Abstract 14327: Tricuspid Valve Annular Area Correlations and Determinants in Healthy Controls and Patients With Severe Mitral Regurgitation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sohum Kapadia ◽  
Amar Krishnaswamy ◽  
Brian P Griffin ◽  
Per Wierup ◽  
Paul SCHOENHAGEN ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Tricuspid Valve ◽  
Valvular Heart Disease ◽  
Cardiac Computed Tomography ◽  
Coronary Cta ◽  
Percutaneous Therapy ◽  
Diastolic Phase ◽  
Annular Dilation ◽  
Lower Ejection Fraction

Introduction: Concomitant tricuspid valve (TV) repair during mitral valve (MV) surgery based on annular dilation rather than the degree of regurgitation (TR) has been shown to be beneficial and is supported by the guidelines. Hypothesis: Assess the correlations between tricuspid and mitral annular areas (TVA and MVA, respectively) indexed to body surface area (BSA) measured by cardiac computed tomography (CT), and identify the determinants of the TVA in normal and diseased states. Methods: We included 50 consecutive controls (no valvular heart disease undergoing coronary CTA), 50 primary mitral regurgitation (PMR) patients referred for robotic repair, and 25 functional MR (FMR) patients referred for percutaneous therapy, without significant associated TR (≤2+ TR). We used dedicated CT software (Aquarius, TeraRecon) to perform the annular measurements. A mid-diastolic phase acquisition (~70%) was used Results: Patients with FMR were older (median age [25th, 75th] = 70 years [63,77.5] vs. 55 [48,59] in PMR and 48 [38,55] in controls), had more clinical comorbidities, and lower ejection fraction (32% [23,40] vs. >60% in both other groups). TVA was significantly correlated to MVA in controls (r≥0.5; p<0.001), as well as in patients with PMR and FMR. (Figure 1). Table 1 shows the univariate correlations and multivariate determinants of the TVA. In the multivariate analysis, the MVA, RA area, and LVEDV were the independent predictors of TVA. Interestingly, the MVA was the most important predictor (β= 0.420, p<0.001). Conclusion: In individuals without valvular heart disease and in patients with severe MR (PMR and FMR) with ≤ 2+ TR, the TVA was largely determined by the MVA.

scholarly journals Valvular heart disease in autoimmune diseases in Mexico

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Aceituno Melgar ◽  
JF Fritche-Salazar ◽  
ME Soto-Lopez
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Autoimmune Diseases ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Valvular Heart Disease ◽  
Valve Disease ◽  
Calcium Deposit

Abstract Funding Acknowledgements Type of funding sources: None. Background  The autoimmune diseases (AD) have high morbidity and mortality due to their affection to the heart. Purpose Our objective was to describe the valvular heart disease (VHD) in patients with AD. Methods Patients with systemic lupus erythematous (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SS) diagnosis were included, from January 1st 2008 to December 31th 2018. Prevalence rates of valve involvement were calculated. Results A total of 163 patients (57.6% with SLE, 23.3% with RA, 19.0% with SS) were included. The global prevalence of VHD was 5.4% in SLS, 23.6% en RA, and 15.9% in SS. The more affected valve in SLS was the tricuspid valve in 24% (12% with severe tricuspid regurgitation (STR), p = 0.028), in RA was the aortic valve in 26% (13% with severe aortic stenosis (SAS), p = 0.02), and with SS was the tricuspid valve in 48% (29% with moderate tricuspid regurgitation (MTR)). The calcium deposit was present in 66% in RA (37% in aortic valve, p &lt; 0.001). The valve thickening (&gt;5 mm) was higher in RA (50%, p &lt; 0.001), with predominance in mitral valve (26%). Conclusions We found significant higher rates of STR in SLE, SAS in RA, and MTR in SS compared with the literature. Moreover, calcification and valve thickening were found more often in RA. Early diagnosis of subclinical VHD is mandatory to improve the long-term prognosis of these patients. Valvular heart disease. Autoimmune Disease (n = 163) P value* SLE (n = 94) RA (n = 38) ES (n = 31) Demographic characteristics Age, years. Gender, Male / Female, n Body Mass Index (kg/m2) Arterial hypertension, n (%) Diabetes Mellitus, n (%) 38.8 (12.6) 9/85 26.2 (5.9) 21(22.3%) 6 (6.3%) 62.45 (12.3) 7/31 26.6 (7.1) 14(36.8%) 4 (10.5%) 53.8 (13.3) 2/29 25.4 (4.7) 12 (38.7) 5 (16.1%) &lt;0.001 NS NS NS NS Echocardiographic findings. Valve thickening Aortic Mitral 8 (9%) 1 (1%) 7 (7%) 19 (50%) 9 (24%) 10 (26%) 1 (3%) 0 1 (3%) &lt;0.001 Calcium Deposit Aortic Mitral 4 (4%) 2 (2%) 2 (2%) 25 (66%) 14 (37%) 11 (29%) 8 (26%) 4 (12.8%) 4 (12.9%) &lt;0.001 Aortic valve disease 4 (4%) 10 (26%) 0 Aortic stenosis Moderate Severe 0 0 0 7 (18%) 2 (5%) 5 (13%) 0 0 0 0,02 Moderate Aortic Regurgitation 4 (4%) 3 (8%) 0 NS Mitral valve disease 8 (9%) 2 (5%) 2 (6%) Mitral stenosis Moderate Severe 4 (4%) 2 (2%) 2 (2%) 1 (3%) 0 1 (3%) 1 (3%) 0 1 (3%) NS Mitral Regurgitation Moderate Severe 4 (4%) 2 (2%) 2 (2%) 1 (3%) 0 1 (3%) 1 (3%) 0 1 (3%) NS Tricuspid Regurgitation Moderate Severe 22 (24%) 11 (12%) 11 (12%) 8 (21%) 7 (18%) 1 (3%) 15 (48%) 9 (29%) 6 (19%) 0,028 Pulmonic valve disease Moderate Pulmonic Stenosis Moderate Pulmonic Regurgitation 6 (6%) 1 (1%) 5 (5%) 1 (3%) 0 1 (3%) 0 0 0 NS * Not Significant.

