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Asymptomatic aortic stenosis

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https://www.readbyqxmd.com/read/29339687/subclinical-left-ventricular-systolic-dysfunction-in-patients-with-severe-aortic-stenosis-a-speckle-tracking-echocardiography-study
#1
Betül Cengiz, Şükrü Taylan Şahin, Selen Yurdakul, Serkan Kahraman, Ayşen Bozkurt, Saide Aytekin
OBJECTIVE: In patients with aortic stenosis (AS), the left ventricular (LV) geometry changes due to the increased LV afterload. However, subclinical myocardial dysfunction can develop despite a normal LV ejection fraction (EF). This study was an investigation of subclinical LV systolic dysfunction in patients with severe AS with a normal LV EF using a strain imaging method, speckle-tracking echocardiography (STE), and an evaluation of its correlation with novel indices to assess the severity of AS...
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29330520/association-of-homocysteine-with-aysmptomatic-intracranial-and-extracranial-arterial-stenosis-in-hypertension-patients
#2
Yan Wang, Jin Zhang, Yuesheng Qian, Xiaofeng Tang, Huawei Ling, Kemin Chen, Yan Li, Pingjin Gao, Dingliang Zhu
Elevated plasma homocysteine (Hcy) is suggested as an independent risk factor for stroke. We aimed to investigate the association of Hcy concentration with intracranial atherosclerosis (ICAS) and extracranial AS (ECAS) in hypertensive patients without stroke in Chinese population and to explore modified effect of methylenetetrahydrofolate reductase (MTHFR) C677T on their relationship. The stenosis of intracranial and extracranial arteries were evaluated in a total of 929 subjects through computerized tomographic angiography (CTA) from aortic arch to the skull base...
January 12, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29326776/aorto-right-ventricular-fistula-following-percutaneous-transcatheter-aortic-valve-replacement-case-report-and-literature-review
#3
Monoj K Konda, Jagadeesh K Kalavakunta, Jerry W Pratt, David Martin, Vishal Gupta
An 88-year-old woman with a prior history of aortic stenosis and history of valvuloplasty presented with worsening symptoms of heart failure and dizziness. She underwent successful transcatheter aortic valve replacement (TAVR) without complications. Follow-up echocardiograms revealed a small fistula connecting aorta to the right ventricle. The patient was initially asymptomatic but 3 months later developed overload of the right ventricle and heart failure and chose to continue medical therapy. She died of progressive heart failure at 9 months from onset of fistula...
October 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/29290389/treatment-strategies-in-symptomatic-intermediate-low-risk-and-asymptomatic-patients-with-severe-aortic-stenosis
#4
Marko D Banovic, Serge D Nikolic
Survival of symptomatic patients with severe aortic stenosis (AS) is very poor, with an average mortality reaching up to 2% per month. Approach to diagnosis and treatment of patients with AS was conservative; patients were referred to surgery only if the AS-induced symptoms become apparent and significantly limit the quality of patient' life. In the past 15 years, the novel treatment strategy in subgroups of symptomatic patients with AS have been the subject of extensive research, starting from introduction of transcatheter aortic valve implant (TAVI) in inoperable symptomatic patients with severe AS and continuing further to patients with very high and high operative risk...
December 12, 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29279888/prevalence-of-systemic-atherosclerosis-burdens-and-overlapping-stroke-etiologies-and-their-associations-with-long-term-vascular-prognosis-in-stroke-with-intracranial-atherosclerotic-disease
#5
Takao Hoshino, Leila Sissani, Julien Labreuche, Gregory Ducrocq, Philippa C Lavallée, Elena Meseguer, Céline Guidoux, Lucie Cabrejo, Cristina Hobeanu, Fernando Gongora-Rivera, Pierre-Jean Touboul, Philippe Gabriel Steg, Pierre Amarenco
Importance: Patients who have experienced stroke with intracranial atherosclerotic disease (ICAD) may also have concomitant atherosclerosis in different arterial beds and other possible causes for ischemic stroke. However, little is known about the frequency and prognostic effect of such overlapping diseases. Objectives: To describe the prevalence of systemic atherosclerotic burdens and overlapping stroke etiologies and their contributions to long-term prognoses among patients who have experienced stroke with ICAD...
