Caudal vena cava point-of-care ultrasound in dogs with degenerative mitral valve disease without clinically important right heart disease

Abstract Background Valvular heart disease (VHD) has been caught in two important cross-currents in recent decades: aging demography and the rise of multimodality imaging and transcatheter valve therapy. In this setting, we aim to identify the distribution, characteristics, and management of Chinese VHD patients according to age. Methods China Valvular Heart Disease Cohort Study (China-VHD) was conducted from March to September 2019 in 46 centers over China. It included prospectively 12331 adults with native moderate or severe VHD, of which we described the distribution, management, and in-hospital events according to age (18–44, 45–54, 55–64, 65–74, ≥75). Multivariate Logistic regression was employed to investigate the impact of age on in-hospital events composed of in-hospital mortality, acute heart failure, and stoke. Results In Chinese VHD population, overall percentage peaked in 55–64 year olds. The frequency of multivalvular heart disease (MVHD) saw an increasing trend with age (p for trend <0.001). Of single valvular heart disease, mitral regurgitation (MR) was the most frequent left-sided VHD followed by aortic regurgitation (AR), aortic stenosis (AS), and mitral stenosis (MS). AS frequency significantly grew with age (p for trend = 0.02) while AR peaked in 18–44 year olds and fluctuated at a lower level in the older population. In contrast, mitral valve disease (MS, MR, and mixed mitral valve disease) was most frequent in 45–54 year olds and dropped with age (p for trend all <0.001). Noteworthily, all aortic valve disease was notably frequent in men whereas mitral valve disease and MVHD more common in women. Similar to developed countries, degenerative etiology rose steeply while rheumatic and congenital origin fell with age. Regarding management, surgical valve replacement rate was similar in age groups lower than 75 years old with increasing frequency of concomitant CABG. No matter aortic or mitral, the percentage of bio-prosthesis rocketed after 65 years (aortic: 74.7%, mitral: 70.6%). In multivariate logistic regression, covariables included age, sex, BMI, hypertension, diabetes, coronary heart disease, aortic disease, cardiomyopathy, COPD, NYHA class and valvular intervention. Compared to patients younger than 45, in-hospital events significantly higher in patients over 75 only (OR: 1.69 [95% CI: 1.07–2.66], p<0.02). Moreover, women showed a lower risk of in-hospital events (OR: 0.78 [95% CI: 0.63–0.96], p<0.01). Age distribution of VHD Conclusion Age plays a crucial role in valvular heart disease, best illustrated in AS. Unlike the western world, AR and MR are more frequent than AS but show a slightly decreasing trend with age. As expected, degenerative etiology is becoming more prevalent whereas rheumatism decreases. Age over 75 and male are associated with growing in-hospital events. Degenerative VHD thus present an important public-health burden. Acknowledgement/Funding Innovation project of Chinese academy of medical science

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Mitral valve disease

10.1093/med/9780199599639.003.0015 ◽

2011 ◽

Cited By ~ 1

Author(s):

Patrizio Lancellotti ◽

Julien Magne ◽

Kim O’Connor ◽

Luc A. Pierard

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Mitral Valve Disease ◽

Aortic Valve Disease ◽

Valve Disease ◽

Two Dimensional ◽

Valve Repair ◽

Associated Lesions ◽

Echocardiographic Evaluation ◽

Valve Diseases

Native mitral valve disease is the second valvular heart disease after aortic valve disease. For the last few decades, two-dimensional Doppler echocardiography was the cornerstone technique for evaluating patients with mitral valve disease. Besides aetiological information, echocardiography allows the description of valve anatomy, the assessment of disease severity, and the description of the associated lesions.This chapter will address the echocardiographic evaluation of mitral regurgitation (MR) and mitral stenosis (MS).In MR, the following findings should be assessed: 1. Aetiology. 2. Type and extent of anatomical lesions and mechanisms of regurgitation. 3. The possibility of mitral valve repair. 4. Quantification of MR severity. 5. Quantification of MR repercussions.In MS, the following findings should be assessed: 1. Aetiology. 2. Type and extent of anatomical lesions. 3. Quantification of MS severity. 4. Quantification of MS repercussions. 5. Wilkins or Cormier scores for the possibility of percutaneous mitral commissuroplasty.Management of patients with mitral valve disease is currently based on symptoms and on echocardiographic evaluation at rest. Therefore, knowing how to assess the severity of valve diseases as well as the pitfalls and the limitations of each echocardiographic method is of primary importance.

