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JACC. Cardiovascular Imaging Sep 2019The first-line evaluation of aortic stenosis severity is Doppler echocardiography. However, in up to 40% of patients, resting echocardiographic assessment of aortic... (Review)
Review
The first-line evaluation of aortic stenosis severity is Doppler echocardiography. However, in up to 40% of patients, resting echocardiographic assessment of aortic stenosis severity is discordant, leading to clinical uncertainty. Interest has therefore grown in aortic valve calcium scoring by multidetector computed tomography (CT-AVC) as an alternative load independent assessment of aortic stenosis severity. This paper will briefly review the pathophysiology of aortic stenosis and the crucial role that calcification plays in driving progressive obstruction of the valve. Subsequently, it will describe published reports that have investigated CT-AVC, validating this parameter against histology, and establishing its diagnostic accuracy versus echocardiography as well as its powerful independent prognostic capability. Finally, this review seeks to provide a practical guide about how best to acquire and interpret CT-AVC with a close focus on potential pitfalls and how these might be best avoided as this technique becomes more widely adopted in to clinical practice.
Topics: Aged; Aged, 80 and over; Aortic Valve; Aortic Valve Stenosis; Calcinosis; Echocardiography, Doppler, Color; Echocardiography, Transesophageal; Female; Hemodynamics; Humans; Male; Multidetector Computed Tomography; Predictive Value of Tests; Prognosis; Reproducibility of Results; Severity of Illness Index
PubMed: 31488252
DOI: 10.1016/j.jcmg.2019.01.045 -
Science Advances Jun 2023Hemodynamic overload and dysregulation of cellular metabolism are involved in development of calcific aortic valve disease (CAVD). However, how mechanical stress relates...
Hemodynamic overload and dysregulation of cellular metabolism are involved in development of calcific aortic valve disease (CAVD). However, how mechanical stress relates to metabolic changes in CAVD remains unclear. Here, we show that Piezo1, a mechanosensitive ion channel, regulated glutaminase 1 (GLS1)-mediated glutaminolysis to promote osteogenic differentiation of valve interstitial cells (VICs). In vivo, two models of aortic valve stenosis were constructed by ascending aortic constriction (AAC) and direct wire injury (DWI). Inhibition of Piezo1 and GLS1 in these models respectively mitigated aortic valve lesion. In vitro, Piezo1 activation induced by Yoda1 and oscillatory stress triggered osteogenic responses in VICs, which were prevented by Piezo1 inhibition or knockdown. Mechanistically, Piezo1 activation promoted calcium-dependent Yes-associated protein (YAP) activation. YAP modulated GLS1-mediated glutaminolysis, which enhanced osteogenic differentiation through histone acetylation of runt-related transcription factor 2 (RUNX2) promoters. Together, our work provided a cross-talk between mechanotransduction and metabolism in the context of CAVD.
Topics: Aortic Valve; Osteogenesis; Mechanotransduction, Cellular; Cells, Cultured; Cell Differentiation
PubMed: 37267365
DOI: 10.1126/sciadv.adg0478 -
Anaesthesiology Intensive Therapy 2019
Topics: Aortic Valve; Aortic Valve Insufficiency; Echocardiography, Transesophageal; Humans
PubMed: 31995954
DOI: 10.5114/ait.2019.90986 -
JACC. Cardiovascular Interventions Nov 2020
Topics: Aortic Valve; Aortic Valve Stenosis; Humans; Transcatheter Aortic Valve Replacement; Treatment Outcome
PubMed: 33153564
DOI: 10.1016/j.jcin.2020.07.042 -
The Journal of Thoracic and... May 2021
Topics: Aortic Valve; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Robotic Surgical Procedures
PubMed: 33461816
DOI: 10.1016/j.jtcvs.2020.11.122 -
Cleveland Clinic Journal of Medicine Oct 2018
Topics: Aortic Valve; Aortic Valve Stenosis; Bicuspid Aortic Valve Disease; Heart Valve Diseases; Humans; Transcatheter Aortic Valve Replacement; Treatment Outcome
PubMed: 30289753
DOI: 10.3949/ccjm.85a.18101 -
Cardiology 2018
Topics: Aortic Valve; Aortic Valve Stenosis; Humans; Tomography, X-Ray Computed; Transcatheter Aortic Valve Replacement; Treatment Outcome
PubMed: 29996138
DOI: 10.1159/000490094 -
Cardiology 2022Unicuspid aortic valve (UAV) is a rare congenital aortic valve anomaly. It has 2 subtypes and often is associated with aortic valve dysfunction and corresponding... (Review)
Review
Unicuspid aortic valve (UAV) is a rare congenital aortic valve anomaly. It has 2 subtypes and often is associated with aortic valve dysfunction and corresponding clinical presentations. Echocardiography is the first choice of diagnostic method for UAV. Three-dimensional echocardiography has played an increasingly important role in diagnosis, intraprocedural guidance, and post-procedural assessment in recent years. There remain challenges in distinguishing UAV from bicuspid aortic valve or tricuspid aortic valve. Misdiagnosis is most resulted from raphes or leaflet calcifications. Multi-modality imaging has obvious advantages over single-modality imaging and is crucial for UAV diagnosis. Accurate identification of aortic valve morphology is important to choose the best treatment. Aortic balloon valvoplasty, surgical valvotomy, commissurotomy, Ross procedure, surgical valve repair, and surgical replacement are most common treatment modalities of UAV. In this review, we aim to discuss UAV including epidemiology, definition, classification, diagnostic importance and necessity, valvular function, clinical presentation, associated disorders, noninvasive diagnostic modalities, and therapeutic approaches.
Topics: Aortic Valve; Aortic Valve Stenosis; Echocardiography; Heart Defects, Congenital; Heart Valve Diseases; Humans
PubMed: 34965530
DOI: 10.1159/000521623 -
The Journal of Thoracic and... Apr 2021
Topics: Aortic Valve; Aortic Valve Stenosis; Humans; Simvastatin; Transcatheter Aortic Valve Replacement
PubMed: 31813536
DOI: 10.1016/j.jtcvs.2019.10.138 -
JACC. Cardiovascular Imaging Jan 2019
Topics: Aortic Valve; Heart Valve Prosthesis; Transcatheter Aortic Valve Replacement
PubMed: 29778870
DOI: 10.1016/j.jcmg.2018.04.007