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Subannular repair in secondary mitral regurgitation with restricted leaflet motion during systole
Conclusions Our study demonstrates the safety and feasibility of standardised subannular repair to treat ventricular SMR (Carpentier type IIIb) in a multicentre setting. By addressing mitral leaflet tethering, papillary muscle relocation results in very satisfactory 1-year outcomes and has the potential to durably restore MV geometry; nevertheless, long-term FU is mandatory. Trial registration number NCT03470155.
Source: Heart - August 24, 2023 Category: Cardiology Authors: Pausch, J., Harmel, E., Reichenspurner, H., Kempfert, J., Kuntze, T., Owais, T., Holubec, T., Walther, T., Krane, M., Vitanova, K., Borger, M. A., Eden, M., Hachaturyan, V., Bramlage, P., Falk, V., Girdauskas, E. Tags: Valvular heart disease Source Type: research

Early surgical intervention versus conservative management of asymptomatic severe aortic stenosis: a systematic review and meta-analysis
Conclusions This study suggests that for patients with asymptomatic severe AS an early surgical intervention compared with a conservative WW strategy was associated with a lower heart failure hospitalisation and a similar rate of stroke or myocardial infarction, although with significant risk of bias. PROSPERO registration number CRD42021291144.
Source: Heart - January 27, 2023 Category: Cardiology Authors: Costa, G. N. F., Cardoso, J. F. L., Oliveiros, B., Goncalves, L., Teixeira, R. Tags: Valvular heart disease Source Type: research

Hypertensive response to exercise in adult patients with repaired aortic coarctation
Conclusions A hypertensive response to exercise was present in nearly half of the patients in this large, prospective cohort of adults with repaired CoA. Risk factors for increased peak exercise SBP were male sex, absence of a bicuspid aortic valve and elevated resting SBP. Increased peak exercise SBP independently predicted hypertension at follow-up. These results support close follow-up of patients with a hypertensive response to exercise to ensure timely diagnosis and treatment of future hypertension.
Source: Heart - June 24, 2022 Category: Cardiology Authors: Meijs, T. A., Muller, S. A., Minderhoud, S. C. S., de Winter, R. J., Mulder, B. J. M., van Melle, J. P., Hoendermis, E. S., van Dijk, A. P. J., Zuithoff, N. P. A., Krings, G. J., Doevendans, P. A., Spiering, W., Witsenburg, M., Roos-Hesselink, J. W., van Tags: Congenital heart disease Source Type: research

Echocardiographic predictors of outcomes in adults with aortic stenosis
Conclusions The most powerful echocardiographic predictors of mortality are low LVEF and low flow, whereas AS severity parameters predict valve-related events but not overall mortality. Hence, low flow should be integrated in the risk stratification and therapeutic decision-making in patients with AS.
Source: Heart - June 5, 2016 Category: Cardiology Authors: Capoulade, R., Le Ven, F., Clavel, M.-A., Dumesnil, J. G., Dahou, A., Thebault, C., Arsenault, M., O'Connor, K., Bedard, E., Beaudoin, J., Senechal, M., Bernier, M., Pibarot, P. Tags: Editor's choice, Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Clinical diagnostic tests, Epidemiology Valvular heart disease Source Type: research

Risk of death and stroke associated with anticoagulation therapy after mitral valve repair
Conclusion VKA treatment after mitral valve repair is associated with a markedly lower risk of adverse events as stroke or death without excess major bleeding risk during the first 3 months following surgery.
Source: Heart - April 11, 2016 Category: Cardiology Authors: Valeur, N., Merie, C., Hansen, M. L., Torp-Pedersen, C., Gislason, G. H., Kober, L. Tags: Drugs: cardiovascular system, Interventional cardiology, Epidemiology Valvular heart disease Source Type: research

Watchful observation versus early aortic valve replacement for symptomatic patients with normal flow, low-gradient severe aortic stenosis
Conclusions Early AVR and watchful observation strategy show similar survival in symptomatic patients with normal flow, low-gradient severe AS and preserved LVEF. Watchful observation with timely performance of AVR should be considered a therapeutic option.
Source: Heart - August 12, 2015 Category: Cardiology Authors: Kang, D.-H., Jang, J. Y., Park, S.-J., Kim, D.-H., Yun, S.-C., Song, J.-M., Park, S. W., Chung, C.-H., Song, J.-K., Lee, J.-W. Tags: Drugs: cardiovascular system, Aortic valve disease, Epidemiology Valvular heart disease Source Type: research

