scholarly journals Outpatient management of heart valve disease following the COVID-19 pandemic: implications for present and future care

Heart ◽  
2020 ◽  
Vol 106 (20) ◽  
pp. 1549-1554 ◽  
Author(s):  
Benoy Nalin Shah ◽  
Dominik Schlosshan ◽  
Hannah Zelie Ruth McConkey ◽  
Mamta Heena Buch ◽  
Andrew John Marshall ◽  
...  
Keyword(s):  
Heart Valve ◽  
Waiting Times ◽  
Severe Disease ◽  
Valve Disease ◽  
Heart Valve Disease ◽  
The Novel ◽  
Future Care ◽  
Novel Coronavirus

The established processes for ensuring safe outpatient surveillance of patients with known heart valve disease (HVD), echocardiography for patients referred with new murmurs and timely delivery of surgical or transcatheter treatment for patients with severe disease have all been significantly impacted by the novel coronavirus pandemic. This has created a large backlog of work and upstaging of disease with consequent increases in risk and cost of treatment and potential for worse long-term outcomes. As countries emerge from lockdown but with COVID-19 endemic in society, precautions remain that restrict ‘normal’ practice. In this article, we propose a methodology for restructuring services for patients with HVD and provide recommendations pertaining to frequency of follow-up and use of echocardiography at present. It will be almost impossible to practice exactly as we did prior to the pandemic; thus, it is essential to prioritise patients with the greatest clinical need, such as those with symptomatic severe HVD. Local procedural waiting times will need to be considered, in addition to usual clinical characteristics in determining whether patients requiring intervention would be better suited having surgical or transcatheter treatment. We present guidance on the identification of stable patients with HVD that could have follow-up deferred safely and suggest certain patients that could be discharged from follow-up if waiting lists are triaged with appropriate clinical input. Finally, we propose that novel models of working enforced by the pandemic—such as increased use of virtual clinics—should be further developed and evaluated.

scholarly journals Tricuspid valve repair in isolated tricuspid pathology: a 12-year single center experience

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Alina Zubarevich ◽  
Marcin Szczechowicz ◽  
Andreas Brcic ◽  
Anja Osswald ◽  
Konstantinos Tsagakis ◽  
...  
Keyword(s):  
Heart Valve ◽  
Tricuspid Valve ◽  
Valve Disease ◽  
Heart Valve Disease ◽  
Tricuspid Valve Repair ◽  
Single Center ◽  
Valve Repair ◽  
Single Center Experience

Abstract Objectives Long-term data on isolated surgical tricuspid valve procedures is limited. Current guidelines on heart valve disease recommend valve repair over valve replacement. In this study we report our 12-year single-center experience with isolated surgical tricuspid valve repair in patients with various tricuspid valve pathologies. Methods Between May 2007 and December 2019, 26 consecutive patients underwent isolated tricuspid valve annuloplasty/repair for various indications. In 18 patients (69.2%) an open ring or band annuloplasty (26.9 and 42.3%, respectively) was performed, 5 patients (19.2%) underwent a tightening of the annulus using the DeVega technique, 5 patients (19.2%) had a leaflet reconstruction with patch or bicuspidalization and in 3 patients (11.5%) a leaflet debridement was performed. In 15.4% of the cohort a combination of the techniques was utilized. Results The mean follow-up time was 2.1 (0.3–5.0) years. Early survival at 30 days after surgery was 84.6%. Mean hospital stay was 11 (6.7–16) days. One-year survival was 73%. No patient required a redo procedure on the tricuspid valve during follow-up. Conclusion Tricuspid valve repair is suggested as a treatment of choice according to recent guidelines on heart valve disease. If chosen correctly, various repair techniques provide good long-term results. Tricuspid valve repair may be safely applied in patients undergoing surgical isolated tricuspid valve procedures.

A cardiac sonographer led follow up clinic for heart valve disease

2009 ◽  
Vol 132 (2) ◽  
pp. 240-243 ◽  
Author(s):  
Wasing Taggu ◽  
Ann Topham ◽  
Leslie Hart ◽  
Gerald Carr-White ◽  
Neil Sulke ◽  
...  
Keyword(s):  
Heart Valve ◽  
Valve Disease ◽  
Heart Valve Disease

scholarly journals Long-Term Serotonin Administration Induces Heart Valve Disease in Rats

