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Aortic valve stenosis

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https://www.readbyqxmd.com/read/28433492/is-tavr-ready-for-the-global-aging-population
#1
REVIEW
Travis Bergmann, Partho P Sengupta, Jagat Narula
The emergence of the global pandemic of chronic diseases necessitates critical assessment of interventions that can be targeted at both the individual and population levels. Among cardiovascular diseases, the increasing prevalence of valvular heart diseases such as aortic stenosis parallels the rising burden of atherosclerotic cardiovascular diseases. As an alternative to surgical aortic valve replacement, technological innovation has allowed development of minimally invasive transcatheter aortic valve replacement (TAVR)...
April 19, 2017: Global Heart
https://www.readbyqxmd.com/read/28433490/evaluating-health-of-emerging-economies-through-the-eyes-of-heart-valve-disease-in%C3%A2-the%C3%A2-transcatheter-era
#2
REVIEW
Sameer Arora, Cassandra J Ramm, Amol A Bahekar, John P Vavalle
China and India are the 2 fastest growing major world economies. However, they suffer from great differences in health policies, demographics, and rates of population growth. Whereas China has seen a steep decline in rheumatic heart disease (RHD) and a rise in life expectancy, India continues to suffer from a significant burden of RHD due to insufficient distribution of economic prosperity to health care, denser population, and ineffective application of World Health Organization RHD prevention guidelines. As China faces the burden of the world's largest geriatric population, focus has shifted to calcific aortic stenosis for which it prepares by expansions in the field of transcatheter aortic valve replacement...
April 19, 2017: Global Heart
https://www.readbyqxmd.com/read/28432156/epidemiology-of-valvular-heart-disease-in-a-swedish-nationwide-hospital-based-register-study
#3
Pontus Andell, Xinjun Li, Andreas Martinsson, Charlotte Andersson, Martin Stagmo, Bengt Zöller, Kristina Sundquist, J Gustav Smith
OBJECTIVE: Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking. METHODS: We used nationwide registers to identify all patients with a first diagnosis of VHD at Swedish hospitals between 2003 and 2010. Age-stratified and sex-stratified incidence of each VHD and adjusted comorbidity profiles were assessed...
April 21, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28431738/aortic-valve-replacement-in-low-flow-low-gradient-aortic-stenosis-left-ventricular-ejection-fraction-matters
#4
EDITORIAL
Victor Dayan, Philippe Pibarot
No abstract text is available yet for this article.
April 2, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28431442/-aortic-valve-stenosis-when-to-treat-interventionally-when%C3%A2-surgically
#5
Won-Keun Kim, Christian W Hamm
The mainstay for the current treatment of severe aortic stenosis includes surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). In patients with high operative risk TAVI is established as first line therapy. New data on intermediate and low risk groups demonstrate at least non-inferiority of TAVI against SAVR, and in the near future a consistently rising number of transcatheter procedures may be anticipated. The purpose of this review is to outline the decision making process, hence to illustrate the diagnostic algorithm and to provide criteria for a differentiated approach against the background of recent data...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28431214/interferon-%C3%AE-released-by-activated-cd8-t-lymphocytes-impairs-the-calcium-resorption-potential-of-osteoclasts-in-calcified-human-aortic-valves
#6
Edit Nagy, Yang Lei, Eduardo Martínez-Martínez, Simon C Body, Florian Schlotter, Michael Creager, Alexander Assmann, Kamal Khabbaz, Peter Libby, Göran K Hansson, Elena Aikawa
Calcium content in patients with calcific aortic valve disease (CAVD) correlates with the severity of stenosis. In CAVD, activated T lymphocytes localize with osteoclast regions; however, the functional consequences of this association remain unknown. We hypothesized that CD8(+) T cells modulate calcification in CAVD. Explanted CAVD valves (n = 52) dissected into noncalcified and calcified portions were subjected to mRNA extraction, real-time quantitative PCR, enzyme-linked immunosorbent assay, and immunohistochemical analyses...
April 18, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#7
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28429500/electrocardiographic-appearance-of-aortic-stenosis-before-and-after-aortic-valve-replacement
#8
Ivana I Vranic
BACKGROUND: So far, the specific appearance of QRS complex, ST-segment, and T wave was observed in aortic stenosis (AS). S-wave dynamic change in leads V1 -V3 was not reported in AS. METHODS: In a single-center, prospective study, we included a total number of 1.175 patients who underwent surgical aortic valve replacement (AVR). We conducted 3-year gathering of patients with symptomatic and asymptomatic severe AS, and separated them by hemodynamic stability into groups A and B, through EFLV (of more or less than 50%), AVA (of more or less than 0...