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Evaluation of the functional capacity in dogs with naturally acquired heart disease

Veterinární Medicína ◽

10.17221/6808-vetmed ◽

2013 ◽

Vol 58 (No. 5) ◽

pp. 264-270 ◽

Cited By ~ 3

Author(s):

CF Agudelo ◽

P. Schanilec

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Functional Capacity ◽

Mitral Valve Disease ◽

Maximal Exercise ◽

Valve Disease ◽

Exercise Tests ◽

Walking Test ◽

Acquired Heart Disease ◽

Healthy Dogs

Functional capacity is the physical ability to perform a defined task. In humans it can be evaluated by using exercise testing, for instance sub-maximal exercise tests. Walking tests are widely used variations of sub-maximal exercise tests and in human medicine are considered to be realistically related to daily physical activity and prognosis in patients with heart failure. The aim of this study was to assess a sub-maximal exercise test in dogs with varying degrees of heart disease. The 6-minute walking test was used to test the functional capacity in healthy dogs and dogs with heart disease (degenerative mitral valve disease). Three groups of untrained owned dogs were compared. Two groups were dogs had mild and moderate degenerative mitral valve disease (ME-1 and ME-2, respectively) and the third group comprised healthy dogs with the same age and size conditions. Both groups of dogs with mitral valve disease walked shorter distances during 6 min (control 448.92 m; ME-1: 406.89 m; ME-2: 350.04 m). The influence of the test on the heart rate, electrocardiography and blood pressure was also evaluated. Although the 6-minute walking test has already been tested in healthy dogs, dogs with chronic pulmonary disease and dogs with artificially induced heart disease, this is the first time that this test has been validated in elderly dogs with naturally acquired heart disease. Thus, we demonstrate here that this test can be used reliably for assessing functional capacity in dogs with heart disease.  

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Use of measurements from thoracic radiographs to identify high mean left atrium pressure in dogs with myxomatous mitral valve disease

Semina Ciências Agrárias ◽

10.5433/1679-0359.2019v40n1p191 ◽

2019 ◽

Vol 40 (1) ◽

pp. 191

Author(s):

Flavio Shigueru Jojima ◽

Stephany Buba Lucina ◽

Alexandre Leseur Santos ◽

Marlos Gonçalves Sousa ◽

Tilde Rodrigues Froes

Keyword(s):

Mitral Valve ◽

Left Atrium ◽

Mitral Valve Disease ◽

Vena Cava ◽

Cross Sectional Study ◽

Valve Disease ◽

Radiographic Measurement ◽

Cross Sectional ◽

Heart Score ◽

Radiographic Measurements

The aim of this study was to estimate echocardiographic elevated mean left atrium pressure (MLAP) based on measurements from thoracic radiographs and to determine a cut-off value for each radiographic measurement that suggests a high MLAP. A retrospective cross-sectional study was performed to include cases admitted from January 2015 to December 2016. Thoracic radiographic examinations from 93 dogs with and without a high MLAP were included. Specific measurements were made from thoracic radiographs and compared with echocardiographic variables known to indicate high MLAP. This comparison was used to generate equations that allowed the estimation of echocardiographic surrogates from the radiographic measurements. The values indicative of high MLAP were obtained using a regression curve. Formulas that indicated high MLAP were generated using a number of radiographic measurements. Positive echocardiographic findings of high MLAP were used as the gold standard. These formulas helped to predict high MLAP in myxomatous mitral valve disease (MMVD) without the need for echocardiographic examination. The best formula was left atrium (LA):aorta (Ao)echo = 0.03×(vertebral heart score,VHS) + 0.14×(LA) + 0.27×(LA:caudal vena cava (CVC)rad). Values ? 12.2v for VHS, ? 4.5cm for LA, ? 3.3 for LA:Aorad and ? 3.2 for LA:CVCrad suggested high MLAP. Thus, we propose equations, based on measurements from thoracic radiographs, to identify high MLAP. Simple radiographic thoracic measurements, such as LA:CVCrad, can be used to define overload and a high MLAP in dogs with MMVD.

