• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

The contemporary role of echocardiography in the assessment and management of aortic stenosis
AbstractAortic stenosis (AS) represents a major healthcare issue because of its ever-increasing prevalence, poor prognosis, and complex pathophysiology. Echocardiography plays a central role in providing a comprehensive morphological and hemodynamic evaluation of AS. The diagnosis of severe AS is currently based on three hemodynamic parameters including maximal jet velocity, mean pressure gradient (mPG) across the aortic valve, and aortic valve area (AVA). However, inconsistent grading of AS severity is common when the AVA is  <  1.0 cm2 but the mPG is  <  40 mmHg, also known as low-gradient AS (LGAS). Spec...
Source: Journal of Medical Ultrasonics - December 1, 2019 Category: Radiology Source Type: research

Clinical and echocardiographic features of paradoxical low-flow and normal-flow severe aortic stenosis patients with concomitant mitral regurgitation
AbstractMitral regurgitation (MR) coexists in a significant proportion of patients with severe aortic stenosis (AS), and portends inferior therapeutic outcomes. In severe AS, MR is thought to contribute to a low-flow state by decreasing forward stroke volume. We investigated concomitant MR on the clinical and echocardiographic features of patients with “paradoxical” low-flow (PLF) and normal-flow (NF) severe AS. Clinical and echocardiographic profiles of 886 consecutive patients with index echocardiographic diagnosis of severe AS (AVA <  1.0 cm2) were analysed retrospectively. All patients had preserved ejectio...
Source: The International Journal of Cardiovascular Imaging - November 26, 2019 Category: Radiology Source Type: research

Postoperative Reverse Remodeling and Symptomatic Improvement in Normal-Flow Low-Gradient Aortic Stenosis After Aortic Valve Replacement Valvular Heart Disease
Conclusions— Patients with NFLG had less severe AS and LV remodeling than patients with normal-flow high-gradient. Furthermore, NFLG patients experienced less reverse remodeling but the same symptomatic benefit. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT02316587.
Source: Circulation: Cardiovascular Imaging - December 8, 2017 Category: Radiology Authors: Carter-Storch, R., Moller, J. E., Christensen, N. L., Irmukhadenov, A., Rasmussen, L. M., Pecini, R., Ovrehus, K. A., Sondergard, E. V., Marcussen, N., Dahl, J. S. Tags: Valvular Heart Disease, Aortic Valve Replacement/Transcatheter Aortic Valve Implantation Source Type: research

Clinical outcome and functional characteristics of patients with asymptomatic low-flow low-gradient severe aortic stenosis with preserved ejection fraction are closer to high-gradient severe than to moderate aortic stenosis
AbstractAsymptomatic “paradoxic” severe low-flow low-gradient aortic stenosis with preserved ejection fraction (PAS) constitutes a challenging condition where the optimal management and follow-up remain elusive. We evaluated the clinical outcome in patients with PAS as compared to asymptomatic patients with moderate (MAS) or classical severe aortic stenosis (CAS). Consecutive asymptomatic moderate or severe aortic stenosis patients without concomitant other heart or lung disease (n = 121) were invited. Participants (n = 74) were assigned to three subgroups with regard to degree of aortic stenosis: MAS (n = ...
Source: The International Journal of Cardiovascular Imaging - November 9, 2017 Category: Radiology Source Type: research

Dynamic changes in aortic impedance after transcatheter aortic valve replacement and its impact on exploratory outcome
AbstractValvulo-arterial impedance (Zva) has been shown to predict worse outcome in medically managed aortic stenosis (AS) patients. We aimed to investigate the association between Zva and left ventricular (LV) adaptation and to explore the predictive value of Zva for cardiac functional recovery and outcome after transcatheter aortic valve replacement (TAVR). We prospectively enrolled 128 patients with AS who underwent TAVR. Zva was calculated as: (systolic blood pressure  + mean transaortic gradient)/stroke volume index). Echocardiographic assessment occurred at baseline, 1-month and 1-year after TAVR. The primary end...
Source: The International Journal of Cardiovascular Imaging - November 1, 2017 Category: Radiology Source Type: research

Lower Transaortic Flow Rate Is Associated With Increased Mortality in Aortic Valve Stenosis
Conclusions In patients with AS without known cardiovascular disease or diabetes, low transaortic FR was independently associated with higher rates of cardiovascular and all-cause mortality. (An Investigational Drug on Clinical Outcomes in Patients With Aortic Stenosis (Narrowing of the Major Blood Vessel of the Heart) (MK-0653A-043 AM4); NCT00092677)
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - August 7, 2017 Category: Radiology Authors: Saeed, S., Senior, R., Chahal, N. S., Lonnebakken, M. T., Chambers, J. B., Bahlmann, E., Gerdts, E. Tags: Original Research Source Type: research

Turbulent Kinetic Energy Assessed by Multipoint 4-Dimensional Flow Magnetic Resonance Imaging Provides Additional Information Relative to Echocardiography for the Determination of Aortic Stenosis Severity Valvular Heart Disease
Conclusions— Elevated TKE levels imply higher energy losses associated with bicuspid aortic valves and dilated ascending aortic geometries that are not assessable by current echocardiographic measures. These findings indicate that TKE may provide complementary information to echocardiography, helping to distinguish within the heterogeneous population of patients with moderate to severe AS.
Source: Circulation: Cardiovascular Imaging - June 13, 2017 Category: Radiology Authors: Binter, C., Gotschy, A., Sundermann, S. H., Frank, M., Tanner, F. C., Luscher, T. F., Manka, R., Kozerke, S. Tags: Hemodynamics, Pathophysiology, Valvular Heart Disease, Magnetic Resonance Imaging (MRI) Source Type: research

