Exercise right heart catheterization predicts outcome in asymptomatic degenerative aortic stenosis

ConclusionsExercise RHC is feasible and safe in this population. Peak pulmonary artery oxygen saturation might identify patients with increased risk of serious adverse events.ResumenIntroducción y objetivosLa estenosis aórtica degenerativa es la valvulopatía más frecuente. Aún no está claro cómo identificar a los pacientes asintomáticos con fracción de eyección del ventrículo izquierdo normal y alta probabilidad de eventos que por ello pudieran beneficiarse de una intervención valvular precoz. En este estudio se describe un protocolo de hemodinámica de esfuerzo para los pacientes asintomáticos con estenosis aórtica moderada o grave para evaluar su valor pronóstico para esta población.MétodosEstudio prospectivo unicéntrico de una población de pacientes con estenosis aórtica moderada o grave asintomáticos. Los pacientes realizaron una ergoespirometría para confirmar la ausencia de síntomas en esfuerzo. Después los pacientes se sometieron a un cateterismo cardiaco derecho basal y de esfuerzo. Se definió evento como muerte o necesidad de reemplazo de válvula aórtica quirúrgico o percutáneo basado en las guías clínicas.ResultadosSe sometió a 33 pacientes a cateterismo cardiaco derecho basal y de esfuerzo. El área valvular aórtica media fue ...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research

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This study was conducted to evaluate the prevalence of significant coronary artery disease (CAD) in patients with severe valvular heart disease (VHD) and the association between these two cardiac entities. Our research aims to introduce the theory of a possible causal relationship.MethodsA retrospective study was conducted on 1308 consecutive patients who underwent surgery due to severe VHD in the cardio-vascular department of NDSUH (Notre-Dame de Secours University Hospital) between December 2000 and December 2016. According to transthoracic echocardiography, patients were divided into 4 groups: patients with severe aorti...
Source: Indian Heart Journal - Category: Cardiology Source Type: research
AbstractPurpose of ReviewAging is associated with an increased prevalence of both cancer and heart disease. The progression of aortic valve calcification to aortic stenosis may be accelerated by both cardiovascular risk factors and cancer treatments, such as radiotherapy with mediastinal involvement. Symptomatic aortic stenosis is occasionally diagnosed in cancer patients undergoing cardiovascular evaluation; likewise, cancer is often recognized during assessment preceding aortic valve interventions. In these complex cases, physicians face difficult treatment decisions. Due to a myriad of clinical presentations of cancer a...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
Publication date: Available online 28 June 2019Source: Revista Española de Cardiología (English Edition)Author(s): Ángel Cequier, Armando Pérez de Prado, Raúl Moreno, Juan Cosín-Sales, Esteban López de Sá, Artur Evangelista, Héctor Bueno, Manuel AnguitaAbstractThe percutaneous treatment of coronary artery disease and some structural cardiovascular diseases has undergone spectacular changes. More and more patients with different types of heart disease are being treated by percutaneous or transcatheter interventions, with no such increase in patients undergoing c...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
Eko, a digital health company is using artificial intelligence and machine learning to aid in the fight against heart disease. The Berkley, CA-based company recently unveiled its Aortic Stenosis (AS) detection algorithm at the American Society of Echocardiography (ASE) 2019 Scientific Sessions. The algorithm was developed and tested in partnership with the Northwestern Medicine Bluhm Cardiovascular Institute. It is significant and stands to be more objective application than current detection methods for AS. The disease is often initially identified during the physical exam when a provider hears a heart murmur using his or...
Source: MDDI - Category: Medical Devices Authors: Tags: Cardiovascular Source Type: news
Introduction Significant tricuspid regurgitation is a well recognized indicator of right ventricular dysfunction. Recent studies have shown that significant tricuspid regurgitation is potentially associated with increased mortality in patients with severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR). However, data remained sparse and inconclusive. Thus, we performed a systematic review and meta-analysis of the literature to assess the association between significant tricuspid regurgitation and mortality in post TAVR patients. Hypothesis Significant tricuspid regurgitation is predictive f...
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Interventional cardiology. Structural heart disease Source Type: research
Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis. A series of trials in which patients were randomized to receive TAVR or surgical valve replacement have provided arguably the best data collected for this intervention. The 2 most recent randomized clinical trials involving patients who have less than 3% risk of surgical operative mortality suggest that TAVR might be the preferred treatment strategy for this particular patient group. The patient group tested is a critical factor for all randomized clinical trials and determines the potential for generalizability. The data fro...
Source: JAMA - Category: General Medicine Source Type: research
In the evaluation of syncope, history is most important to arrive at a diagnosis.The first step is to confirm whether its truly a syncope or (Metabolic/TIA or seizure. We are easily carried away by the urge to order a Holter monitoring routimely. In reality, the yield is too low (3-5sec Or it may lead to Brady (Pause) dependent escape VT. A pause can be a sinus arrest, Pause or SA block .If pause ends with a junctional escape it becomes a arrest. Look PR interval specifically(A bifasicular block shouldn’t be missed .It can be more dangerous than say a congenital CHB)PR interal represents condcution from SA node to Pu...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized Source Type: blogs
Degenerative or fibrocalcific aortic stenosis (AS) is now the most common native valvular heart disease assessed and managed by cardiologists in developed countries.Transthoracic echocardiography remains the quintessential imaging modality for the non-invasive characterization of AS due to its widespread availability, superior assessment of flow hemodynamics, and a wealth of prognostic data accumulated over decades of clinical utility and research applications. With expanding technologies and increasing availability of treatment options such as transcatheter aortic valve replacements, in addition to conventional surgical a...
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Source Type: research
Degenerative or fibrocalcific aortic stenosis (AS) is now the most common native valvular heart disease assessed and managed by cardiologists in developed countries.Transthoracic echocardiography remains the quintessential imaging modality for the non-invasive characterisation of AS due to its widespread availability, superior assessment of flow haemodynamics, and a wealth of prognostic data accumulated over decades of clinical utility and research applications. With expanding technologies and increasing availability of treatment options such as transcatheter aortic valve replacements, in addition to conventional surgical ...
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Review Source Type: research
Authors: Ren X, Li F, Wang C, Hou Z, Gao Y, Yin W, Lu B Abstract Bicuspid aortic valve (BAV) is the most common congenital heart disease. Different distribution of valve dysfunction was found in patients with BAV in different age and sex groups, but related difference was not well established. The aim of our study is to investigate age- and sex-related clinical characteristics differences in patients with BAV.Six hundred twenty patients with BAV who had moderate or severe aortic valve dysfunction were included in the study. Basic clinical data and image data were recorded. Patients were classified into four differe...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
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