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Myxomatous mitral valve disease and related entities: The role of matrix in valvular heart disease

Cardiovascular Pathology ◽

10.1016/1054-8807(95)00052-7 ◽

1995 ◽

Vol 4 (4) ◽

pp. 257-264 ◽

Cited By ~ 9

Author(s):

Wanda M. Lester

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Valvular Heart Disease ◽

Mitral Valve Disease ◽

Valve Disease

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Association of IL-4 (intron 3) and IL-10 (-1082) gene polymorphisms with risk of mitral valve disease in children with rheumatic heart disease

Cardiology in the Young ◽

10.1017/s1047951115002413 ◽

2015 ◽

Vol 26 (7) ◽

pp. 1290-1296 ◽

Cited By ~ 3

Author(s):

Sherif M. Yousry ◽

Yasser Sedky ◽

Alaa Sobieh

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Rheumatic Heart Disease ◽

Mitral Valve Disease ◽

Gene Polymorphisms ◽

Cardiac Tissue ◽

Valve Disease ◽

Egyptian Children ◽

Significant Difference ◽

Rheumatic Heart

AbstractAimRheumatic heart disease is an inflammatory disease of cardiac tissue. The underlying pathogenic mechanisms highlight a complex interplay of immunological, genetic, and environmental factors. The aim of the present study was to investigate whether IL-4 (intron 3) and IL-10 (-1082) gene polymorphisms could be associated with susceptibility and/or severity of rheumatic heart disease among patients from the Egyptian population.Materials and methodsA cohort of 140 Egyptian children with rheumatic heart disease and 100 healthy controls were enrolled in this case–control study. Genotyping for IL-4 (intron 3) and IL-10 (-1082) gene polymorphisms was carried out for all patients using a polymerase chain reaction-based analysis.ResultsNo significant difference in the distribution of genotypes and allelic frequencies between rheumatic heart disease cases and controls for IL-4 (intron 3) (p=0.17; OR 1.07, 95% CI 0.82–3.74) and IL-10 (-1082) (p=0.49; OR 1.03, 95% CI 0.65–2.71) gene polymorphisms was observed. Further categorisation of patients into mitral valve disease and combined valve disease subgroups showed that cases with mitral valve disease have significantly higher frequency of the RP2 allele of IL-4 (intron 3) (p=0.03; OR 2.98, 95% CI 1.93–6.15) and the G allele of IL-10 (-1082) (p=0.04; OR 2.14, 95% CI 1.62–4.95) when compared with controls.DiscussionOur study shows that IL-4 (intron 3) and IL-10 (-1082) gene polymorphisms are not significantly associated with susceptibility to rheumatic heart disease, but they might play a role in the pathogenesis of patients with mitral valve disease.

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Repair versus replacement for degenerative mitral valve disease with coexisting ischemic heart disease

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/s0022-5223(02)73274-1 ◽

2003 ◽

Vol 125 (6) ◽

pp. 1350-1361 ◽

Cited By ~ 60

Author(s):

A.Marc Gillinov ◽

Christiano Faber ◽

Penny L Houghtaling ◽

Eugene H Blackstone ◽

Buu-Khanh Lam ◽

...

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Ischemic Heart Disease ◽

Mitral Valve Disease ◽

Valve Disease ◽

Ischemic Heart

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Transseptal Approach for Mitral Valve Replacement in Dextrocardia with Situs Inversus Totalis: A Case Report and Review of the Literature

The Heart Surgery Forum ◽

10.1532/hsf.2757 ◽

2020 ◽

Vol 23 (1) ◽

pp. E030-E033 ◽

Cited By ~ 1

Author(s):

Ovidiu Stiru ◽

Roxana Carmen Geana ◽

Razvan Radu Ilie ◽

Ovidiu Chioncel ◽

Raluca Tulin ◽

...

Keyword(s):

Case Report ◽

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Situs Inversus ◽

Mitral Valve Disease ◽

Vena Cava ◽

Situs Inversus Totalis ◽

Valve Disease ◽

Transseptal Approach

We consider mitral valve disease requiring surgery in a patient with dextrocardia and situs inversus totalis to be an exceptional finding. The transseptal approach for mitral valve surgery in dextrocardia represents a technical challenge owing to its anatomic particulars. We present the case of a 56-year-old female patient who had been diagnosed with situs inversus totalis in childhood and with chronic atrial fibrillation in adulthood and was under oral anticoagulant treatment. She was referred to our hospital for increasing dyspnea and palpitation. Transthoracic echocardiography detected severe mitral regurgitation associated with moderate tricuspid regurgitation, with normal left and right ventricular function. Contrast chest computed tomography (CT) and preoperative abdominal CT showed both dextrocardia and situs inversus totalis, with normal continuity of the inferior vena cava. Biatrial cannulation was performed with the surgeon standing on the right side of the patient, and mitral valve replacement using a transseptal approach was performed with the surgeon standing on the left side of the patient. In this case report, we emphasize the rarity of mitral valve disease in a patient with dextrocardia and the inherent potential difficulty that can appear in this particular anatomic condition.

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