Lack of Stroke Volume Determined Flow Reserve Does Not Always Preclude Assessment of Severity of Aortic Stenosis in Low-Flow Low-Gradient State During Dobutamine Echocardiography
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - April 3, 2017 Category: Radiology Authors: Vamvakidou, A., Chahal, N., Senior, R. Tags: Letter to the Editor Source Type: research

The Functional Significance of Paradoxical Low-Gradient Aortic Valve Stenosis: Hemodynamic Findings During Cardiopulmonary Exercise Testing
Conclusions In symptomatic patients with PLGAS, the capacity to dynamically reduce vascular and valvular loads determines the effect of exercise on PCWP, which, in turn, conditions the functional status. A critically fixed valvular obstruction may not be the main mechanism of functional impairment in a large proportion of patients with PLGAS. Exercise echocardiography is suitable to study the dynamics of PLGAS.
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - January 1, 2017 Category: Radiology Authors: Perez del Villar, C., Yotti, R., Espinosa, M. A., Gutierrez-Ibanes, E., Barrio, A., Lorenzo, M. J., Sanchez Fernandez, P. L., Benito, Y., Prieto, R., Perez David, E., Martinez-Legazpi, P., Fernandez-Aviles, F., Bermejo, J. Tags: Original Research Source Type: research

Integration of Flow-Gradient Patterns Into Clinical Decision Making for Patients With Suspected Severe Aortic Stenosis and Preserved LVEF: A Systematic Review of Evidence and Meta-Analysis
Conclusions Patients with LFLG SAS have similar outcomes compared to HG SAS but worse compared to NFLG SAS. These findings support estimating stroke volume index in patients with suspected LG SAS. All analyses revealed high heterogeneity and further high-quality studies are necessary.
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - October 31, 2016 Category: Radiology Authors: Bavishi, C., Balasundaram, K., Argulian, E. Tags: Original Research Source Type: research

Transcatheter Aortic Valve Replacement With Early- and New-Generation Devices in Bicuspid Aortic Valve Stenosis
ConclusionsThe clinical outcomes of TAVR in patients with bicuspid AS were favorable. New-generation devices were associated with less paravalvular leak and, hence, a higher device success rate than early-generation devices. (The  Bicuspid Aortic Stenosis Following Transcatheter Aortic Valve Replacement Registry [Bicuspid TAVR]; NCT02394184)
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - September 5, 2016 Category: Radiology Source Type: research

Real-time phase contrast magnetic resonance imaging for assessment of haemodynamics: from phantom to patients
Conclusions The real-time sequence is accurate compared to conventional segmented PC-MRI. Its applicability in Afib was shown. Real-time PC-MRI might become a valuable tool in arrhythmia. Key Points • Assessment of haemodynamics is crucial in many cardiac diseases. • Arrhythmias are a major limitation of conventional techniques in cardiac magnetic resonance. • A real-time technique, which allows application in arrhythmia, was validated. ...
Source: European Radiology - March 5, 2016 Category: Radiology Source Type: research

Clinical Aspects and Current Evidence Base for Transcatheter Aortic Valve Implantation
Aortic stenosis (AS) is a common disorder that affects nearly 5% of individuals over 75 years of age. Many patients with AS are unable to undergo surgical valve replacement (SAVR) as they are commonly deemed to be of very high risk. Transcatheter aortic valve implantation (TAVI), introduced in 2002, is a new method for treatment of these patients. Computed tomography (CT) is becoming the gold standard imaging modality for preprocedural planning, including assessment of annular size and access. Since 2002,>100,000 procedures have been performed with either a balloon-expandable valve (Edwards SAPIEN valve) or the self-expand...
Source: Journal of Thoracic Imaging - October 23, 2015 Category: Radiology Tags: Symposium Review Articles Source Type: research

Replicating Patient-Specific Severe Aortic Valve Stenosis With Functional 3D Modeling Valvular Heart Disease
Conclusions— By combing the technologies of high-spatial resolution computed tomography, computer-aided design software, and fused dual-material 3D printing, we demonstrate that patient-specific models can replicate both the anatomic and functional properties of severe degenerative aortic valve stenosis.
Source: Circulation: Cardiovascular Imaging - October 8, 2015 Category: Radiology Authors: Maragiannis, D., Jackson, M. S., Igo, S. R., Schutt, R. C., Connell, P., Grande-Allen, J., Barker, C. M., Chang, S. M., Reardon, M. J., Zoghbi, W. A., Little, S. H. Tags: Catheter-based coronary and valvular interventions: other, CT and MRI, Echocardiography, CV surgery: valvular disease Valvular Heart Disease Source Type: research

Exploring the Role of Transcatheter Aortic Valve Replacement as the Preferred Treatment for Lower-Risk Patients
The investigators of the NOTION (Nordic Aortic Valve Intervention) trial showed that in an all-comers population of patients with severe aortic stenosis, transcatheter aortic valve replacement (TAVR) using the CoreValve self-expanding bioprosthesis (Medtronic Inc., Minneapolis, Minnesota) yielded similar rates of the composite endpoint of all-cause death, stroke, or myocardial infarction at 1 year compared with surgical bioprosthetic aortic valve replacement (1). Their study is the first to assess in a randomized trial the results of TAVR in a population including a high proportion of patients with low surgical risk (81.8...
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - September 28, 2015 Category: Radiology Source Type: research

Pages: 1  2  3