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Assessing Optimal Blood Pressure in Patients with Asymptomatic Aortic Valve Stenosis: The SEAS Study.
CONCLUSIONS: -Optimal BP seems to be systolic 130-139 mmHg and diastolic 70-90 mmHg in these patients with asymptomatic AS and no manifest atherosclerotic disease or diabetes. Clinical Trial Registration-http://www.clinicaltrials.gov; NCT00092677. PMID: 27486164 [PubMed - as supplied by publisher]
Source: Circulation - August 1, 2016 Category: Cardiology Authors: Nielsen OW, Sajadieh A, Sabbah M, Greve AM, Olsen MH, Boman K, Nienaber CA, Kesäniemi YA, Pedersen TR, Willenheimer R, Wachtell K Tags: Circulation Source Type: research

One-Year Clinical Outcomes With SAPIEN 3 Transcatheter Aortic Valve Replacement in High-Risk and Inoperable Patients With Severe Aortic Stenosis.
CONCLUSIONS: In this large, adjudicated registry of SAPIEN 3 HR and inoperable patients, the very low rates of important complications resulted in a strikingly low mortality rate at 1 year. Between 30 and 365 days, the incidence of moderate paravalvular aortic regurgitation did not increase, and no association between mild paravalvular leak and 1-year mortality was observed, although a small increase in disabling stroke occurred. These results, which likely reflect device iteration and procedural evolution, support the use of transcatheter aortic valve replacement as the preferred therapy in HR and inoperable patients with...
Source: Circulation - July 11, 2016 Category: Cardiology Authors: Herrmann HC, Thourani VH, Kodali SK, Makkar RR, Szeto WY, Anwaruddin S, Desai N, Lim S, Malaisrie SC, Kereiakes DJ, Ramee S, Greason KL, Kapadia S, Babaliaros V, Hahn RT, Pibarot P, Weissman NJ, Leipsic J, Whisenant BK, Webb JG, Mack MJ, Leon MB, PARTNER Tags: Circulation Source Type: research

Gait Speed Predicts 30-Day Mortality Following Transcatheter Aortic Valve Replacement: Results From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry™.
CONCLUSIONS: -Gait speed is independently associated with 30-day mortality following TAVR. Identification of frail patients with the slowest gait speeds facilitates pre-procedural evaluation and anticipation of a higher level of post-procedural care. Clinical Trial Registration Information-ClinicalTrials.gov. Identifier: NCT01737528. PMID: 26920495 [PubMed - as supplied by publisher]
Source: Circulation - February 26, 2016 Category: Cardiology Authors: Alfredsson J, Stebbins A, Brennan JM, Matsouaka R, Afilalo J, Peterson ED, Vemulapalli S, Rumsfeld JS, Shahian D, Mack MJ, Alexander KP Tags: Circulation Source Type: research

Apixaban Compared with Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease: Findings From the ARISTOTLE Trial.
CONCLUSIONS: -More than a quarter of the patients in ARISTOTLE with "nonvalvular" atrial fibrillation had moderate or severe valvular heart disease. There was no evidence of a differential effect of apixaban over warfarin in reducing stroke or systemic embolism, causing less bleeding, and reducing death in patients with and without valvular heart disease. Clinical Trial Registration Information-clinicaltrials.gov. Identifier: NCT00412984. PMID: 26106009 [PubMed - as supplied by publisher]
Source: Circulation - June 23, 2015 Category: Cardiology Authors: Avezum A, Lopes RD, Schulte PJ, Lanas F, Gersh BJ, Hanna M, Pais P, Erol C, Diaz R, Bahit MC, Bartunek J, De Caterina R, Goto S, Ruzyllo W, Zhu J, Granger CB, Alexander JH Tags: Circulation Source Type: research

Propensity-Matched Comparisons of Clinical Outcomes after Transapical or Transfemoral TAVR: A PARTNER-I Trial Substudy.
CONCLUSIONS: -Likelihood of adverse periprocedural events and prolonged recovery is greater after TA-TAVR than TF-TAVR in vasculopathic patients after accounting for differences in cardiovascular risk factors, although stroke risk is equivalent and aortic regurgitation less. As smaller delivery systems permit TF-TAVR in many of these patients, we recommend a TF-first access strategy for TAVR when anatomically feasible. Clinical Trial Registration-www.clinicaltrials.gov. Identifier: NCT00530894. PMID: 25832034 [PubMed - as supplied by publisher]
Source: Circulation - April 1, 2015 Category: Cardiology Authors: Blackstone EH, Suri RM, Rajeswaran J, Babaliaros V, Douglas PS, Fearon WF, Miller DC, Hahn RT, Kapadia SR, Kirtane AJ, Kodali SK, Mack M, Szeto WY, Thourani VH, Tuzcu EM, Williams MR, Akin JJ, Leon MB, Svensson LG Tags: Circulation Source Type: research

Prevalence and long-term outcome of aortic prosthesis-patient mismatch in patients with paradoxical low-flow severe aortic stenosis.
CONCLUSIONS: In this large catheterization-based study, the coexistence of PLF-AS before surgery and PPM after surgery is associated with the poorest outcome. PMID: 25200051 [PubMed - in process]
Source: Circulation - September 9, 2014 Category: Cardiology Authors: Mohty D, Boulogne C, Magne J, Pibarot P, Echahidi N, Cornu E, Dumesnil J, Laskar M, Virot P, Aboyans V Tags: Circulation Source Type: research

