scholarly journals Impact of valvular heart disease on hip replacement: a retrospective nationwide inpatient sample database study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Qiang Lian ◽  
Jian Wang ◽  
Yun Lian ◽  
Qinfeng Yang ◽  
Mingchen Zhao ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mortality Rate ◽  
Hip Arthroplasty ◽  
Valvular Heart Disease ◽  
Hip Replacement ◽  
Medical Complications ◽  
Cerebrovascular Event ◽  
Elective Admission ◽  
Female Patients ◽  
The Impact

Abstract Background To study the impact of valvular heart disease (VHD) on hip replacement, particularly the clinical impactions of aortic stenosis before total/partial hip arthroplasty. Methods This was a retrospective cohort study. Data on patients who had undergone hip replacement from 2005 to 2014 were extracted from the NIS database. Independent t test and chi-square test were used to analyze the essential characteristics of patients. Multivariate regression was used to estimate the correlation among demographics, comorbidities, complications, hospitalization costs, and time. Results VHD accounted for 5.56% and AS accounted for 0.03% of the patients before hip replacement surgeries. Patients with VHD before hip replacement are related to the following characteristics: female patients (odds ratio [OR] = 1.15 [1.12–1.18]), elective admission (OR = 0.78 [0.76–0.80]), Charlson Comorbidity Index ≥3 (OR = 1.06 [1.03–1.08]), large-volume hospitals (OR = 1.13 [1.1–1.2]), teaching hospitals (OR = 5 4.4 [2.9–6.7]), and hospital location in urban areas (OR = 1.22 [1.2–1.3]). In addition, VHD is a risk factor for mortality and some acute postoperative medical complications, such as acute cardiac event (OR = 2.96 [2.87–3.04]), acute pulmonary edema (OR = 1.13 [1.06–1.21]), acute cerebrovascular event (OR = 1.22 [1.16–1.74]), and acute renal failure (OR = 1.22 [1.17–1.27]). It also has an impact on DVT/PE (OR = 0.89 [0.8–0.99]). Patients with AS before hip replacement have basic demographic characteristics like those of hip replacement patients with valvular disease. Patients with AS are older than those without AS before surgery (OR = 3.28 [2.27–4.75) and are related to the following characteristics: female patients (OR = 1.92 [1.32–2.8]) and elective admission (OR = 0.51 [0.36–0.75]). The perioperative period is limited to acute postoperative complications, such as acute cardiac events (OR = 2.50 [1.76–3.53]) and acute hepatic failure (OR = 7.69 [1.8–32.89]). Both valvular diseases and AS are associated with a higher mortality rate and hospitalization cost. Conclusion VHD independently predicted mortality rate and surgical and medical complications after total/partial hip arthroplasty.

Impact of Valvular Heart Disease on Hip Replacement: A Retrospective Nationwide Inpatient Sample Database Study

2021 ◽  
Author(s):  
Qiang Lian ◽  
Jian Wang ◽  
Qinfeng Yang ◽  
Yun Lian ◽  
Mingchen Zhao ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mortality Rate ◽  
Aortic Stenosis ◽  
Hip Arthroplasty ◽  
Joint Replacement ◽  
Valvular Heart Disease ◽  
Hip Replacement ◽  
Medical Complications ◽  
Elective Admission ◽  
Female Patients

Abstract BackgroundTo study the impact of valvular heart disease (VHD) on joint replacement, particularly the clinical impactions of aortic stenosis before total/partial hip arthroplasty. MethodsThis was a retrospective cohort study. Data on patients who had undergone joint replacement from 2005 to 2014 were extracted from the NIS database. Linear regression was used to analyze the essential characteristics of patients. Multivariate regression was used to estimate the correlation among demographics, comorbidities, complications, hospitalization costs, and time.ResultsOf the hip replacement surgeries, VHDs accounted for 5.56% and aortic stenosis (AS) accounted for 0.03% before surgery. VHD patients are related to the following characteristics: female patients (odds ratio [OR]=1.15 [1.12–1.18]), elective admission (OR=0.78 [0.76–0.80]), Charlson Comorbidity Index ≥3 (OR=1.06 [1.03–1.08]), large-volume hospitals (OR=1.13 [1.1–1.2]), teaching hospitals (OR=5 4.4 [2.9–6.7]), and hospital location in urban areas (OR=1.22 [1.2–1.3]). In addition, VHD is a risk factor for mortality and some acute postoperative medical complications, such as acute cardiac event (OR=2.96 [2.87–3.04]), acute pulmonary edema (OR=1.13 [1.06–1.21]), acute cerebrovascular event (OR=1.22 [1.16–1.74]), and acute renal failure (OR=1.22 [1.17–1.27]). It also has an impact on DVT/PE (OR=0.89 [0.8–0.99]). Patients with AS before hip replacement have basic demographic characteristics similar to those of TJA patients with valvular disease. Patients with AS are older (≥80 years) than those without AS before surgery (OR=3.28 [2.27–4.75) and have the following characteristics: female patients (OR=1.92 [1.32–2.8]) and elective admission (OR=0.51 [0.36–0.75]). The perioperative period is limited to acute postoperative complications, such as acute cardiac events (OR=2.50 [1.76–3.53]) and acute hepatic failure (OR=7.69 [1.8–32.89]). Both valvular diseases and AS are associated with a higher mortality rate and hospitalization cost. ConclusionValvular heart disease (VHD) independently predicted mortality rate and surgical and medical complications after total/partial hip arthroplasty.

