Hagen, Renate Schmidt, Daniel Tobler, Matthias Greutmann, Regina Jonkaitiene, Amro Elnagar, Mark R Johnson, Roger Hall, Jolien W Roos-Hesselink, Helmut Baumgartner
BACKGROUND: Controversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). OBJECTIVES: The authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. METHODS: The Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient ≥64 mm Hg) were analyzed...
October 18, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27728056/global-longitudinal-strain-imaging-in-detection-of-subclinical-left-ventricular-systolic-dysfunction-in-patients-with-asymptomatic-severe-aortic-stenosis-with-normal-lv-systolic-dysfunction
#10
C Guruchaithanya Kumar
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27714716/exercise-induced-changes-in-left-ventricular-global-longitudinal-strain-in-asymptomatic-severe-aortic-stenosis
#11
Agnieszka Krystyna Lech, Piotr Paweł Dobrowolski, Anna Klisiewicz, Piotr Hoffman
BACKGROUND: The management of patients with asymptomatic severe aortic stenosis (ASAS) is still under discussion. Therefore, it is advisable to search for the parameters of early damage to left ventricular function. AIM: The aim of the study was to assess exercise-induced changes in left ventricular global longitudinal strain (GLS) in ASAS. METHODS: The ASAS group consisted of 50 patients (26W/24M, aged 38.4±18.1) meeting the echocardiographic criteria of severe aortic stenosis (AVA<1cm², AVAI<0...
October 7, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27698329/the-conundrum-of-watchful-waiting-versus-pre-emptive-surgery-in-asymptomatic-aortic-stenosis-are-we-any-closer-to-an-answer
#12
Milind Y Desai, Amgad Mentias
No abstract text is available yet for this article.
September 28, 2016: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/27696586/new-estimate-of-valvuloarterial-impedance-in-aortic-valve-stenosis-a-cardiac-magnetic-resonance-study
#13
Gilles Soulat, Nadjia Kachenoura, Emilie Bollache, Ludivine Perdrix, Benoit Diebold, Valentina Zhygalina, Christian Latremouille, Stephane Laurent, Jean-Noel Fabiani, Elie Mousseaux
PURPOSE: Valvuloarterial impedance (ZVA ), estimating left ventricle (LV) afterload, has been proposed in transthoracic echocardiography (TTE) as a predictor of mortality in aortic valve stenosis (AVS). However, its calculation differs from arterial characteristic impedance (ZC ). Our aim was to apply the concept of ZC calculation to estimate ZVA from MR with carotid tonometry and to evaluate these indices through their associations with symptoms, LV diastolic function and aortic stiffness...
October 3, 2016: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/27664003/early-surgery-versus-watchful-waiting-for-asymptomatic-severe-aortic-valve-stenosis-a-hot-topic-for-the-past-20%C3%A2-years
#14
Sylvestre Marechaux, Christophe Tribouilloy
No abstract text is available yet for this article.
September 23, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27643238/os-01-01-association-of-lp-pla2-mass-and-aysmptomatic-intracranial-and-extracranial-arterial-stenosis-in-hypertension-patients
#15
Yan Wang, Jin Zhang, Yuesheng Qian, Xiaofeng Tang, Huawei Ling, Kemin Chen, Pingjin Gao, Dingliang Zhu
OBJECTIVE: Intracranial arterial stenosis (ICAS) is a common cause of ischemic stroke in Asians, whereas whites tend to have more extracranial lesions. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been associated with ischemic stroke by a large amount of work. However, there are few studies focusing on the relationship of Lp-PLA2 and asymptomatic ICAS or extracranial arterial stenosis (ECAS). We hereby sought to explore the relationship of Lp-PLA2 and ICAS, ECAS and concurrent stenosis in stroke-free hypertensive patients in Chinese population...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27639765/should-we-reappraise-surgical-indications%C3%A2-in-asymptomatic-severe-high-gradient-aortic%C3%A2-stenosis
#16
Jean-Louis Vanoverschelde, Sophie Pierard
No abstract text is available yet for this article.
September 8, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27639763/asymptomatic-severe-aortic-stenosis-in%C3%A2-the-elderly
#17
Robert Zilberszac, Harald Gabriel, Michael Schemper, Günther Laufer, Gerald Maurer, Raphael Rosenhek
OBJECTIVES: This study sought to assess the natural history and optimal timing of surgery in elderly patients with severe asymptomatic aortic stenosis (AS). BACKGROUND: AS is increasingly diagnosed in an aging population, and large numbers of elderly patients are undergoing aortic valve procedures. However, the average age of patients represented in most natural history studies on AS is between 60 and 70 years. METHODS: A total of 103 consecutive patients >70 years of age (51 female; mean age 77 ± 5 years) with asymptomatic severe AS (peak aortic jet velocity [AV-Vel] 4...
September 8, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27590534/results-of-celiac-trunk-stenting-during-fenestrated-or-branched-aortic-endografting
#18
Hélène Wattez, Teresa Martin-Gonzalez, Benjamin Lopez, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Jonathan Sobocinski, Stéphan Haulon
BACKGROUND: Endovascular repair of aortic aneurysms involving the visceral segment of the aorta often requires placement of a covered bridging stent in the celiac axis (CA). The median arcuate ligament (MAL) is a fibrous arch that unites the diaphragmatic crura on either side of the aortic hiatus. The ligament may compress and distort the celiac artery and result in difficult cannulation, or stenosis and occlusion of the vessel. This study evaluated the influence of the MAL compression on the technical success and the patency of the celiac artery after branched and fenestrated endovascular aortic repair...
August 30, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27580533/factors-influencing-the-prognosis-of-octogenarians-with-aortic-stenosis-in-the-advanced-aging-societies
#19
Shuai Liang, Kazuto Yamaguchi, Hiroyuki Yoshitomi, Saki Ito, Ryuma Nakashima, Takashi Sugamori, Akihiro Endo, Nobuyuki Takahashi, Kazuaki Tanabe
Objective The recognition of clinical symptoms is critical to developing an effective therapeutic strategy for aortic valve stenosis (AS). Although AS is common, little is known about the factors influencing the natural history of AS patients who are 80 years of age older in advanced aging societies. We investigated the natural history and indications for valve procedures in AS patients of 80 years of age or older. Methods The medical records of 108 consecutive AS patients (moderate grade or higher) who are 80 years of age or older (mean age, 84...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27576373/branch-graft-patency-after-open-repair-of-thoracoabdominal-aortic-aneurysms
#20
Nicholas T Kouchoukos, Alexander Kulik, Catherine Castner
OBJECTIVES: The long-term function of branch grafts to the visceral and renal arteries during open thoracoabdominal aortic aneurysm repair is unknown. We assessed the patency of single and multiple branch grafts with postoperative imaging studies in patients followed for up to 13 years. METHODS: A total of 99 of 130 patients undergoing open thoracoabdominal aortic aneurysm repair who received a total of 298 branch grafts to the celiac, superior mesenteric, and renal arteries were evaluated with serial imaging studies at 6- to 12-month intervals...
August 6, 2016: Journal of Thoracic and Cardiovascular Surgery
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