Stroke after Aortic Valve Surgery: Results from a Prospective Cohort.
CONCLUSIONS: Clinical stroke after AVR was more common than previously reported, more than double for this same cohort in the STS database, and silent cerebral infarctions were detected in over half of patients undergoing AVR. Clinical stroke complicating AVR is associated with increased length of stay and mortality. PMID: 24690611 [PubMed - as supplied by publisher]
Source: Circulation - April 1, 2014 Category: Cardiology Authors: Messé SR, Acker MA, Kasner SE, Fanning M, Giovannetti T, Ratcliffe SJ, Bilello M, Szeto WY, Bavaria JE, Hargrove WC, Mohler ER, Floyd TF, for the Determining Neurologic Outcomes from Valve Operations (DeNOVO) investigators Tags: Circulation Source Type: research

Stroke after Aortic Valve Replacement: The Known and Unknown.
Abstract Stroke following aortic valve surgery is known as a devastating complication and is associated with increased morbidity and mortality.(1) Transcatheter aortic valve replacement (TAVR) has emerged as a valid alternative for surgical aortic valve replacement (SAVR) in both inoperable patients and in those at high risk for surgery; however, the encouraging results were hampered by various complications including stroke. In the pivotal Placement of AoRTic TraNscathetER (PARTNER) trial, the initial stroke rates of TAVR patients were almost double in comparison to patients who underwent SAVR (3.8% vs. 2.1%; p=0...
Source: Circulation - April 1, 2014 Category: Cardiology Authors: Waksman R, Minha S Tags: Circulation Source Type: research

Predictors of Long-Term Outcomes in Patients with Significant Myxomatous Mitral Regurgitation Undergoing Exercise Echocardiography.
CONCLUSIONS: In patients with ≥III+ myxomatous MR undergoing ExEc, lower %age-gender predicted METS, lower HRR, atrial fibrillation, lower LV ejection fraction and high resting RVSP predicted worse outcomes. PMID: 24396041 [PubMed - as supplied by publisher]
Source: Circulation - January 6, 2014 Category: Cardiology Authors: Naji P, Griffin BP, Asfahan F, Barr TS, Rodriguez LL, Grimm R, Agarwal S, Stewart WJ, Mihaljevic T, Gillinov AM, Desai MY Tags: Circulation Source Type: research

Flow-Gradient Patterns in Severe Aortic Stenosis with Preserved Ejection Fraction: Clinical Characteristics and Predictors of Survival.
CONCLUSIONS: NF/LG severe AS with preserved EF exhibits favorable survival with medical management and impact of AVR on survival was neutral. LF/LG severe AS is characterized by a high prevalence of atrial fibrillation, heart failure and reduced survival, and AVR was associated with improved survival. These findings have implications for evaluation of AS severity and subsequent management. PMID: 24048203 [PubMed - as supplied by publisher]
Source: Circulation - September 18, 2013 Category: Cardiology Authors: Eleid MF, Sorajja P, Michelena HI, Malouf JF, Scott CG, Pellikka PA Tags: Circulation Source Type: research

Paradoxical Low-Flow, Low-Gradient Aortic Stenosis: New Evidences, More Questions.
Abstract In the American Heart Association (AHA) / American College of Cardiology (ACC) and European Society of Cardiology (ESC) / European Association of Cardiothoracic Surgery (EACTS) guidelines,(1,2) severe aortic stenosis (AS) is defined as a peak aortic jet velocity >4.0 m/s, a mean gradient >40 mmHg, and/or an aortic valve area (AVA) <1.0 cm(2) and it is considered a class I indication for aortic valve replacement (AVR) if the patient has symptoms or LV systolic dysfunction defined as LV ejection fraction (LVEF) <50%. However, the cardiologist is often confronted with patients with discordant ech...
Source: Circulation - September 18, 2013 Category: Cardiology Authors: Pibarot P, Dumesnil JG Tags: Circulation Source Type: research

Systemic Hypertension in Low Gradient Severe Aortic Stenosis with Preserved Ejection Fraction.
CONCLUSIONS: Systemic hypertension in LG severe AS with preserved EF is associated with elevated LV filling pressures and pulmonary hypertension. Treatment of hypertension with vasodilator therapy results in a lowering of the total LV afterload, with a decrease in LV filling pressures and pulmonary artery pressures. These findings have important implications for the management of patients with LG severe AS with preserved EF and hypertension. PMID: 23956211 [PubMed - as supplied by publisher]
Source: Circulation - August 16, 2013 Category: Cardiology Authors: Eleid MF, Nishimura RA, Sorajja P, Borlaug BA Tags: Circulation Source Type: research

Impact of Aortic Valve Replacement on Outcome of Symptomatic Patients with Severe Aortic Stenosis with Low Gradient and Preserved Left Ventricular Ejection Fraction.
CONCLUSIONS: AVR is associated with better survival than medical therapy in patients with symptomatic low gradient severe AS and preserved LVEF. PMID: 23812184 [PubMed - as supplied by publisher]
Source: Circulation - June 27, 2013 Category: Cardiology Authors: Ozkan A, Hachamovitch R, Kapadia SR, Tuzcu EM, Marwick TH Tags: Circulation Source Type: research

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