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Valvular Heart Disease
Published in Paul Schoenhagen, Frank Dong, Cardiac CT Made Easy, 2023
The assessment of valvular heart disease is a strength of echocardiography and magnetic resonance imaging, because of their ability to assess anatomic and functional detail. Imaging with CT is limited secondary to the lower temporal resolution. However, advances in scanner technology have improved the assessment of valvular structures, and dynamic ‘4-D’ reconstruction of retrospective gated CT acquisition with fast multidetector scanners can provide insight into valvular function.68
Minimally Invasive Tricuspid Valve Surgery
Published in Theo Kofidis, Minimally Invasive Cardiac Surgery, 2021
Christos Alexiou, Theo Kofidis
Most commonly, TS results from rheumatic heart disease. Other less common causes of TS include congenital abnormalities (Ebstein’s anomaly or isolated tricuspid valve stenosis), metabolic or enzymatic abnormalities (Fabry’s disease, Whipple’s disease and carcinoid) and active infective endocarditis [12]. The 2014 AHA/ACC and ESC Valvular Heart Disease Guidelines recommend tricuspid valve surgery for (a) patients with severe TS at the time of operation for left-sided valve disease and (b) isolated, symptomatic severe TS (Class I recommendations). The guidelines further suggest percutaneous balloon commissurotomy in patients with isolated, symptomatic severe TS without accompanying TR and without calcified tricuspid valve [6–8].
Morphologic features and pathology of the elderly heart
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
Atsuko Seki, Gregory A. Fishbein, Michael C. Fishbein
Degenerative/calcific aortic stenosis (AS), also known as aortic stenosis of the elderly, or more politically correct, aging-related aortic stenosis, has become the most common type of valvular heart disease requiring valve surgery in industrialized countries, and is associated with significant morbidity and mortality (Figure 2.6) (61–64). Calcification of the aortic valve (AV) is seen in more than one fourth of individuals over 65 years and more than half of those over 85 years (63). Among octogenarians, AS was seen in 2.4%–8.1% (64,65).
Left ventricular long-axis ultrasound strain (GLS) is an ideal indicator for patients with anti-hypertension treatment
Published in Clinical and Experimental Hypertension, 2022
Tingting Wu, Lulu Zheng, Saidan Zhang, Lan Duan, Jing Ma, Lihuang Zha, Lingfang Li
The Research Ethics Committee of the Xiangya Hospital of Central South University had approved this study. All participating members had carefully read and signed informed consent. All enrolled members were divided into three groups, including 1) hypertensive treatment experimental group: 56 patients with newly diagnosed essential hypertension were followed up. 3) Healthy control group: 37 normal volunteers from the physical examination center were collected. The inclusion criteria are as follows: 1) Newly diagnosed essential hypertension. The diagnostic criteria included not taking antihypertensive drugs, measuring blood pressure three times on a different day, systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg (14); 2) 2) Patients with the previous diagnosis of hypertension and poor blood pressure control. After taking antihypertensive drugs, blood pressure was measured three times on a different day. The systolic blood pressure ≥140 mmHg and/or diastolic blood pressure≥90 mmHg. Moreover, exclusion criteria were as follows: 1) Patients have diagnosed as coronary heart disease; 2) Patients with various types of valvular heart disease; 3) Patients with various types of cardiomyopathy; 4) Patients with atrial fibrillation and atrial flutter; 5) Patients were previously diagnosed with primary and secondary pulmonary hypertension; 6) Patients with secondary hypertension; 7) LVEF <50% of patients with hypertension; 8) Patients with diabetes; 9) Patients with atrioventricular block of
The Revolution in Heart Valve Therapy: Focus on Novel Imaging Techniques in Intra-Procedural Guidance
Published in Structural Heart, 2021
Michaela M. Hell, Felix Kreidel, Martin Geyer, Tobias F. Ruf, Alexander R. Tamm, Jaqueline G. da Rocha e Silva, Thomas Münzel, Ralph Stephan von Bardeleben
Over the last decade, a great variety of novel treatment options have been developed for patients with valvular heart disease. Instead of open-chest heart surgery, the majority of patients are now treated with a transcatheter-based approach with this transition. Consequently, the toolbox of available interventional techniques and devices for transcatheter valvular repair and replacement therapy is steadily growing. As a relevant proportion of patients is deemed to be at high risk for surgery, the benefits of a less invasive therapy are obvious. However, the restricted field of view of the interventionalist requires comprehensive and precise intra-procedural imaging and 3D virtual rendering of the anatomic and flow information for device steering, precise positioning, and the evaluation of the final procedural result. Similar to the revolutionary advances in treatment devices, novel imaging tools have likewise emerged over the last years for empowering the cardiac interventionalist during transcatheter valvular interventions. These include advanced fusion imaging, three-dimensional (3D) intracardiac echocardiography, and refined 3D echocardiography rendering tools. This review provides an overview of the latest advanced imaging techniques with the focus on intraprocedural transcatheter valve intervention imaging.Figure 1Table 1
Biomarker and Invasive Hemodynamic Assessment of Cardiac Damage Class in Aortic Stenosis
Published in Structural Heart, 2021
James W. Lloyd, Allan S. Jaffe, Brian R. Lindman, Patricia A. Pellikka, Hector I. Michelena, Philippe Pibarot, Rick A. Nishimura, Barry A. Borlaug, Mackram F. Eleid
In developed countries, aortic valve stenosis (AS) constitutes the most commonly encountered form of valvular heart disease and stems from several pathophysiologic factors, including genetic contributions, inflammation, and fibrocalcific remodeling.1–3 Untreated, progressive AS precipitates left ventricular remodeling, cardiomyopathy, and heart failure.4 With its rising prevalence, new treatment modalities for AS have evolved, and transcatheter aortic valve replacement (TAVR) has become a first-line therapy in low- to high-risk surgical candidates.5,6 In response, numerous methods to identify suitable TAVR candidates and to gauge periprocedural risk have arisen. Recently, such methods have included an integrated assessment of “cardiac damage” in patients with AS, combining a collection of valve-specific and other echocardiographic variables of cardiovascular dysfunction and remodeling into a single model of candidacy and risk.7