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https://www.readbyqxmd.com/read/28714932/thrombospondins-a-role-in-cardiovascular-disease
#1
REVIEW
Dimitry A Chistiakov, Alexandra A Melnichenko, Veronika A Myasoedova, Andrey V Grechko, Alexander N Orekhov
Thrombospondins (TSPs) represent extracellular matrix (ECM) proteins belonging to the TSP family that comprises five members. All TSPs have a complex multidomain structure that permits the interaction with various partners including other ECM proteins, cytokines, receptors, growth factors, etc. Among TSPs, TSP1, TSP2, and TSP4 are the most studied and functionally tested. TSP1 possesses anti-angiogenic activity and is able to activate transforming growth factor (TGF)-β, a potent profibrotic and anti-inflammatory factor...
July 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28712585/conduction-disturbance-after-isolated-surgical-aortic-valve-replacement-in-degenerative-aortic-stenosis
#2
You Mi Hwang, Jun Kim, Ji Hyun Lee, Minsu Kim, Jongmin Hwang, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Gi Byoung Nam, Kee Joon Choi, Cheol Hyun Chung, Jae Won Lee, You Ho Kim
OBJECTIVE: Conduction disturbances are common in patients with aortic stenosis. We investigated the incidence, reversibility, and prognosis of conduction disorders requiring permanent pacemaker implantation in patients with degenerative aortic stenosis after isolated aortic valve replacement. METHODS: This was a retrospective study conducted at a tertiary care center. We evaluated the incidence of conduction disturbances in patients who underwent isolated surgical aortic valve replacement for aortic stenosis between January 2005 and May 2015...
June 15, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28712069/left-atrial-dysfunction-as-a-determinant-of-pulmonary-hypertension-in-patients-with-severe-aortic-stenosis-and-preserved-left-ventricular-ejection-fraction
#3
Andreea Calin, Anca D Mateescu, Monica Rosca, Carmen C Beladan, Roxana Enache, Simona Botezatu, Iulian Cosei, Cosmin Calin, Marian Simion, Carmen Ginghina, Andreea C Popescu, Bogdan A Popescu
In patients with severe aortic stenosis (AS), the presence of pulmonary hypertension (PH) has been linked to a poor prognosis. We aimed to assess the main determinants of PH in patients with severe AS and preserved left ventricular ejection fraction (LVEF). We prospectively enrolled 108 consecutive patients with isolated severe AS (indexed aortic valve area <0.6 cm(2)/m(2)) and LVEF >50%, in sinus rhythm. Left atrial (LA) function was assessed using longitudinal deformation parameters (by speckle tracking echocardiography)...
July 15, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28710182/elevation-of-b-type-natriuretic-peptide-at-discharge-is-associated-with-2-year-mortality-after-transcatheter-aortic-valve-replacement-in-patients-with-severe-aortic-stenosis-insights-from-a-multicenter-prospective-ocean-tavi-optimized-transcatheter-valvular
#4
Kazuki Mizutani, Masahiko Hara, Shinichi Iwata, Takashi Murakami, Toshihiko Shibata, Minoru Yoshiyama, Toru Naganuma, Futoshi Yamanaka, Akihiro Higashimori, Norio Tada, Kensuke Takagi, Motoharu Araki, Hiroshi Ueno, Minoru Tabata, Shinichi Shirai, Yusuke Watanabe, Masanori Yamamoto, Kentaro Hayashida
BACKGROUND: In this study, we sought to investigate the 2-year prognostic impact of B-type natriuretic peptide (BNP) levels at discharge, following transcatheter aortic valve replacement. METHODS AND RESULTS: We enrolled 1094 consecutive patients who underwent transcatheter aortic valve replacement between 2013 and 2016. Study patients were stratified into 2 groups according to survival classification and regression tree analysis (high versus low BNP groups). We evaluated the impact of high BNP on 2-year mortality compared with that of low BNP using a multivariable Cox model, and assessed whether this stratification would improve predictive accuracy for determining 2-year mortality by assessing time-dependent net reclassification improvement and integrated discrimination improvement...