Circulation ◽  
2005 ◽  
Vol 111 (12) ◽  
pp. 1517-1522 ◽  
Author(s):  
Björn I. Gustafsson ◽  
Karin Tømmerås ◽  
Ivar Nordrum ◽  
Jan P. Loennechen ◽  
Anders Brunsvik ◽  
...  
Keyword(s):  
Heart Valve ◽  
Valve Disease ◽  
Heart Valve Disease

scholarly journals Longitudinal determination of mRNA-vaccination induced strongly binding SARS-CoV-2 IgG antibodies in a cohort of healthcare workers with and without prior exposure to the novel coronavirus

2021 ◽  
Author(s):  
Monika Korodi ◽  
Kinga Rakosi ◽  
Zsuzsanna Jenei ◽  
Gabriella Hudak ◽  
Istvan Horvath ◽  
...  
Keyword(s):  
Immune Response ◽  
Immune Responses ◽  
Healthcare Workers ◽  
Infected Group ◽  
The Novel ◽  
Post Vaccination ◽  
Humoral Immune ◽  
Novel Coronavirus

Mass vaccination against the disease caused by the novel coronavirus (COVID-19) is a crucial step in slowing the spread of SARS-CoV-2. The BioNTech/Pfizer (BNT162b2) vaccine has been shown to induce strong immune responses among the vaccinated population. Measuring SARS-CoV-2 anti-spike protein IgG levels is a clinically convenient way to estimate post-vaccination humoral immune responses, but only limited data exists about its short- and long-term dynamics. We present a longitudinal analysis of post-vaccination IgG levels in a cohort of 122 healthcare workers vaccinated with BNT162b2 with weekly follow-up until 35 days past the first dose and results of the first monthly follow-up after that for a subset of these. This prospective, multicenter cohort study consists of two periods for short-term and long-term evaluation of post-vaccination IgG levels. Tests were carried out on 666 samples from 122 participants, using in-house anti-spike 1 and anti-nucleocapsid IgG ELISA assays and a commercial, combined version of these. Participants with previous SARS-CoV-2 infection mount a quick immune response, reaching peak IgG levels two weeks after vaccination. In contrast, the corresponding IgG levels for previously uninfected participants increase gradually, changing abruptly after the booster dose. Overall higher IgG levels are maintained for the previously infected group 35-70 days after vaccination, and we observe age-dependence of immune response as well. Our results show a robust humoral immune response mounting gradually after the first vaccine dose for the uninfected group, and a much stronger immune response within 7-14 days after the first dose for the previously infected group.

scholarly journals Waning antibody responses in COVID-19: what can we learn from the analysis of other coronaviruses?

Infection ◽  
2021 ◽  
Author(s):  
Ali Hamady ◽  
JinJu Lee ◽  
Zuzanna A. Loboda
Keyword(s):  
Cross Reactivity ◽  
Antibody Responses ◽  
The Novel ◽  
Incidence And Mortality ◽  
Antibody Titres ◽  
Human Coronaviruses ◽  
Public Health Strategies ◽  
Antibody Dynamics

Abstract Objectives The coronavirus disease 2019 (COVID-19), caused by the novel betacoronavirus severe acute respiratory syndrome 2 (SARS-CoV-2), was declared a pandemic in March 2020. Due to the continuing surge in incidence and mortality globally, determining whether protective, long-term immunity develops after initial infection or vaccination has become critical. Methods/Results In this narrative review, we evaluate the latest understanding of antibody-mediated immunity to SARS-CoV-2 and to other coronaviruses (SARS-CoV, Middle East respiratory syndrome coronavirus and the four endemic human coronaviruses) in order to predict the consequences of antibody waning on long-term immunity against SARS-CoV-2. We summarise their antibody dynamics, including the potential effects of cross-reactivity and antibody waning on vaccination and other public health strategies. At present, based on our comparison with other coronaviruses we estimate that natural antibody-mediated protection for SARS-CoV-2 is likely to last for 1–2 years and therefore, if vaccine-induced antibodies follow a similar course, booster doses may be required. However, other factors such as memory B- and T-cells and new viral strains will also affect the duration of both natural and vaccine-mediated immunity. Conclusion Overall, antibody titres required for protection are yet to be established and inaccuracies of serological methods may be affecting this. We expect that with standardisation of serological testing and studies with longer follow-up, the implications of antibody waning will become clearer.

scholarly journals SARS-CoV-2/DENV co-infection: a series of cases from the Federal District, Midwestern Brazil

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Luise Schulte ◽  
José Diego Brito-Sousa ◽  
Marcus Vinicius Guimarães Lacerda ◽  
Luciana Ansaneli Naves ◽  
Eliana Teles de Gois ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Federal District ◽  
Therapeutic Interventions ◽  
Diagnostic Process ◽  
The Novel ◽  
Prevention Measures ◽  
Laboratory Findings ◽  
Novel Coronavirus ◽  
The Impact

