Assessment of Aortic Stenosis Severity

Severe aortic stenosis (AS) is associated with a progressive cardiac remodeling that ultimately leads to heart failure and death if the valve is not replaced. The confirmation of AS severity is therefore crucial to adequately manage patients with AS. Transthoracic echocardiography is the first-line examination to confirm AS severity, but it may be inconclusive in discordant cases. In this setting, AS severity should be confirmed using a multimodality imaging approach. This review gives an overview of how to assess and/or confirm AS severity, especially in case of discordance.
Source: Cardiology Clinics - Category: Cardiology Authors: Source Type: research

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Computed tomography angiography derived global longitudinal strain (CTA-GLS) has been shown to be feasible, however its prognostic value remains unclear in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). We evaluated the association of baseline CTA-GLS with outcomes including all-cause mortality and composite endpoint of death and heart failure hospitalization in 223 patients treated with TAVR. Patients with normal LVEF but reduced CTA-GLS had similar event rate to those with impaired LVEF, and higher than those with normal LVEF and preserved CTA-GLS. Baseline CTA-GLS assessme...
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Source Type: research
Conclusions: This study unravels the complex transcriptome profiles of the heart tissues and highlighting the candidate genes involved in cardiac remodeling induced by mechanical stress may usher in a new era of precision diagnostics and treatment in patients with cardiac remodeling. PMID: 31772688 [PubMed - in process]
Source: Disease Markers - Category: Laboratory Medicine Tags: Dis Markers Source Type: research
CONCLUSIONS: Within nonagenarians with AS, patients treated with TAVI had lower risk of cardiovascular events than matched patients treated medically. The patients undergoing a TAVI at this age were often highly selected and the procedure was associated with acceptable long term outcomes. PMID: 31763981 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
Publication date: Available online 21 November 2019Source: Canadian Journal of CardiologyAuthor(s): Gabriele Crimi, Claudio Montalto, Luca Angelo Ferri, Luigi Piatti, Irene Bossi, Nuccia Morici, Alessandro Mandurino-Mirizzi, Daniele Grosseto, Giovanni Tortorella, Stefano Savonitto, Stefano De Servi, Elderly-ACS 2 InvestigatorsABSTRACTBackgroundElderlies are underrepresented in clinical trials and registries and a gap of evidence exists for clinical decision making in the setting of acute coronary syndromes (ACS). We aimed to assess the prevalence and independent prognostic impact of valvular heart disease (VHD) diagnosed d...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
We present the data on the prevalence of ATTR-CA in AS and their prognostic associations. Since diagnosis of ATTR-CA may be challenging, special attention is paid to the diagnostic utility of different imaging modalities, echocardiography, cardiovascular magnetic resonance, nuclear imaging, and distinctive imaging features in patients with dual pathology. We also present a flow diagram summarizing integrated imaging in patients with suspected ATTR-CA. PMID: 31740363 [PubMed - as supplied by publisher]
Source: Hellenic Journal of Cardiology - Category: Cardiology Tags: Hellenic J Cardiol Source Type: research
All eyes will be on ISCHEMIA in Philadelphia, but a study on asymptomatic aortic stenosis as well as trials in heart failure and cardiogenic shock also piqued Dr John Mandrola's on Medscape
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Cardiology Commentary Source Type: news
We describe the case of a 64-year-old man who came to the emergency room due to acute heart failure and intermittent gastrointestinal bleeding. Treatment involves initial correction of anemia and heart failure followed by aortic valve replacement. The prosthesis used depends on the characteristics of each patient and valve replacement allows the resolution of bleeding in most cases. Gastrointestinal bleeding in patients with aortic stenosis is associated with severity of the valve obstruction. A mechanical prosthesis was used with no recurrent bleeding even with the need for lifelong anticoagulation therapy.
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
The development of aortic valve stenosis is strongly associated with older adults. Patients who undergo transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) frequently have heart failure (HF). We investigated the predictors of mortality after TAVI according to the presence of HF, and specifically HF with preserved ejection fraction (HFpEF) versus HF with reduced ejection fraction (HFrEF). Patients were identified from the Nationwide Inpatient Sample registry from January 2011 to September 2015  using the ICD-9 codes. Patients with HF who underwent TAVI were classified according to whethe...
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Diastolic dysfunction (DD) is a common finding in severe aortic stenosis (AS) patients.1 Myocardial remodeling eventually affects left ventricular (LV) relaxation, therefore impairing LV diastolic function with an increase in left atrial (LA) pressure, ultimately causing pulmonary congestion and symptoms of heart failure.2,3 Relief of stenosis through transcatheter aortic valve implantation (TAVI) results in reverse remodeling of the left ventricle, regression of LV hypertrophy, and improvement of LV systolic function.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Abstract Despite mounting evidence implicating inflammation in cardiovascular diseases, attempts at clinical translation have shown mixed results. Recent preclinical studies have reenergized this field and provided new insights into how to favorably modulate cardiac macrophage function in the context of acute myocardial injury and chronic disease. In this review, we discuss the origins and roles of cardiac macrophage populations in the steady-state and diseased heart, focusing on the human heart and mouse models of ischemia, hypertensive heart disease, and aortic stenosis. Specific attention is given to delineatin...
Source: Annual Review of Physiology - Category: Physiology Authors: Tags: Annu Rev Physiol Source Type: research
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