Valvular Heart Disease - Part II

2021 ◽  
Author(s):  
Miriam S. Jacob ◽  
Brian P Griffin
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
Valvular Heart Disease ◽  
Mitral Valve Prolapse ◽  
Developed Countries ◽  
Cardiac Morbidity ◽  
Mechanical Prostheses

Valvular heart disease is an important cause of cardiac morbidity in developed countries despite a decline in the prevalence of rheumatic disease in those countries. This chapter discusses the many etiologies of valvular heart disease and presents methods for assessment and management. Specific valvular lesions discussed include mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation, and tricuspid and pulmonary disease. The section on tricuspid disease includes a discussion of mechanical prostheses (ball-in-cage and tilting-disk) and biologic prostheses (xenografts, allografts, and autografts) and their complications.  This review contains 5 figures, 9 tables, and 53 references. Keywords: Valvular heart disease, stenosis, regurgitation, mitral regurgitation, mitral valve prolapse (MVP), aortic stenosis, congenital bicuspid valve, senile valvular calcification, aortic regurgitation, chordae or papillary muscles

Incidence & Pattern of Valvular Heart Disease in Patients attended in Echo Lab at a tertiary care Hospital: A single Centre Study

2021 ◽  
Vol 13 (2) ◽  
pp. 144-153
Author(s):  
Masuma Jannat Shafi ◽  
Sahela Nasrin
Keyword(s):  
Heart Disease ◽  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Valvular Heart Disease ◽  
Tertiary Care ◽  
Common Symptom ◽  
Care Hospital ◽  
Single Centre Study ◽  
Incidence Pattern ◽  
Valvular Lesion

Background: This echocardiographic study was undertaken to establish incidence, pattern & complications in patients of valvular heart disease. Methods: A total of 97 patients were enrolled among the patients attended in echo lab at Ibrahim cardiac hospital & Research Institute over a period of 1 year. Results: Mean age was 53.8±1.5 years. Male were predominant (58.76% vs 41.23%). Most common symptom was shortness of breath (60.8%) followed by palpitation (43.3%). 39.2% of patients had normal ECG & 12.4% revealed AF. The most common complication was pulmonary hypertension (54.6%) followed by pulmonary edema (26.8%), Stroke (10.3%), Left atrial thrombus (7.3%), & infective endocarditis (6.2%). MV was most commonly involved (72.2%) followed by aortic valve (AV) (66.0%), tricuspid valve (TV) (54.6%) & pulmonary valve (PV) was (20.6%). Rheumatic involvement (52.6%) constituted the dominant cause than degenerative & congenital (24.7% in each). Mitral stenosis (MS) was predominant (52.6%) & was rheumatic in origin; then aortic stenosis (AS) (48.5%) which was mostly degenerative followed by bicuspid aortic valve (8.2%). Mitral regurgitation (MR) was the most common valvular lesion (64.9%); then aortic regurgitation (AR) (51.5%) which was also rheumatic in etiology. Multiple valve involvement was also present. The most common variety was MS+MR (43.3%). Tricuspid stenosis (TS) was in association with MR+AR (1.03%). Tricuspid regurgitation (TR) was 58.8%, mostly secondary to rheumatic involvement of other valves. Severe TR (5.2%) was due to Ebstain anomaly and prolapse (4.1% & 3.1%). ventricular systolic & diastolic functions were normal mostly. Conclusion: Among the rheumatic heart disease patients’ mitral valve was the most commonly affected valve. Mitral regurgitation was the most common valvular lesion. Rheumatic involvement remains the dominant cause of valvular heart disease in Bangladesh. Cardiovasc. j. 2021; 13(2): 144-153

