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Christophe Baufreton, Patrick Bruneval, Marie-Christine Rousselet, Pierre-Vladimir Ennezat, Olivier Fouquet, Raphael Giraud, Carlo Banfi
RATIONALE: Drug-induced valvular heart disease (DI-VHD) remains an under-recognized entity. PATIENT CONCERNS: This report describes a heart valve replacement which was complicated by intractable systemic pulmonary arterial hypertension in a 61-year-old female with severe restrictive mitral and aortic disease. The diagnosis of valvular disease was preceded by a history of unexplained respiratory distress. The patient had been exposed to benfluorex for 6.5 years. DIAGNOSES: The diagnostic procedure documented specific drug-induced valvular fibrosis...
January 2017: Medicine (Baltimore)
Erich J Baker, Nicole A R Walter, Alex Salo, Pablo Rivas, Sharon Moore, Steven Gonzales, Kathleen A Grant
BACKGROUND: The Monkey Alcohol and Tissue Research Resource (MATRR) is a repository and analytics platform for detailed data derived from well-documented Non-Human Primate (NHP) alcohol self-administration studies. This macaque model has demonstrated categorical drinking norms reflective of human drinking populations, resulting in consumption pattern classifications of Very Heavy Drinking (VHD), Heavy Drinking (HD), Binge Drinking (BD), and Low Drinking (LD) individuals. Here we expand on previous findings that suggest ethanol drinking patterns during initial drinking to intoxication can reliably predict future drinking category assignment...
January 5, 2017: Alcoholism, Clinical and Experimental Research
Ryan E Owens, Rajesh Kabra, Carrie S Oliphant
Direct oral anticoagulants (DOACs) are indicated for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), which, according to the American College of Cardiology/American Heart Association/Heart Rhythm Society atrial fibrillation (AF) guidelines, excludes patients with rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair. However, the data regarding use of DOACs in AF patients with other types of valvular heart disease (VHD) are unclear. We aimed to summarize and evaluate the literature regarding the safety and efficacy of DOAC use in NVAF patients with other types of VHD...
December 22, 2016: Clinical Cardiology
Po Hu, Xian-Bao Liu, Jie Liang, Qi-Feng Zhu, Chao-Xia Pu, Meng-Yao Tang, Jian-An Wang
OBJECTIVES: Due to increasing aging, the epidemiology of VHD may have changed in China. This study aimed to provide contemporary information on the prevalence, distribution patterns, and etiology of severe VHD in China. METHODS: This was a retrospective survey at Second Affiliated Hospital of Zhejiang University, which included all consecutive patients between 2010 and 2015. RESULTS: In all, 139,496 patients were enrolled. Among severe valve diseases, MR was the most frequent (n=946, 0...
November 25, 2016: International Journal of Cardiology
Rita Cervera-Juanes, Larry J Wilhelm, Byung Park, Kathleen A Grant, Betsy Ferguson
Alcohol use disorders encompass a range of drinking levels and behaviors, including low, binge and heavy drinking. In this regard, investigating the neural state of individuals who chronically self-administer lower doses of alcohol may provide insight into mechanisms that prevent the escalation of alcohol use. DNA methylation is one of the epigenetic mechanisms that stabilizes adaptations in gene expression and has been associated with alcohol use. Thus, we investigated DNA methylation, gene expression and the predicted neural effects in the nucleus accumbens core (NAcc) of male rhesus macaques categorized as "low" or "binge" drinkers, compared to "alcohol-naïve" and "heavy" drinkers based on drinking patterns during a 12 month alcohol self-administration protocol...
November 10, 2016: Alcohol
Domenico Iossa, Rosa Molaro, Roberto Andini, Antonio Parrella, Maria Paola Ursi, Irene Mattucci, Lucia De Vincentiis, Giovanni Dialetto, Riccardo Utili, Emanuele Durante-Mangoni
Blood coagulation plays a key role in the pathogenesis of infective endocarditis (IE). Conditions associated with thrombophilia could enhance IE vegetation formation and promote embolic complications.In this study, we assessed prevalence, correlates, and clinical consequences of hyper-homocysteinemia (h-Hcy) in IE.Homocysteine (Hcy) plasma levels were studied in 246 IE patients and 258 valvular heart disease (VHD) patients, as well as in 106 healthy controls.IE patients showed Hcy levels comparable to VHD patients (14...
September 2016: Medicine (Baltimore)
Florencia Vivero, Cristina Gonzalez-Echavarri, Beatriz Ruiz-Estevez, Irene Maderuelo, Guillermo Ruiz-Irastorza
OBJECTIVES: We aimed to study the frequency, severity and predictors of valvular heart disease (VHD) in our lupus cohort. MATERIAL AND METHODS: 211 patients were included. A transthoracic echocardiogram was used for this study. Significant valvular lesions were classified into two groups: valvular thickening and valvular dysfunction. Univariate logistic regression was performed in order to find associations with valvular thickening and dysfunction. Those variables with a p value ≤0...