April 21, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28427598/computed-tomography-based-oversizing-degrees-and-incidence-of-paravalvular-regurgitation-of-a-new-generation-transcatheter-heart-valve
#9
Philipp Blanke, Philippe Pibarot, Rebecca Hahn, Neil Weissman, Susheel Kodali, Vinod Thourani, Rupa Parvataneni, Danny Dvir, Christopher Naoum, Bjarne L Nørgaard, Pamela Douglas, Wael Jaber, Omar K Khalique, Hasan Jilaihawi, Michael Mack, Craig Smith, Martin Leon, John Webb, Jonathon Leipsic
OBJECTIVES: The aim of the study was to investigate the influence of the extent of computed tomography (CT)-based area and perimeter oversizing on the incidence and severity of paravalvular aortic regurgitation (PAR) for the Edwards SAPIEN 3 (Edwards Lifesciences, Irvine, California) device, using CT data and echocardiographic outcome data of the PARTNER II (Placement of AoRTic TraNscathetER Valves Trial II) SAPIEN 3 intermediate-risk cohort. BACKGROUND: Transcatheter heart valve (THV) sizing algorithms are device specific, requiring refinements for new valve designs...
April 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28425248/the-effect-of-transcatheter-aortic-valve-implantation-on-mean-platelet-volume
#10
Mehmet Burak Özen, Hüseyin Ayhan, Hacı Ahmet Kasapkara, Telat Keleş, Tahir Durmaz, Kemal Eşref Erdoğan, Bilge Duran Karaduman, Serdal Baştuğ, Cenk Sari, Abdullah Nabi Aslan, Engin Bozkurt
BACKGROUND/AIM: Transcatheter aortic valve implantation (TAVI) is an innovative approach to the treatment of aortic stenosis (AS) as an alternative to surgery in high-risk patients. Mean platelet volume (MPV) is considered an indicator of endothelial dysfunction, platelet function, and activation. In this study, we aimed to investigate MPV changes in patients undergoing TAVI. MATERIALS AND METHODS: This study included 100 patients diagnosed with symptomatic severe AS and treated with TAVI between July 2011 and August 2013...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28420669/a-possible-early-biomarker-for-bicuspid-aortopathy-circulating-transforming-growth-factor-beta-1-to-soluble-endoglin-ratio
#11
Amalia Forte, Ciro Bancone, Gilda Cobellis, Marianna Buonocore, Giuseppe Santarpino, Theodor Fischlein, Marilena Cipollaro, Marisa De Feo, Alessandro Della Corte
Rationale: The pathogenesis of bicuspid aortic valve (BAV)-associated aortopathy is poorly understood and no prognostic biomarker is currently available. Objective: We aimed to identify putative circulating biomarkers pathogenetically and prognostically linked to bicuspid aortopathy. Methods and Results: By RT-PCR, we evaluated gene expression variations (versus normal aorta) of transforming growth factor-beta1 (TGF-β1), connective tissue growth factor (CTGF), matrix metalloproteinase-2 (MMP-2), MMP-14, endoglin (ENG) and superoxide dismutase 3 (SOD3) in ascending aorta samples from 50 tricuspid and 70 BAV patients undergoing surgery for aortic stenosis (aorta diameter ≤45mm: BAVnon-dil or >45mm: BAVdil)...
April 18, 2017: Circulation Research
https://www.readbyqxmd.com/read/28418954/aortic-root-abscess-clearly-shown-on-111in-leukocyte-scan-but-less-obvious-on-transesophageal-echocardiogram
#12
Harleen Kaur, John Seitz, Mitchel Muhleman, David Cragg, Feng Qing
A 79-year-old man with history of aortic stenosis, status post bioprosthetic aortic valve replacement, episodes of bacteremia, and endocarditis presented to hospital with fever. Clinical assessment led to suspicion of possible endocarditis. Initial interpretation of transesophageal echocardiogram was inconclusive without vegetation in mitral/aortic valve. An In-leukocyte scan demonstrated increased uptake in the area of aortic valve, suggestive of infection. Further review of the transesophageal echocardiogram showed signs of annular abscess...