Abstract Background Since the novel coronavirus disease outbreak, over 179.7 million people have been infected by SARS-CoV-2 worldwide, including the population living in dengue-endemic regions, particularly Latin America and Southeast Asia, raising concern about the impact of possible co-infections. Methods Thirteen SARS-CoV-2/DENV co-infection cases reported in Midwestern Brazil between April and September of 2020 are described. Information was gathered from hospital medical records regarding the most relevant clinical and laboratory findings, diagnostic process, therapeutic interventions, together with clinician-assessed outcomes and follow-up. Results Of the 13 cases, seven patients presented Acute Undifferentiated Febrile Syndrome and six had pre-existing co-morbidities, such as diabetes, hypertension and hypopituitarism. Two patients were pregnant. The most common symptoms and clinical signs reported at first evaluation were myalgia, fever and dyspnea. In six cases, the initial diagnosis was dengue fever, which delayed the diagnosis of concomitant infections. The most frequently applied therapeutic interventions were antibiotics and analgesics. In total, four patients were hospitalized. None of them were transferred to the intensive care unit or died. Clinical improvement was verified in all patients after a maximum of 21 days. Conclusions The cases reported here highlight the challenges in differential diagnosis and the importance of considering concomitant infections, especially to improve clinical management and possible prevention measures. Failure to consider a SARS-CoV-2/DENV co-infection may impact both individual and community levels, especially in endemic areas.

scholarly journals Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 749-753
Author(s):  
Wenyuan Li ◽  
Beibei Huang ◽  
Qiang Shen ◽  
Shouwei Jiang ◽  
Kun Jin ◽  
...  
Keyword(s):  
The Novel ◽  
Chain Reaction ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Oxygen Inhalation ◽  
New Strategy ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
Specific Symptoms

Abstract In recent months, the novel coronavirus disease 2019 (COVID-19) pandemic has become a major public health crisis with takeover more than 1 million lives worldwide. The long-lasting existence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not yet been reported. Herein, we report a case of SARS-CoV-2 infection with intermittent viral polymerase chain reaction (PCR)-positive for >4 months after clinical rehabilitation. A 35-year-old male was diagnosed with COVID-19 pneumonia with fever but without other specific symptoms. The treatment with lopinavir-ritonavir, oxygen inhalation, and other symptomatic supportive treatment facilitated recovery, and the patient was discharged. However, his viral PCR test was continually positive in oropharyngeal swabs for >4 months after that. At the end of June 2020, he was still under quarantine and observation. The contribution of current antivirus therapy might be limited. The prognosis of COVID-19 patients might be irrelevant to the virus status. Thus, further investigation to evaluate the contagiousness of convalescent patients and the mechanism underlying the persistent existence of SARS-CoV-2 after recovery is essential. A new strategy of disease control, especially extending the follow-up period for recovered COVID-19 patients, is necessary to adapt to the current situation of pandemic.

Evaluation of Patients with Heart Valve Disease

2019 ◽  
pp. 9-19
Author(s):  
Jose Zamorano ◽  
Ciro Santoro ◽  
Álvaro Marco del Castillo
Keyword(s):  
Heart Valve ◽  
Valve Disease ◽  
Heart Valve Disease

scholarly journals Inflammatory Regulation of Valvular Remodeling: The Good(?), the Bad, and the Ugly

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
Gretchen J. Mahler ◽  
Jonathan T. Butcher
Keyword(s):  
Heart Valve ◽  
Cell Biology ◽  
Heart Valves ◽  
Valve Disease ◽  
Heart Valve Disease ◽  
Inflammatory Signaling ◽  
Current State ◽  
Valve Remodeling ◽  
Inflammatory Regulation ◽  
Key Questions

Heart valve disease is unique in that it affects both the very young and very old, and does not discriminate by financial affluence, social stratus, or global location. Research over the past decade has transformed our understanding of heart valve cell biology, yet still more remains unclear regarding how these cells respond and adapt to their local microenvironment. Recent studies have identified inflammatory signaling at nearly every point in the life cycle of heart valves, yet its role at each stage is unclear. While the vast majority of evidence points to inflammation as mediating pathological valve remodeling and eventual destruction, some studies suggest inflammation may provide key signals guiding transient adaptive remodeling. Though the mechanisms are far from clear, inflammatory signaling may be a previously unrecognized ally in the quest for controlled rapid tissue remodeling, a key requirement for regenerative medicine approaches for heart valve disease. This paper summarizes the current state of knowledge regarding inflammatory mediation of heart valve remodeling and suggests key questions moving forward.

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