July 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28710181/severe-aortic-stenosis-in-dialysis-patients
#5
Yuichi Kawase, Tomohiko Taniguchi, Takeshi Morimoto, Kazushige Kadota, Keiichiro Iwasaki, Akimune Kuwayama, Masanobu Ohya, Takenobu Shimada, Hidewo Amano, Takeshi Maruo, Yasushi Fuku, Chisato Izumi, Takeshi Kitai, Naritatsu Saito, Eri Minamino-Muta, Takao Kato, Tsukasa Inada, Moriaki Inoko, Katsuhisa Ishii, Tatsuhiko Komiya, Michiya Hanyu, Kenji Minatoya, Takeshi Kimura
BACKGROUND: Characteristics and prognosis of hemodialysis patients with severe aortic stenosis have not yet been well defined. METHODS AND RESULTS: The CURRENT AS (contemporary outcomes after surgery and medical treatment in patients with severe aortic stenosis) registry, a Japanese multicenter registry, enrolled 3815 consecutive patients with severe aortic stenosis. There were 405 hemodialysis patients (initial aortic valve replacement [AVR] group: N=135 [33.3%], and conservative group: N=270) and 3410 nonhemodialysis patients (initial AVR group: N=1062 [31...
July 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28709382/severe-aortic-valve-stenosis-due-to-alkaptonuric-ochronosis
#6
Magdy El-Sayed Ahmed, Omar Hussain, David A Ott, Muhammad Aftab
Alkaptonuric ochronosis is a rare cause of aortic valve stenosis. We report the case of a 61-year-old female patient with alkaptonuria who presented to our institute with the clinical picture of severe aortic valve stenosis, which was confirmed by transthoracic echocardiography. On aortotomy, she was noted to have an impressive black discoloration of ascending aorta and the aortic root complex involving the aortic valve leaflets. She underwent an uneventful aortic valve replacement. She was discharged home 10 days postoperatively...
July 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28707021/the-response-to-trendelenburg-position-is-minimally-affected-by-underlying-hemodynamic-conditions-in-patients-with-aortic-stenosis
#7
Abraham Sonny, Daniel I Sessler, Jing You, Babak Kateby Kashy, Sheryar Sarwar, Akhil K Singh, Shiva Sale, Andrej Alfirevic, Andra E Duncan
PURPOSE: Trendelenburg positioning is commonly used to temporarily treat intraoperative hypotension. The Trendelenburg position improves cardiac output in normovolemic or anesthetized patients, but not hypovolemic or non-anesthetized patients. Therefore, the response to Trendelenburg positioning may vary depending on patient population or hemodynamic conditions. We thus tested the hypothesis that the effectiveness of the Trendelenburg position, as indicated by an increase in cardiac output, improves after replacement of a stenotic aortic valve...
July 13, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28706584/assessment-of-aortic-valve-disease-a-clinician-oriented-review
#8
REVIEW
Andrei D Mǎrgulescu
Aortic valve disease [aortic stenosis (AS) and aortic regurgitation (AR)] represents an important global health problem; when severe, aortic valve disease carries poor prognosis. For AS, aortic valve replacement, either surgical or interventional, may provide definite treatment in carefully selected patients. For AR, valve surgery (either replacement or - in selected cases - aortic valve repair) remains the gold standard of care. To properly identify those patients who are candidates for surgery, the clinician has to carefully assess the severity of valve disease with an understanding of the potential pitfalls involved in these assessments...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28705379/prognostic-usefulness-of-cardiopulmonary-exercise-testing-for-managing-patients-with-severe-aortic-stenosis
#9
Van D Le, Gunnar V Jensen, Lars Kjøller-Hansen
The approach to managing asymptomatic or questionably symptomatic patients for aortic stenosis is difficult. We aimed to determine whether cardiopulmonary exercise testing (CPET) is prognostically useful in such patients. Patients judged asymptomatic or questionably symptomatic for aortic stenosis with aortic valve area index <0.6 cm(2)/m(2) and left ventricular ejection fraction ≥0.50 were managed conservatively provided they had either (group 1) normal peak oxygen consumption and peak oxygen pulse (>83% and >95% of the predicted values, respectively) or (group 2) subnormal peak oxygen consumption or peak oxygen pulse but with CPET data pointing to pathologies other than hemodynamic compromise from aortic stenosis...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28702876/cardiovascular-histopathology-of-a-11-year-old-with-mucopolysaccharidosis-vii-demonstrates-fibrosis-macrophage-infiltration-and-arterial-luminal-stenosis
#10
Valerie Lew, Louis Pena, Robert Edwards, Raymond Y Wang
Mucopolysaccharidosis type VII (MPS VII) is caused by β-glucuronidase deficiency, resulting in lysosomal accumulation of glycosaminoglycans (GAGs) and multisystemic disease. We present cardiovascular gross and histopathology findings from a 11-year-old MPS VII male, who expired after developing ventricular fibrillation following anesthesia induction. Gross anatomic observations were made at autopsy; postmortem formalin-fixed paraffin-embedded samples of the carotid artery, aorta, myocardium, and valves were sectioned and stained with hematoxylin-eosin, Verhoeff-Van Gieson, CD68, and trichrome stains...