December 2016: Autoimmunity Reviews
Joshua W Hustedt, Oren Goltzer, Daniel D Bohl, James F Fraser, Nina J Lara, Mark J Spangehl
BACKGROUND: With increased scrutiny regarding the cost and safety of health care delivery, there is increasing interest in judicious patient selection for total joint arthroplasty (TJA) procedures. It is unknown which comorbidities incur the greatest increase in risk to the patient and cost to the system after TJA. Therefore, this study sought to characterize the association of common preoperative comorbidities with both the risk for postoperative in-hospital complications and the total hospital cost in patients undergoing TJA...
August 9, 2016: Journal of Arthroplasty
Michael D Ezekowitz, Rangadham Nagarakanti, Herbert Noack, Martina Brueckmann, Claire Litherland, Mark Jacobs, Andreas Clemens, Paul A Reilly, Stuart J Connolly, Salim Yusuf, Lars Wallentin
BACKGROUND: The RE-LY trial (Randomized Evaluation of Long-Term Anticoagulant Therapy) compared dabigatran 150 and 110 mg twice daily with warfarin in 18 113 patients with atrial fibrillation. Those with prosthetic heart valves, significant mitral stenosis, and valvular heart disease (VHD) requiring intervention were excluded. Others with VHD were included. METHODS: This is a post hoc analysis of the RE-LY trial. RESULTS: There were 3950 patients with any VHD: 3101 had mitral regurgitation, 1179 with tricuspid regurgitation, 817 had aortic regurgitation, 471 with aortic stenosis, and 193 with mild mitral stenosis...
August 23, 2016: Circulation
Florent Le Ven, Zarrin Alavi, Yannick Jobic, Yves Etienne, Romain Didier, Raphaël Porcher
There is a risk of misdiagnosis between benfluorex-induced VHD and acute rheumatic fever (ARF)-related VHD due to common characteristics of both etiologies. We aimed at estimating the probability for a patient exposed to benfluorex presenting with VHD to have, at the same time, a history of ARF-related VHD. Such epidemiological approach could help at reducing the risk of misdiagnosis. We used INSEE data and related literature as well as various modeling hypotheses to drive and test a formula for calculating the probability of a patient presenting with VHD and a history of benfluorex intake to have a prior history of ARF-related VHD...
2016: PloS One
Patrick T O'Gara
No abstract text is available yet for this article.
August 9, 2016: Circulation
Kohei Ishibashi, Koji Miyamoto, Tsukasa Kamakura, Mitsuru Wada, Ikutaro Nakajima, Yuko Inoue, Hideo Okamura, Takashi Noda, Takeshi Aiba, Shiro Kamakura, Wataru Shimizu, Satoshi Yasuda, Takashi Akasaka, Kengo Kusano
Previous studies showed that continuous anticoagulation or single antiplatelet therapy during implantations of cardiac implantable electronic devices (CIED) was relatively safe. However, the safety of continuous multi antithrombotic therapy (AT) in patients undergoing CIED interventions has not been clearly defined. We sought to evaluate the safety of this therapy during CIED implantations. A total of 300 consecutive patients (mean 69 years old, 171 males) with CIED implantations were enrolled in this study...
July 28, 2016: Heart and Vessels
Pierre-Vladimir Ennezat, Patrick Bruneval, Daniel Czitrom, Jean-Pierre Gueffet, Nicolas Piriou, Jean Noël Trochu, Odile Patra, Bénédicte Blanchard-Lemoine, Xavier Halna du Fretay, Pierre Nazeyrollas, Bernard Assoun, Yannick Jobic, Eric Brochet, Emmanuel Bogino, Raymond Roudaut, Caroline Augier, Lorraine Greffe, Hélène Petit-Eisenmann, Camille Dambrin, Olivier Chavanon, Louis Guillou, Dominique Grisoli, Pierre Morera, Carlo Banfi, Jean Paul Remadi, Olivier Fabre, André Vincentelli, Sylvie Lantuejoul, Jean-Fortuné Ikoli, Marie-Christine Copin, Marie-Christine Malergue, Sylvestre Maréchaux, Christophe Tribouilloy
BACKGROUND: We have been intrigued by the observation that aortic stenosis (AS) may be associated with characteristic features of mitral drug-induced valvular heart disease (DI-VHD) in patients exposed to valvulopathic drugs, thus suggesting that beyond restrictive heart valve regurgitation, valvulopathic drugs may be involved in the pathogenesis of AS. METHODS: Herein are reported echocardiographic features, and pathological findings encountered in a series of patients suffering from both AS (mean gradient >15mmHg) and mitral DI-VHD after valvulopathic drugs exposure...
October 1, 2016: International Journal of Cardiology
Joanna L d'Arcy, Sean Coffey, Margaret A Loudon, Andrew Kennedy, Jonathan Pearson-Stuttard, Jacqueline Birks, Eleni Frangou, Andrew J Farmer, David Mant, Jo Wilson, Saul G Myerson, Bernard D Prendergast
BACKGROUND: Valvular heart disease (VHD) is expected to become more common as the population ages. However, current estimates of its natural history and prevalence are based on historical studies with potential sources of bias. We conducted a cross-sectional analysis of the clinical and epidemiological characteristics of VHD identified at recruitment of a large cohort of older people. METHODS AND RESULTS: We enrolled 2500 individuals aged ≥65 years from a primary care population and screened for undiagnosed VHD using transthoracic echocardiography...