December 26, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29248646/symptom-onset-in-aortic-stenosis-relation-to-sex-differences-in-left-ventricular-remodeling
#6
Anvesha Singh, Daniel C S Chan, John P Greenwood, Dana K Dawson, Piotr Sonecki, Kai Hogrefe, Damian J Kelly, Vijay Dhakshinamurthy, Chim C Lang, Jeffery P Khoo, David Sprigings, Richard P Steeds, Ruiqi Zhang, Ian Ford, Michael Jerosch-Herold, Jing Yang, Zhuyin Li, Leong L Ng, Gerry P McCann
OBJECTIVES: The aim of this study was to establish sex differences in remodeling and outcome in aortic stenosis (AS) and their associations with biomarkers of myocardial fibrosis. BACKGROUND: The remodeling response and timing of symptoms is highly variable in AS, and sex plays an important role. METHODS: A total of 174 patients (133 men, mean age 66.2 ± 13.3 years) with asymptomatic moderate to severe AS underwent comprehensive stress cardiac magnetic resonance imaging, transthoracic echocardiography, and biomarker analysis (matrix metalloproteinase [MMP]-2, -3, -7, -8, and -9; tissue inhibitor matrix metalloproteinases-1 and -4; syndecan-1 and -4; and N-terminal pro-B-type natriuretic peptide), and were followed up at 6-month intervals...
December 8, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29217633/stress-echocardiography-in-patients-with-native-valvular-heart-disease
#7
REVIEW
Patrizio Lancellotti, Raluca Dulgheru, Yun Yun Go, Tadafumi Sugimoto, Stella Marchetta, Cécile Oury, Madalina Garbi
Valve stress echocardiography (VSE) can be performed as exercise stress echocardiography (ESE) or dobutamine stress echocardiography (DSE) depending on the patient's clinical status, severity and type of valve disease. ESE combines exercise testing with two-dimensional grey scale and Doppler echocardiography during exercise. Thus, it provides objective assessment of symptomatic status (exercise test), as well as exercise-induced changes of a series of echocardiographic parameters (different depending on the valve disease type), which yield prognostic information in individual patients and help in a better treatment planning...
December 7, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29195844/leaflet-thrombosis-following-transcatheter-aortic-valve-implantation
#8
M Marwan, N Mekkhala, M Göller, J Röther, D Bittner, A Schuhbaeck, M Hell, G Muschiol, J Kolwelter, R Feyrer, C Schlundt, S Achenbach, M Arnold
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is increasingly being offered to high-risk patients with symptomatic aortic valve stenosis. Recent reports have suggested a high incidence of subclinical leaflet thrombosis following bioprosthestic aortic valve replacement. We report the frequency and clinical presentation of leaflet thrombosis identified by cardiac CT in patients referred for follow-up contrast enhanced CT angiography following TAVI. METHODS: 91 consecutive patients referred for follow-up contrast-enhanced CT angiography following TAVI were screened for inclusion in this analysis...
November 9, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29180457/antihypertensive-treatment-with-%C3%AE-blockade-in-patients-with-asymptomatic-aortic-stenosis-and-association-with-cardiovascular-events
#9
Casper N Bang, Anders M Greve, Anne B Rossebø, Simon Ray, Kenneth Egstrup, Kurt Boman, Christoph Nienaber, Peter M Okin, Richard B Devereux, Kristian Wachtell
BACKGROUND: Patients with aortic stenosis (AS) often have concomitant hypertension. Antihypertensive treatment with a β-blocker (Bbl) is frequently avoided because of fear of depression of left ventricular function. However, it remains unclear whether antihypertensive treatment with a Bbl is associated with increased risk of cardiovascular events in patients with asymptomatic mild to moderate AS. METHODS AND RESULTS: We did a post hoc analysis of 1873 asymptomatic patients with mild to moderate AS and preserved left ventricular ejection fraction in the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) study...
November 27, 2017: Journal of the American Heart Association
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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