July 13, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28701592/risk-factors-of-postcardiotomy-ventricular-dysfunction-in-moderate-to-high-risk-patients-undergoing-open-heart-surgery
#11
Christoph Ellenberger, Tornike Sologashvili, Mustafa Cikirikcioglu, Gabriel Verdon, John Diaper, Tiziano Cassina, Marc Licker
INTRODUCTION: Ventricular dysfunction requiring inotropic support frequently occurs after cardiac surgery, and the associated low cardiac output syndrome largely contributes to postoperative death. We aimed to study the incidence and potential risk factors of postcardiotomy ventricular dysfunction (PCVD) in moderate-to-high risk patients scheduled for open-heart surgery. METHODS: Over a 5-year period, we prospectively enrolled 295 consecutive patients undergoing valve replacement for severe aortic stenosis or coronary artery bypass surgery who presented with Bernstein-Parsonnet scores >7...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28701528/blood-pressure-and-arterial-load-after-transcatheter-aortic-valve-replacement-for-aortic-stenosis
#12
Brian R Lindman, Catherine M Otto, Pamela S Douglas, Rebecca T Hahn, Sammy Elmariah, Neil J Weissman, William J Stewart, Girma M Ayele, Feifan Zhang, Alan Zajarias, Hersh S Maniar, Hasan Jilaihawi, Eugene Blackstone, Khaja M Chinnakondepalli, E Murat Tuzcu, Martin B Leon, Philippe Pibarot
BACKGROUND: After aortic valve replacement, left ventricular afterload is often characterized by the residual valve obstruction. Our objective was to determine whether higher systemic arterial afterload-as reflected in blood pressure, pulsatile and resistive load-is associated with adverse clinical outcomes after transcatheter aortic valve replacement (TAVR). METHODS AND RESULTS: Total, pulsatile, and resistive arterial load were measured in 2141 patients with severe aortic stenosis treated with TAVR in the PARTNER I trial (Placement of Aortic Transcatheter Valve) who had systolic blood pressure (SBP) and an echocardiogram obtained 30 days after TAVR...
July 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28700016/primary-mitral-valve-regurgitation-outcome-in-patients-with-severe-aortic-stenosis-1-year-after-transcatheter-aortic-valve-implantation-echocardiographic-evaluation
#13
Thiago Marinho Florentino, David Le Bihan, Alexandre Antonio Cunha Abizaid, Alexandre Vianna Cedro, Amably Pessoa Corrêa, Alexandre Roginski Mendes Dos Santos, Alexandre Costa Souza, Tiago Costa Bignoto, José Eduardo Moraes Rego Sousa, Amanda Guerra de Moraes Rego Sousa
Background: Mitral valve regurgitation (MR), present in up to 74% of the patients with severe aortic stenosis (AS), can be a negative prognostic factor when moderate or severe. The outcome of MR after percutaneous transcatheter aortic valve implantation (TAVI) and predictors associated with that outcome have not been well established in the literature. Objective: To assess the outcome of primary MR in patients submitted to TAVI and to identify associated factors...
July 10, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28698585/effects-of-aortic-valve-replacement-on-severe-aortic-stenosis-and-preserved-systolic-function-systematic-review-and-network-meta-analysis
#14
Qishi Zheng, Andie H Djohan, Enghow Lim, Zee Pin Ding, Lieng H Ling, Luming Shi, Edwin Shih-Yen Chan, Calvin Woon Loong Chin
The survival benefits of aortic valve replacement (AVR) in the different flow-gradient states of severe aortic stenosis (AS) is not known. A comprehensive search in PubMed/MEDLINE, Embase, Cochrane Library, CNKI and OpenGrey were conducted to identify studies that investigated the prognosis of severe AS (effective orifice area ≤1.0 cm(2)) and left ventricular ejection fraction ≥50%. Severe AS was stratified by mean pressure gradient [threshold of 40 mmHg; high-gradient (HG) and low-gradient (LG)] and stroke volume index [threshold of 35 ml/m(2); normal-flow (NL) and low-flow (LF)]...
