Valvular heart disease

2017 ◽  
Author(s):  
Petri T. Kovanen ◽  
Magnus Bäck
Keyword(s):  
Extracellular Matrix ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Inflammatory Cell ◽  
Valvular Interstitial Cells ◽  
Mitral Valves ◽  
Cardiac Blood ◽  
Extracellular Matrix Remodelling ◽  
Flow Through

The heart valves, which maintain a unidirectional cardiac blood flow, are covered by endothelial cells and structurally composed by valvular interstitial cells and extracellular matrix. Valvular heart disease can be either stenotic, causing obstruction of the valvular flow, or regurgitant, referring to a back-flow through the valve. The pathophysiological changes in valvular heart disease include, for example, lipid and inflammatory cell infiltration, calcification, neoangiogenesis, and extracellular matrix remodelling. The present chapter addresses the biology of the aortic and mitral valves, and the pathophysiology of aortic stenosis and mitral valve prolapse.

Extracellular matrix coating improves the biocompatibility of polymeric heart valves

2020 ◽  
Vol 8 (46) ◽  
pp. 10616-10629
Author(s):  
Binggang Wu ◽  
Linhe Jin ◽  
Kailei Ding ◽  
Yonghua Zhou ◽  
Li Yang ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Heart Disease ◽  
Valve Replacement ◽  
Heart Valve ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Prosthetic Heart Valve ◽  
Effective Therapy ◽  
Heart Valve Replacement

Prosthetic heart valve replacement is an effective therapy for patients with valvular heart disease.

Oral anticoagulants in atrial fibrillation with valvular heart disease and bioprosthetic heart valves

Heart ◽  
2019 ◽  
Vol 105 (18) ◽  
pp. 1432-1436 ◽  
Author(s):  
Aaqib H Malik ◽  
Srikanth Yandrapalli ◽  
Wilbert S Aronow ◽  
Julio A Panza ◽  
Howard A Cooper
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Major Bleeding ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Cardiac Events ◽  
Increased Risk ◽  
Randomised Controlled

ObjectiveCurrent guidelines endorse the use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF). However, little is known about their safety and efficacy in valvular heart disease (VHD). Similarly, there is a paucity of data regarding NOACs use in patients with a bioprosthetic heart valve (BPHV). We, therefore, performed a network meta-analysis in the subgroups of VHD and meta-analysis in patients with a BPHV.MethodsPubMed, Cochrane and Embase were searched for randomised controlled trials. Summary effects were estimated by the random-effects model. The outcomes of interest were a stroke or systemic embolisation (SSE), myocardial infarction (MI), all-cause mortality, major adverse cardiac events, major bleeding and intracranial haemorrhage (ICH).ResultsIn patients with VHD, rivaroxaban was associated with more ICH and major bleeding than other NOACs, while edoxaban 30 mg was associated with least major bleeding. Data combining all NOACs showed a significant reduction in SSE, MI and ICH (0.70, [0.57 to 0.85; p<0.001]; 0.70 [0.50 to 0.99; p<0.002]; and 0.46 [0.24 to 0.86; p<0.01], respectively). Analysis of 280 patients with AF and a BPHV showed similar outcomes with NOACs and warfarin.ConclusionsNOACs performed better than warfarin for a reduction in SSE, MI and ICH in patients with VHD. Individually NOACs performed similarly to each other except for an increased risk of ICH and major bleeding with rivaroxaban and a reduced risk of major bleeding with edoxaban 30 mg. In patients with a BPHV, results with NOACs seem similar to those with warfarin and this needs to be further explored in larger studies.

scholarly journals A study to assess valvular heart disease in a tertiary care hospital: a single centre finding

2019 ◽  
Vol 6 (3) ◽  
pp. 774
Author(s):  
Prakash R. Ghogale ◽  
Shishir K. Wanjari ◽  
Daneshwar Singh ◽  
Hanumanth N. ◽  
Harshal G. Mendhe
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Tertiary Care ◽  
Care Hospital ◽  
Longitudinal Case Study ◽  
Dominant Form ◽  
Medical College ◽  
Cardiovascular Morbidity And Mortality