Evolution and prognostic impact of low flow after transcatheter aortic valve replacement
Conclusions The measurement of EP-SVi is useful to assess the immediate haemodynamic benefit of TAVR and to predict the risk of late mortality.
Source: Heart - July 9, 2015 Category: Cardiology Authors: Le Ven, F., Thebault, C., Dahou, A., Ribeiro, H. B., Capoulade, R., Mahjoub, H., Urena, M., Nombela-Franco, L., Allende Carrera, R., Clavel, M.-A., Dumont, E., Dumesnil, J., De Larochelliere, R., Rodes-Cabau, J., Pibarot, P. Tags: Drugs: cardiovascular system, Echocardiography, Clinical diagnostic tests, Epidemiology Valvular heart disease Source Type: research

Paradoxical low-flow, low-gradient severe aortic stenosis: a distinct disease entity
Low-flow, low-gradient (LFLG) severe aortic stenosis (AS), despite preserved LVEF, that is, paradoxical LFLG, is one of the most challenging entities in valvular heart disease.1 Hachicha et al were the first to report that patients with small aortic valve area (AVA) and preserved LVEF may concomitantly have an LF and thus often low gradient.1 This new entity is defined as an AVA ≤1.0 cm2 or indexed AVA ≤0.6 cm2/m2, a mean pressure gradient (MPG) <40 mm Hg, an LVEF ≥50% and a stroke volume index (SVi) <35 mL/m2. The most recent European2 and American3 guidelines have recognised parado...
Source: Heart - June 10, 2015 Category: Cardiology Authors: Magne, J., Mohty, D. Tags: Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Right sided valvular heart disease, Clinical diagnostic tests Editorials Source Type: research

Impact of exercise pulmonary hypertension on postoperative outcome in primary mitral regurgitation
Conclusions ExPHT is associated with increased risk of adverse cardiac events following mitral valve surgery in patients with primary MR.
Source: Heart - February 12, 2015 Category: Cardiology Authors: Magne, J., Donal, E., Mahjoub, H., Miltner, B., Dulgheru, R., Thebault, C., Pierard, L. A., Pibarot, P., Lancellotti, P. Tags: Drugs: cardiovascular system, Echocardiography, Hypertension, Mitral valve disease, Clinical diagnostic tests Valvular heart disease Source Type: research

Aortic stenosis: flow matters
The presence of a low transvalvular pressure gradient (<40 mm Hg) in conjunction with a small aortic valve area (AVA ≤1 cm2) is a challenging situation as it raises uncertainty about the actual severity of aortic stenosis (AS) and therefore about the indication of aortic valve replacement (AVR) if the patient is symptomatic. This low-gradient ‘severe’ (small AVA) AS entity may in fact be related to: (i) measurement errors: underestimation of stroke volume (SV), AVA and/or gradient;S1 (ii) small body size: a small AVA in a small patient may correspond to moderate AS and low gradient; (iii) i...
Source: Heart - December 12, 2014 Category: Cardiology Authors: Pibarot, P. Tags: Drugs: cardiovascular system, Echocardiography, Hypertension, Aortic valve disease, Mitral valve disease, Right sided valvular heart disease, Clinical diagnostic tests, Epidemiology Editorials Source Type: research

Survival by stroke volume index in patients with low-gradient normal EF severe aortic stenosis
Conclusions Lower SVI is incrementally associated with mortality in LG severe AS with preserved EF. These findings have implications for classification of AS severity, identification of high-risk groups and subsequent management.
Source: Heart - December 12, 2014 Category: Cardiology Authors: Eleid, M. F., Sorajja, P., Michelena, H. I., Malouf, J. F., Scott, C. G., Pellikka, P. A. Tags: Editor's choice, Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Clinical diagnostic tests, Epidemiology Valvular heart disease Source Type: research

Asymptomatic adults with mild/moderate isolated native pulmonary valve stenosis are in need of treatment... but not the kind you are thinking of!
As new treatment strategies are developed which outperform previous approaches in terms of safety, efficacy and long-term results, a reappraisal of old therapeutic dogmas is warranted, including lowering the threshold for intervention. Pulmonary valvuloplasty was introduced in 1982 to treat children and adults with significant isolated pulmonary valve stenosis (PS) and provided a very reliable tool to treat the problem avoiding cardiac surgery, with very good long-term results in terms of reinterventions as well as functional outcomes.1 2 Besides the neonate with critical PS, the same technique has been used to treat older...
Source: Heart - August 6, 2014 Category: Cardiology Authors: Giardini, A., Cervi, E. Tags: Congenital heart disease, Drugs: cardiovascular system, Hypertension, Interventional cardiology, Right sided valvular heart disease Editorials Source Type: research