July 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28698413/-aortic-stenosis-combined-with-cold-agglutinin-disease
#15
Zaiqiang Yu, Masahito Minakawa, Takashi Aoki, Norihiro Kondo, Kazuyuki Daitoku, Yasuyuki Suzuki, Ikuo Fukuda
Cardiac surgery on a patient with cold agglutinin disease is high risk for thromboembolism due to hypothermia perioperative. A 75-year-old woman with cold agglutinin disease underwent aortic valve replacement for severe aortic stenosis. Cold antibody was detected by preoperative screening test for blood transfusion. In order to prevent thromboembolic event during the operation, we maintained rectal temperature at around 36 degrees centigrade during the cardiopulmonary bypass by warming blood in the bypass circuit...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28698290/clinical-and-echocardiographic-outcomes-following-permanent-pacemaker-implantation-after-transcatheter-aortic-valve-replacement-meta-analysis-and-meta-regression
#16
Divyanshu Mohananey, Yash Jobanputra, Arnav Kumar, Amar Krishnaswamy, Stephanie Mick, Jonathon M White, Samir R Kapadia
BACKGROUND: Transcatheter aortic valve replacement has become the procedure of choice for inoperable, high-risk, and many intermediate-risk patients with aortic stenosis. Conduction abnormalities are a common finding after transcatheter aortic valve replacement and often result in permanent pacemaker (PPM) implantation. Data pertaining to the clinical impact of PPM implantation are controversial. We used meta-analysis techniques to summarize the effect of PPM implantation on clinical and echocardiographic outcomes after transcatheter aortic valve replacement...
July 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28698259/reversibility-of-cardiac-function-predicts-outcome-after-transcatheter-aortic-valve-replacement-in-patients-with-severe-aortic-stenosis
#17
Kimi Sato, Arnav Kumar, Brandon M Jones, Stephanie L Mick, Amar Krishnaswamy, Richard A Grimm, Milind Y Desai, Brian P Griffin, L Leonardo Rodriguez, Samir R Kapadia, Nancy A Obuchowski, Zoran B Popović
BACKGROUND: Reversibility of left ventricular (LV) dysfunction in high-risk aortic stenosis patient and its impact on survival after transcatheter aortic valve replacement (TAVR) are unclear. We aimed to evaluate longitudinal changes of LV structure and function after TAVR and their impact on survival. METHODS AND RESULTS: We studied 209 patients with aortic stenosis who underwent TAVR from May 2006 to December 2012. Echocardiograms were used to calculate LV end-diastolic volume index (LVEDVi), LV ejection fraction, LV mass index (LVMi), and global longitudinal strain before, immediately (<10 days), late (1-3 months), and yearly after TAVR...
July 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28698175/echocardiographic-aortic-valve-calcification-and-outcomes-in-women-and-men-with-aortic-stenosis
#18
Henrik K Thomassen, Giovanni Cioffi, Eva Gerdts, Eigir Einarsen, Helga Bergljot Midtbø, Constantino Mancusi, Dana Cramariuc
OBJECTIVE: Sex differences in risk factors of aortic valve calcification (AVC) by echocardiography have not been reported from a large prospective study in aortic stenosis (AS). METHODS: AVC was assessed using a prognostically validated visual score and grouped into none/mild or moderate/severe AVC in 1725 men and women with asymptomatic AS in the Simvastatin Ezetimibe in Aortic Stenosis study. The severity of AS was assessed by the energy loss index (ELI) taking pressure recovery in the aortic root into account...
July 11, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28696036/cervical-artery-dissection-expands-the-cardiovascular-phenotype-in-fbn1-related-weill-marchesani-syndrome
#19
Kelsey Newell, Wendy Smith, Brian Ghoshhajra, Eric Isselbacher, Angela Lin, Mark E Lindsay
Weill-Marchesani syndrome (WMS) is a rare form of acromelic dysplasia that is characterized by distinctive skeletal, ocular, and cardiovascular abnormalities. Previously described cardiac manifestations of WMS include aortic and pulmonary valve stenosis, mitral valve prolapse, mitral stenosis, and QTc prolongation. Autosomal dominant forms of WMS result from heterozygous pathogenic variants in FBN1, a gene with a well characterized role in the pathogenesis of thoracic aortic aneurysm (TAA) in the context of Marfan syndrome...
July 11, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28695557/impact-of-new-technologies-and-experience-on-procedural-aspects-of-surgical-aortic-valve-replacement-a-process-analysis
#20
Bettina Langhammer, Maria Nucera, Lars Englberger, Eva Roost, David Reineke, Florian Schönhoff, Henriette Most, Bernhard Winkler, Fabian Gisler, Thierry Carrel, Christoph Huber
BACKGROUND: Surgical aortic valve replacement (SAVR) is the treatment of choice in severe symptomatic aortic valve disease. New techniques and prostheses have been recently developed to facilitate the procedure and reduce aortic cross-clamp time (AOx). The aim of this study was to analyse the different procedural steps in order to identify the most time-consuming part during aortic clamping time and to compare impact of experience on procedural aspects. METHODS: AOx during SAVR was divided into five consecutive steps...
July 11, 2017: Swiss Medical Weekly
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