Background: Diseases of the heart valves constitute a major cause of cardiovascular morbidity and mortality worldwide with an enormous burden on healthcare resources. The present study was undertaken to study incidence and demography of valvular heart disease, to assess echocardiography and colour doppler findings of patients with valvular heart disease and to find out complications in patients with valvular heart disease.Methods: A hospital based longitudinal case study was undertaken at medicine department of Dr. V.M. Government Medical College, Solapur, Maharashtra, India for a period of two years. One hundred and twenty-four (124) patients attending OPD participated in the study.Results: In the present study, out of 124 patients, mitral valve was most commonly involved, 105(84.67%) and the least common involved was tricuspid 1(0.81%). The most common aetiology was rheumatic origin 75(94.94%). In the present study the most common complication was pulmonary hypertension 69(55.65%), followed by congestive cardiac failure (33.87%), acute pulmonary edema (12.09%), infective endocarditis (4.84%), cerebrovascular accident (4.03%), left atrial thrombus (3.23%) and death (3.23%).Conclusions: Multiple valves were affected in more than a third of all cases, although recent research in India continue to demonstrate a declining trend in the prevalence of RHD, rheumatic involvement is still the dominant form of valvular heart disease in India.

scholarly journals Heart failure requiring hospitalization in patients after cardiac surgery for valvular heart disease

2019 ◽  
Vol 26 (2) ◽  
pp. 57-62
Author(s):  
A. V. Zhadan
Keyword(s):  
Heart Failure ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Reverse Remodeling ◽  
Damage Indicators ◽  
Heart Pathology ◽  
Permanent Form

The aim – to determine the factors associated with the frequency of hospitalizations for decompensation of heart failure (HF) after cardiac surgery in patients with valvular heart disease. Materials and methods. 235 patients who underwent cardiac surgery for valvular heart disease were examined. During the period from 2014 to 2017, a part of patients (129 people) had no hospitalizations, while 106 people were on inpatient treatment from 1 to 10 times, on average 2.78±1.95. The complex of examination of patients along with physical examination included electrocardiography, echocardiography. Results and discussion. During dynamic observation for 2 years in the group of patients without hospitalization, a progressive statistically significant decrease in the size of the left atrium (LA) and left ventricle (LV) as well as an increase in LV contractility were noted, while in the group of patients after hospitalization such changes were not observed. The dimensions of the chambers of the heart remained practically unchanged for 2 years. Thus, it can be concluded that the more severe course of heart failure after prosthetics of heart valves is accompanied by the absence of reverse remodeling of the heart chambers. Predictors of hospitalizations for HF are the presence of diabetes mellitus, hypertension and permanent form of atrial fibrillation. Conclusions. The probability of progression of heart failure in patients after cardiosurgical intervention for valvular heart pathology is not affected by sex, age, type of lesion of the valve, etiology of valve damage, indicators of echocardiography. Predictors of hospitalizations for heart faiure in the long-term postoperative period are the presence of diabetes, AF, and AH. The more severe course of heart failure after prosthetics of heart valves is accompanied by the absence of reverse remodeling of the heart chambers.

scholarly journals Ochronotic Involvement of the Aortic and Mitral Valves in a 72-Year-Old Man

2015 ◽  
Vol 42 (1) ◽  
pp. 84-86 ◽  
Author(s):  
Atakan Atalay ◽  
Ugur Gocen ◽  
Yuksel Basturk ◽  
Erkan Kozanoglu ◽  
Hafize Yaliniz
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Aortic Stenosis ◽  
Valve Replacement ◽  
Valvular Heart Disease ◽  
Metabolic Disorder ◽  
Autosomal Recessive ◽  
Homogentisic Acid ◽  
Mitral Insufficiency ◽  
Mitral Valves

Ochronosis, an autosomal recessive metabolic disorder, causes an excess of homogentisic acid that results in adverse pigmentation, calcification, and inflammation of cartilaginous and other tissues. Cardiovascular abnormalities are less frequently reported than are other manifestations. In rare cases, ochronosis can cause valvular heart disease. We report the case of a 72-year-old man with aortic stenosis and mitral insufficiency who was diagnosed with ochronosis while undergoing surgical aortic and mitral valve replacement. We discuss the history and surgical management of alkaptonuric ochronosis.

