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Heart (British Cardiac Society) Sep 2021
Topics: Aged; Aortic Valve Stenosis; Female; Global Health; Heart Valve Prosthesis Implantation; Humans; Male; Prevalence; Severity of Illness Index
PubMed: 34433627
DOI: 10.1136/heartjnl-2021-320128 -
Heart (British Cardiac Society) Sep 2020
Topics: 1-Alkyl-2-acetylglycerophosphocholine Esterase; Aortic Valve; Aortic Valve Stenosis; Calcinosis; Humans; Lipids
PubMed: 32636297
DOI: 10.1136/heartjnl-2020-317188 -
JACC. Cardiovascular Imaging Sep 2021
Topics: Aortic Valve Stenosis; Heart Valve Diseases; Humans; Predictive Value of Tests
PubMed: 34274286
DOI: 10.1016/j.jcmg.2021.05.027 -
Myocardial Damage and Severe Aortic Stenosis: Looking Beyond the Left Ventricular Ejection Fraction.Journal of the American College of... Aug 2021
Topics: Aortic Valve Stenosis; Humans; Stroke Volume; Transcatheter Aortic Valve Replacement; Ventricular Function, Left
PubMed: 34353532
DOI: 10.1016/j.jacc.2021.05.046 -
International Journal of Cardiology Aug 2024
Topics: Humans; Aortic Valve Stenosis; Cost of Illness; Time Factors; Male; Female; Aged
PubMed: 38705208
DOI: 10.1016/j.ijcard.2024.132134 -
Journal of the American College of... Aug 2022
Topics: Aortic Valve; Aortic Valve Stenosis; Humans; Medical Futility; Risk Factors; Transcatheter Aortic Valve Replacement; Treatment Outcome
PubMed: 35981823
DOI: 10.1016/j.jacc.2022.06.011 -
Journal of the American College of... Nov 2019Underserved minorities make up a disproportionately small subset of patients in the United States undergoing transcatheter and surgical aortic valve replacement for... (Review)
Review
Underserved minorities make up a disproportionately small subset of patients in the United States undergoing transcatheter and surgical aortic valve replacement for aortic stenosis. The reasons for these treatment gaps include differences in disease prevalence and patient, health care system, and disease-related factors. This has major implications not only for minority patients, but also for other groups who face similar challenges in accessing state-of-the-art care for structural heart disease. The authors propose the following key strategies to address these treatment disparities: 1) implementation of measure-based quality improvement programs; 2) effective culturally competent communication and team-based care; 3) improving patient health care access, education, and effective diagnosis; and 4) changing the research paradigm that creates an innovation pipeline for patients. Only a concerted effort from all stakeholders will achieve equitable and broad application of this and other novel structural heart disease treatment modalities in the future.
Topics: Aortic Valve Stenosis; Health Status Disparities; Healthcare Disparities; Humans; Vulnerable Populations
PubMed: 31672188
DOI: 10.1016/j.jacc.2019.08.1035 -
European Review For Medical and... Dec 2019Aortic valve stenosis (AS) presents a disease during which there are changes of the aortic valve structure that modify the blood structure of patients. The aim of this...
OBJECTIVE
Aortic valve stenosis (AS) presents a disease during which there are changes of the aortic valve structure that modify the blood structure of patients. The aim of this study was to improve the effectiveness of differential diagnostics of aortic stenosis and aortic regurgitation using molecular techniques on both mRNA (RT-PCR) and protein (biochip protein).
PATIENTS AND METHODS
An experimental group (n = 58) consisting of patients with aortic valve stenosis (n = 26) and aortic regurgitation (AR, n = 32) was compared with a control group (n = 35). Both blood serum and valve tissue samples were used for the determination of gene expression specific genes related to inflammatory response (CRP, IL6, IL2R, IL6R, TNFR1, and 2) as well as genes and proteins involved in remodeling of the extracellular matrix (MMP9, TIMP, Emilin-1).
RESULTS
We found that hsCRP and IL6 plasma levels of patients with AS were higher than both controls and patients with AR (mean 5.6 ng/ml). The differences between AS and AR were detected only in mRNA levels of MMP9 and TIMP where increased levels characteristic for AS were found (about 74%, p < 0.01 and 87%, p < 0.001 higher than AR).
CONCLUSIONS
The achieved results could contribute to the improvement of early diagnosis of selected cardiovascular disease in the future and improve the quality of patient's life.
Topics: Aortic Valve Insufficiency; Aortic Valve Stenosis; Female; Humans; Male; Middle Aged; Protein Array Analysis; Real-Time Polymerase Chain Reaction
PubMed: 31858570
DOI: 10.26355/eurrev_201912_19805 -
European Heart Journal. Cardiovascular... Oct 2020
Topics: Aortic Valve Stenosis; Heart Ventricles; Humans
PubMed: 33020801
DOI: 10.1093/ehjci/jeaa260 -
Journal of Cardiac Surgery Dec 2021Bicuspid aortic valve is the most common congenital heart defect and predisposes patients to developing aortic stenosis more frequently and at a younger age than the...
BACKGROUND
Bicuspid aortic valve is the most common congenital heart defect and predisposes patients to developing aortic stenosis more frequently and at a younger age than the general population. However, the influence of bicuspid aortic valve on the rate of progression of aortic stenosis remains unclear.
METHODS
In 236 patients (177 tricuspid aortic valve and 59 bicuspid aortic valve) matched by initial severity of mild or moderate aortic stenosis, we retrospectively analyzed baseline echocardiogram at diagnosis with latest available follow-up echocardiogram. Baseline comorbidities, annualized progression rate of hemodynamic parameters, and hazard of aortic valve replacement were compared between valve phenotypes.
RESULTS
Median echocardiographic follow-up was 2.6 (interquartile range [IQR] 1.6-4.2) years. Patients with tricuspid aortic stenosis were significantly older with more frequent comorbid hypertension and congestive heart failure. Median annualized progression rate of mean gradient was 2.3 (IQR 0.6-5.0) mmHg/year versus 1.5 (IQR 0.5-4.1) mmHg/year (p = .5), and that of peak velocity was 0.14 (IQR 0-0.31) m/s/year versus 0.10 (IQR 0.04-0.26) m/s/year (p = .7) for tricuspid versus bicuspid aortic valve, respectively. On multivariate analyses, bicuspid aortic valve was not significantly associated with more rapid progression of aortic stenosis. In a stepwise Cox proportional hazards model adjusted for baseline mean gradient, bicuspid aortic valve was associated with increased hazard of aortic valve replacement (hazard ratio: 1.7, 95% confidence interval [1.0-3.0], p = .049).
CONCLUSION
Bicuspid aortic valve may not significantly predispose patients to more rapid progression of mild or moderate aortic stenosis. Guidelines for echocardiographic surveillance of aortic stenosis need not be influenced by valve phenotype.
Topics: Aortic Valve; Aortic Valve Stenosis; Bicuspid Aortic Valve Disease; Humans; Retrospective Studies; Transcatheter Aortic Valve Replacement
PubMed: 34585444
DOI: 10.1111/jocs.16026