scholarly journals Clinical outcomes of Japanese atrial fibrillation patients with combined valvular heart disease: the Fushimi AF Registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Doi ◽  
K Ishigami ◽  
Y Aono ◽  
S Ikeda ◽  
Y Hamatani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Incidence Rate ◽  
Clinical Outcomes ◽  
Valvular Heart Disease ◽  
Cardiac Death ◽  
Clinical Characteristics ◽  
Valve Disease ◽  
The Impact

Abstract Background We previously reported that valvular heart disease (VHD) was not at the significant risk of stroke/systemic embolism (SE), but was associated with an increased risk of hospitalization for heart failure (HF) in Japanese atrial fibrillation patients. However, the impact of combined VHD on clinical outcomes has been little known. Purpose The aim of this study is to investigate the prevalence of combined VHD and its clinical characteristics and impact on outcomes such as stroke/SE, all-cause death, cardiac death and hospitalization for HF. Method The Fushimi AF Registry is a community-based prospective survey of AF patients in one of the wards of our city which is a typical urban district of Japan. We started to enroll patients from March 2011, and follow-up data were available for 4,466 patients by the end of November 2019. In the entire cohort, echocardiography data were available for 3,574 patients. 68 AF patients with prosthetic heart valves were excluded and we compared clinical characteristics and outcomes between 488 single VHD (103 Aortic valve disease (AVD), 315 mitral valve disease (MVD), 70 tricuspid valve disease (TVD)) and 158 combined VHD (46 AVD and MVD, 11 AVD and TVD, 66 MVD and TVD, 35 AVD and MVD and TVD). Result Compared with single VHD, patients with combined VHD were older (combined vs. single VHD: 78.5 vs. 76.0 years, respectively; p<0.01), more likely to have persistent/permanent type AF (73.4% vs. 63.9%, p=0.02) and prescription of warfarin (63.1% vs. 53.8%, p=0.04). Combined VHD was less likely to have diabetes mellitus (13.9% vs. 23.6%, p=0.01) and dyslipidemia (26.6% vs. 40.4%, p<0.01). Sex, body weight, hypertension, pre-existing HF were comparable between the two groups. During the median follow-up of 1,474 days, the incidence rate of stroke/SE was not significantly different between the two groups (1.58 vs. 1.89 per 100 person-years, respectively, log rank p=0.10). The incidence rate of all-cause death (7.35 vs. 5.33, p=0.65), cardiac death (1.20 vs. 0.99, p=0.91) and hospitalization for HF (5.55 vs. 4.43, p=0.53) were also not significantly different. We previously reported AVD had significant impacts on cardiac adverse outcomes in AF patients, and we further analyzed event rates between combined VHD including AVD (AVD and MVD/TVD) and without AVD (MVD and TVD). Combined VHD with AVD group had higher incidence rate of all-cause death (10.7 vs. 5.79, p=0.03) than that without AVD group. However, the incidence rate of stroke/SE (1.98 vs. 1.56, p=0.59), cardiac death (0.98 vs. 1.14, p=0.68), hospitalization for HF (8.03 vs. 5.38, p=0.17) were not significantly different between the two groups. Conclusion As compared with single VHD, the risk of stroke/SE, all-cause death, cardiac death and hospitalization for HF in combined VHD was not significantly different. Among patients with combined VHD, those having AVD had higher incidence rate of all-cause death than those without AVD. Figure 1 Funding Acknowledgement Type of funding source: None