Cyproheptadine prevents pergolide-induced valvulopathy in rats: an echocardiographic and histopathological study

2009 ◽  
Vol 296 (6) ◽  
pp. H1940-H1948 ◽  
Author(s):  
Steven Droogmans ◽  
Bram Roosens ◽  
Bernard Cosyns ◽  
Céline Degaillier ◽  
Sophie Hernot ◽  
...  
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Wistar Rats ◽  
The Other ◽  
Histopathological Study ◽  
Clinical Implications ◽  
Drug Induced ◽  
Mitral Valves ◽  
Male Wistar Rats ◽  
Serotonergic Drugs

Serotonergic drugs, such as pergolide, have been associated with the development of cardiac valvular myxoid thickening and regurgitation in humans and more recently in rats. These effects are potentially mediated by the 5-hydroxytryptamine (5-HT)2B receptor (5-HT2BR). Therefore, we sought to determine whether cyproheptadine, a 5-HT2BR antagonist, might prevent toxic valvulopathy in an animal model of pergolide-induced valvular heart disease. For this purpose, 50 male Wistar rats received daily intraperitoneal injections of pergolide (0.5 mg/kg, n = 14), pergolide (0.5 mg/kg) combined with cyproheptadine (10 mg/kg, n = 12), cyproheptadine (10 mg/kg, n = 12), or no injections (control, n = 12) for 20 wk. Echocardiography was performed blindly at baseline and at 10 and 20 wk followed by pathology. At baseline, no differences between groups were found with echocardiography. At 20 wk, aortic regurgitation was present in all pergolide-treated animals, whereas it was less frequently observed in the other groups ( P < 0.0001). For the other valves, this difference was less pronounced. On histopathology, not only aortic but also mitral valves were thicker, myxoid, and exhibited more 5-HT2BR-positive cells in pergolide-treated animals compared with the other groups. Moreover, regurgitant aortic and mitral valves were thicker than nonregurgitant aortic and mitral valves. In conclusion, we found that cyproheptadine prevented pergolide-induced valvulopathy in rats, which was associated with a reduced number of 5-HT2BR-positive valvular cells. This may have important clinical implications for the prevention of serotonergic drug-induced valvular heart disease.

scholarly journals Platelet Survival Measurement - Clinical Results.

1977 ◽  
Author(s):  
E. Genton
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Clinical Results ◽  
Prosthetic Heart Valves ◽  
Drug Reactions ◽  
Recurrent Thrombosis ◽  
Platelet Survival ◽  
Thrombotic Complications ◽  
Foreign Surface

Platelet survival (PS) time has been studied in patients in a variety of clinical circumstances associated with abnormal numbers of platelets, suspected thrombotic process, or after platelet suppressing drug administration.In conditions with thrombocytopenia, PS may differentiate decreased platelet production (ineffective thrombopoiesis or megakaryocyte hypoplasia) where PS is normal from increased destruction of platelets where PS is shortened. Increased destruction may arise from: extrinsic mechanisms, e.g. immunologic (ITP-SLE-drug reactions) or abnormal surface (diseased endothelium or foreign surface) are associated with short PS, often to extreme degrees; intrinsic platelet defect (Wiskott-Aldrich Syndrome), where autologous PS is shortened and isologous PS is normal.In thrombotic disorders, PS is shortened during active thrombosis and may be chronically shortened in conditions with recurrent thrombosis (homocystinemia, atheroslcerosis, valvular heart disease). The test may prove useful in prognosis (e.g. valvular heart disease patients with shortened platelet survival may have higher risk of embolic events than with normal PS).Only a few platelet suppressing drugs (including sulfinpyrazone and dipyridamole) affect a shortened platelet survival time. These reduce thrombosis in patients with prosthetic heart valves and silastic AV shunts, suggesting PS may identify useful drugs.Thus, PS may differentiate disease conditions associated with abnormal platelets, predict the course of patients at high risk of thrombotic complications, and identify clinically useful platelet suppressing drugs, or serve as a monitor for measuring effects of drug treatment.

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