scholarly journals Contemporary Presentation and Management of Valvular Heart Disease

Circulation ◽  
2019 ◽  
Vol 140 (14) ◽  
pp. 1156-1169 ◽  
Author(s):  
Bernard Iung ◽  
Victoria Delgado ◽  
Raphael Rosenhek ◽  
Susanna Price ◽  
Bernard Prendergast ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
European Society ◽  
Valvular Heart Disease ◽  
Mitral Stenosis ◽  
Heart Association ◽  
Class I ◽  
European Society Of Cardiology

Background: Valvular heart disease (VHD) is an important cause of mortality and morbidity and has been subject to important changes in management. The VHD II survey was designed by the EURObservational Research Programme of the European Society of Cardiology to analyze actual management of VHD and to compare practice with guidelines. Methods: Patients with severe native VHD or previous valvular intervention were enrolled prospectively across 28 countries over a 3-month period in 2017. Indications for intervention were considered concordant if the intervention was performed or scheduled in symptomatic patients, corresponding to Class I recommendations specified in the 2012 European Society of Cardiology and in the 2014 American Heart Association/American College of Cardiology VHD guidelines. Results: A total of 7247 patients (4483 hospitalized, 2764 outpatients) were included in 222 centers. Median age was 71 years (interquartile range, 62–80 years); 1917 patients (26.5%) were ≥80 years; and 3416 were female (47.1%). Severe native VHD was present in 5219 patients (72.0%): aortic stenosis in 2152 (41.2% of native VHD), aortic regurgitation in 279 (5.3%), mitral stenosis in 234 (4.5%), mitral regurgitation in 1114 (21.3%; primary in 746 and secondary in 368), multiple left-sided VHD in 1297 (24.9%), and right-sided VHD in 143 (2.7%). Two thousand twenty-eight patients (28.0%) had undergone previous valvular intervention. Intervention was performed in 37.0% and scheduled in 26.8% of patients with native VHD. The decision for intervention was concordant with Class I recommendations in symptomatic patients with severe single left-sided native VHD in 79.4% (95% CI, 77.1–81.6) for aortic stenosis, 77.6% (95% CI, 69.9–84.0) for aortic regurgitation, 68.5% (95% CI, 60.8–75.4) for mitral stenosis, and 71.0% (95% CI, 66.4–75.3) for primary mitral regurgitation. Valvular interventions were performed in 2150 patients during the survey; of them, 47.8% of patients with single left-sided native VHD were in New York Heart Association class III or IV. Transcatheter procedures were performed in 38.7% of patients with aortic stenosis and 16.7% of those with mitral regurgitation. Conclusions: Despite good concordance between Class I recommendations and practice in patients with aortic VHD, the suboptimal number in mitral VHD and late referral for valvular interventions suggest the need to improve further guideline implementation.

Repeat Tricuspid Valve Replacement for Acquired Valvular Heart Disease: Report of a Case

Surgery Today ◽  
1998 ◽  
Vol 28 (10) ◽  
pp. 1112-1114
Author(s):  
Takaki Sugimoto ◽  
Masayoshi Okada ◽  
Chojiro Yamashita ◽  
Masato Yoshida ◽  
Nobuchika Ozaki
Keyword(s):  
Heart Disease ◽  
Valve Replacement ◽  
Tricuspid Valve ◽  
Valvular Heart Disease ◽  
Tricuspid Valve Replacement

scholarly journals Natriuretic Peptide Release during Exercise in Patients with Valvular Heart Disease: a Systematic Review.