December 14, 2016: European Heart Journal
C Schwarz, L Unger, B Mahr, K Aumayr, H Regele, A M Farkas, K Hock, N Pilat, T Wekerle
B7.1/2-targeted costimulation blockade (CTLA4 immunoglobulin [CTLA4-Ig]) is available for immunosuppression after kidney transplantation, but its potentially detrimental impact on regulatory T cells (Tregs) is of concern. We investigated the effects of CTLA4-Ig monotherapy in a fully mismatched heart transplant model (BALB/c onto C57BL/6). CTLA4-Ig was injected chronically (on days 0, 4, 14, and 28 and every 4 weeks thereafter) in dosing regimens paralleling clinical use, shown per mouse: low dose (LD), 0.25 mg (≈10 mg/kg body weight); high dose (HD), 1...
May 17, 2016: American Journal of Transplantation
Vishal Sharma, Ralph A Stewart, Mildred Lee, Ruvin Gabriel, Niels Van Pelt, David E Newby, Andrew J Kerr
OBJECTIVE: Plasma brain natriuretic peptide (BNP) concentrations predict prognosis in patients with valvular heart disease (VHD), but it is unclear whether this directly relates to disease severity. We assessed the relationship between BNP and echocardiographic measures of disease severity in patients with VHD. METHODS: Plasma BNP concentrations were measured in patients with normal left ventricular (LV) systolic function and isolated VHD (mitral regurgitation (MR), n=33; aortic regurgitation (AR), n=39; aortic stenosis (AS), n=34; mitral stenosis (MS), n=30), and age-matched and sex-matched controls (n=39) immediately prior to exercise stress echocardiography...
2016: Open Heart
Andrew K Capulli, Luke A MacQueen, Blakely B O'Connor, Stephanie Dauth, Kevin Kit Parker
Medications based on ergoline-derived dopamine and serotonin agonists are associated with off-target toxicities that include valvular heart disease (VHD). Reports of drug-induced VHD resulted in the withdrawal of appetite suppressants containing fenfluramine and phentermine from the US market in 1997 and pergolide, a Parkinson's disease medication, in 2007. Recent evidence suggests that serotonin receptor activity affected by these medications modulates cardiac valve interstitial cell activation and subsequent valvular remodeling, which can lead to cardiac valve fibrosis and dysfunction similar to that seen in carcinoid heart disease...
July 2016: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Yong Zhao, Guo-Ming Cui, Nan-Nan Zhou, Cong Li, Qing Zhang, Hui Sun, Bo Han, Cheng-Wei Zou, Li-Juan Wang, Xiao-Dong Li, Jian-Chun Wang
Calpain, calcineurin (CaN), and nuclear factor of activated T cell (NFAT) play a key role in the development of atrial fibrillation. Patients with valvular heart disease (VHD) are prone to develop atrial fibrillation (AF). Thus, our current study was aimed at investigating whether activation of calpain-CaN-NFAT pathway is associated with the incidence of AF in the patients with VHD and diabetes. The expressions of calpain 2 and alpha- and beta-isoforms of CaN catalytic subunit (CnA) as well as NFAT-c3 and NFAT-c4 were quantified by quantitative reverse transcription-polymerase chain reaction in atrial tissues from 77 hospitalized patients with VHD and diabetes...
2016: Journal of Diabetes Research
Y I Zeng, Rongrong Sun, Xianchi Li, Min Liu, Shuang Chen, Peiying Zhang
Valvular heart disease (VHD) is caused by either damage or defect in one of the four heart valves, aortic, mitral, tricuspid or pulmonary. Defects in these valves can be congenital or acquired. Age, gender, tobacco use, hypercholesterolemia, hypertension, and type II diabetes contribute to the risk of disease. VHD is an escalating health issue with a prevalence of 2.5% in the United States alone. Considering the likely increase of the aging population worldwide, the incidence of acquired VHD is expected to increase...
April 2016: Experimental and Therapeutic Medicine
Chia-Hui Lin, Fei-Yuan Hsiao, Yen-Bin Liu, Susan Shur-Fen Gau, Chi-Chuan Wang, Li-Jiuan Shen
Empirical evidence regarding the association between antidepressants and valvular heart disease (VHD) is scarce.Using Taiwan's National Health Insurance Research database, this nested case-control study assessed the association between antidepressants and VHD in a Chinese population.Among a cohort of patients who used at least 3 prescription antidepressants, 874 cases with VHD and 3496 matched controls (1:4 ratio) were identified. Conditional logistic regression models were used to examine the timing, duration, dose and type of antidepressants use, and the risk of VHD...
April 2016: Medicine (Baltimore)
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