April 17, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28415120/p1088match-and-mismatch-between-opening-area-and-resistance-in-mild-and-moderate-rheumatic-mitral-stenosis
#13
I El-Dosouky
Background: Mitral valve resistance (MVR) is a hemodynamic consequence of mitral stenosis but it has no clear threshold and it has a shortage of data to be reliable. Purpose: is to investigate match and mismatch between opening area and resistance especially in patients with moderate and mild mitral stenosis. Materials: This cross section case control study comprised 88 patients with moderate and mild rheumatic mitral stenosis. Transthorathic echocardiographic study estimated: mitral valve area (MVA) both by planimerty (2D) and pressure half time (PHT), mitral valve score (MVS), mean transmitral pressure gradient (MPG), diastolic filling time(DFT), left ventricular out flow tract diameter (LVOTd) and velocity time integral (LVOT vti) , the MVR was calculated as: MPG/aortic flow ratio [(LVOTd) (LVOTvti)/ DFT] in dynes...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28415115/p981lvot-area-measurement-using-gated-ct-data-reclassifies-aortic-stenosis-severity-as-graded-by-echocardiography
#14
L Moderato, A Palumbo, S Coli, D Orlandini, G Russo, N Gaibazzi
Background: Measurement of left ventricular outflow tract (LVOT) diameter and area for estimation of aortic valve area (AVA) using transthoracic echocardiography (TTE) and the continuity equation assumes circular LVOT. The use of direct planimetric measurement of LVOT area by gated-CT can theoretically improve accuracy of AVA calculation. Purpose: We aim to assess reproducibility of LVOT echo measurement and its correlation and agreement with Gated CT measurements...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28415104/p697new-indices-for-a-best-quantification-of-left-ventricular-function-in-heart-valve-diseases
#15
A Hubert, E Galli, G Bouzille, E Samset, E Donal
Aims. The Assessment of left ventricular (LV) function remains a clinical challenge especially in patients with preserved LV ejection fraction (EF) and valvular heart diseases (VHD). Mechanical dispersion is supposed to be a strong predictor of events and, to be related to the extent of fibrosis. Regional cardiac work is a new validated and very promising approach to quantify LV-function. We investigated the differences in mechanical dispersions and global LV work (totW) and wasted work fraction (WWF) in normal subjects and in patients with severe primary mitral regurgitation (MR) and severe aortic stenosis (AS)...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28415102/p650influence-of-fetunin-a-level-on-progression-of-calcific-aortic-valve-stenosis-the-cofrasa-generac-study
#16
N Kubota, Dmz David Messika-Zeitoun
Background.: In recent years, pathophysiology of aortic stenosis (AS) has been considered as a possibly active inflammatory process, but its determinants remain unclear. Calcium tissue deposition observed in dilaysis patients have been linked to low level of Fetuin-A, a powerful inhibitor of ectopic calcification. It is thus suspected to play a role in development of aortic stenosis. Purpose.: To assess correlation between Fetuin-A level and AS progression in a prospective cohort of AS patients, COFRASA (clinicalTrial...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28415097/p544the-importance-of-contractile-reserve-when-assessing-asymptomatic-patients-with-aortic-stenosis
#17
J J Van Zalen, S Badiani, L Hart, A Marshall, N Patel, G Lloyd
Asymptomatic patients may exhibit symptoms during objective exercise testing, but whether symptoms are due to the obstructively of the valve (typified by the mean gradient) or underlying ventricular function remains unknown. While the mean gradient is an easy parameter to measure no consensus about the measurement of contractile reserve exists. Longitudinal abnormalities may occur in the presence of a normal ejection fraction and the augmentation of these parameters is poorly described. To obtain an objective regarding patients exercise ability is best determined using cardiopulmonary exercise testing...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28412434/a-highly-predictive-risk-model-for-pacemaker-implantation-after-tavr
#18
Yoshio Maeno, Yigal Abramowitz, Hiroyuki Kawamori, Yoshio Kazuno, Shunsuke Kubo, Nobuyuki Takahashi, Geeteshwar Mangat, Kazuaki Okuyama, Mohammad Kashif, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, John Friedman, Daniel Berman, Raj R Makkar, Hasan Jilaihawi
OBJECTIVES: This study sought to develop a robust and definitive risk model for new permanent pacemaker implantation (PPMI) after SAPIEN 3 (third generation balloon expandable valve) (Edwards Lifesciences, Irvine, California) transcatheter aortic valve replacement (third generation balloon expandable valve TAVR), including calcification in the aortic-valvular complex (AVC). BACKGROUND: The association between calcium in the AVC and need for PPMI is poorly delineated after third generation balloon expandable valve TAVR...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28412115/outcome-of-isolated-aortic-valve-replacement-in-patients-with-classic-and-paradoxical-low-flow-low-gradient-aortic-stenosis
#19
Ana Lopez-Marco, Harriet Miller, Pankaj Kumar, Saeed Ashraf, Afzal Zaidi, Farah Bhatti, Adrian Ionescu, Aprim Youhana
OBJECTIVE: To analyze operative outcomes and mid-term results after isolated aortic valve replacement (AVR) in low-flow, low-gradient aortic stenosis (LFLG AS) by comparing the 2 subcategories (classic low-flow, low-gradient aortic stenosis [CLFLG] and paradoxical low-flow, low-gradient aortic stenosis [PLFLG]). METHODS: This was a retrospective analysis of prospectively collected data for all isolated AVR in LFLG AS performed in our center during the last 13 years (n = 198; CLFLG AS, n = 66, 33% and PLFLG AS, n = 132, 67%)...
March 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28412039/distal-left-main-trifurcation-disease-in-a-patient-with-porcelain-aorta
#20
Ulises Lopez-Peña, Francisco Garcia-Garcia, Rogelio Robledo-Nolasco, Ernesto Fernandez-Ceseña, Ricardo Borrego-Montoya, Neisser Morales
Coronary trifurcation lesions are a complex subset of lesions and are substantially more complex than bifurcations when treated with percutaneous coronary intervention (PCI) because of higher rates of acute periprocedural complications (dissection, myocardial infarction, acute vessel closure) and less effective long-term outcomes (stent thrombosis, restenosis) as compared to non-bifurcation lesions. We present the case of a 73-year-old man who was admitted to our hospital with symptomatic severe aortic stenosis who was found to have a distal left main trifurcation disease as well as porcelain aorta on work-up...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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