2020 ◽  
Author(s):  
Sveeta Badiani ◽  
Jet van Zalen ◽  
Aeshah Althunayyan ◽  
Sahar Al-borikan ◽  
Thomas Treibel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Heart Disease ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Natriuretic Peptide ◽  
Valvular Heart Disease ◽  
Blood Pressure Response ◽  
Heart Valve Disease ◽  
Optimal Timing ◽  
The Relationship

Aims Serum biomarkers have a potential role in the risk stratification of patients with heart valve disease and may help determine the optimal timing of intervention. Much of the published literature relates to biomarker sampling in a resting state, but the relationship of exercise biomarkers is less well described. We performed a systematic review to examine the significance of exercise natriuretic peptides on echocardiographic variables and cardiovascular events, in valvular heart disease. Methods A search for studies that assessed exercise biomarkers in patients with moderate to severe valve lesions was performed. We examined the relationship between rest and exercise BNP and also the endpoints of symptoms, haemodynamic or echocardiographic variables and clinical outcomes. Results 11 prospective studies were identified (844 participants). 61% were male and the mean age was 55.2 ± 9.6 years. The majority of the blood samples were taken at baseline and within 3 minutes of stopping exercise. There was a significant increase in exercise BNP compared with rest, in patients with aortic stenosis, mitral regurgitation and mitral stenosis. Elevated exercise BNP levels correlated with mean gradient and left atrial area, and there was a relationship between a higher exercise BNP and a blunted blood pressure response, in aortic stenosis. Furthermore, exercise BNP was independently associated with cardiac events, over and above resting values, in patients with mitral regurgitation and aortic stenosis. Conclusions The results suggesting that exercise natriuretic peptide levels may have additive prognostic importance over resting levels, as well as demographic and echocardiographic data.

scholarly journals A Deep Learning Algorithm for Automated Cardiac Murmur Detection Via a Digital Stethoscope Platform

2020 ◽  
Author(s):  
John S. Chorba ◽  
Avi M. Shapiro ◽  
Le Le ◽  
John Maidens ◽  
John Prince ◽  
...  
Keyword(s):  
Heart Disease ◽  
Deep Learning ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Valvular Heart Disease ◽  
Learning Algorithm ◽  
Cardiac Murmur ◽  
Significant Information ◽  
Deep Learning Algorithm ◽  
Clinically Significant

AbstractBackgroundThere is variability among clinicians in their ability to detect murmurs during cardiac auscultation and identify the underlying pathology. Deep learning approaches have shown promise in medicine by transforming collected data into clinically significant information.ObjectiveThe objective of this research is to assess the performance of a deep learning algorithm to detect murmurs and clinically significant valvular heart disease using recordings from a commercial digital stethoscope platform.MethodsUsing over 34 hours of previously acquired and annotated heart sound recordings, we trained a deep neural network to detect murmurs. To test the algorithm, we enrolled 373 patients in a clinical study and collected recordings at the four primary auscultation locations. Ground truth was established using patient echocardiograms and annotations by three expert cardiologists.ResultsAlgorithm performance for detecting murmurs has sensitivity and specificity of 76.3% and 91.4%, respectively. By omitting softer murmurs, those with grade 1, sensitivity increases to 90.0%. The algorithm detects moderate-to-severe or greater aortic stenosis with sensitivity of 97.5% and specificity of 77.7% and detects moderate-to-severe or greater mitral regurgitation with sensitivity of 64.0% and specificity of 90.5%.ConclusionThe deep learning algorithm’s ability to detect murmurs and clinically significant aortic stenosis and mitral regurgitation is comparable to expert cardiologists. The research findings attest to the reliability and utility of such algorithms as front-line clinical support tools to aid clinicians in screening for cardiac murmurs caused by valvular heart disease.

Valvular heart disease

2012 ◽  
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Rheumatic Fever ◽  
Aortic Regurgitation ◽  
Valvular Heart Disease ◽  
Mitral Valve Prolapse ◽  
Mitral Stenosis ◽  
Acute Rheumatic Fever

General considerations 144Acute rheumatic fever 146Mitral stenosis: clinical features 150Mitral stenosis: investigations 152Mitral stenosis guidelines 156Mitral regurgitation 158Mitral regurgitation guidelines 161Mitral valve prolapse 162Aortic stenosis 164Management of aortic stenosis 168Aortic regurgitation 170Aortic regurgitation guidelines ...

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