Access to paediatric cardiac surgery in Colombia: a population-based study

2021 ◽  
Author(s):  
Marlena E Sabatino ◽  
Rodolfo J Dennis ◽  
Pablo Sandoval-Trujillo ◽  
Sergio Valencia ◽  
Karen Moreno-Medina ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Mortality Rate ◽  
Health System ◽  
Latin American ◽  
Perioperative Mortality ◽  
National Team ◽  
Paediatric Cardiac Surgery ◽  
Latin American Region ◽  
The Impact

Abstract OBJECTIVES Globally congenital heart disease mortality is declining, yet the proportion of infant deaths attributable to heart disease rises in Colombia and other middle-sociodemographic countries. We aimed to assess the accessibility of paediatric cardiac surgery (PCS) to children <18 years of age in 2016 in the South American country of Colombia. METHODS In Bogotá, Colombia, a multi-national team used cross-sectional and retrospective cohort study designs to adapt and evaluate 4 health system indicators at the national level: first, the population with timely geographic access to an institution providing PCS; second, the number of paediatric cardiac surgeons; third, this specialized procedure volume and its national distribution; and fourth, the 30-day perioperative mortality rate after PCS in Colombia. RESULTS Geospatial mapping approximates 64% (n = 9 894 356) of the under-18 Colombian population lives within 2-h drivetime of an institution providing PCS. Twenty-eight cardiovascular surgeons report performing PCS, 82% (n = 23) with formal training. In 2016, 1281 PCS procedures were registered, 90% of whom were performed in 6 of the country’s 32 departments. National non-risk-adjusted all-cause 30-day perioperative mortality rate after PCS was 2.73% (n = 35). CONCLUSIONS Colombia’s paediatric population had variable access to cardiac surgery in 2016, largely dependent upon geography. While the country may have the capacity to provide timely, high-quality care to those who need it, our study enables future comparative analyses to measure the impact of health system interventions facilitating healthcare equity for the underserved populations across Colombia and the Latin American region.

P2744Age distribution of valvular heart disease in China: from a national multicenter prospective cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Zhang ◽  
H T Zhang ◽  
H Y Xu ◽  
Y J Wu
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Heart Disease ◽  
Mitral Valve ◽  
Valvular Heart Disease ◽  
Mitral Valve Disease ◽  
Multimodality Imaging ◽  
Valve Disease ◽  
Multivariate Logistic Regression ◽  
The Impact

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

scholarly journals The year 2018 in the European Heart Journal – Cardiovascular Imaging: Part I

2019 ◽  
Vol 20 (8) ◽  
pp. 858-865 ◽  
Author(s):  
Thor Edvardsen ◽  
Kristina H Haugaa ◽  
Steffen E Petersen ◽  
Alessia Gimelli ◽  
Erwan Donal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Myocardial Ischaemia ◽  
Valvular Heart Disease ◽  
Congenital Heart ◽  
Myocardial Function ◽  
European Heart Journal ◽  
Cardiovascular Imaging ◽  
The Impact

Abstract The European Heart Journal – Cardiovascular Imaging has become one of the leading multimodality cardiovascular imaging journal, since it was launched in 2012. The impact factor is an impressive 8.366 and it is now established as one of the top 10 cardiovascular journals. The journal is the most important cardiovascular imaging journal in Europe. The most important studies from 2018 will be highlighted in two reports. Part I of the review will focus on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.

scholarly journals Exercise recommendations in patients with valvular heart disease

Heart ◽  
2018 ◽  
Vol 105 (2) ◽  
pp. 106-110 ◽  
Author(s):  
Sabiha Gati ◽  
Aneil Malhotra ◽  
Sanjay Sharma
Keyword(s):  
Physical Activity ◽  
Heart Disease ◽  
Ventricular Function ◽  
Functional Capacity ◽  
Valvular Heart Disease ◽  
Stress Test ◽  
Exercise Stress ◽  
Competitive Sport ◽  
Increased Risk ◽  
The Impact

Valvular heart disease affects 1%–2% of young individuals, many of whom aspire to partake in competitive sport or high intensity recreational exercise. There are limited reports on the impact of intensive physical activity on the progression of valvular heart disease; therefore, current recommendations are based on consensus opinion. The management of exercising individuals with valvular heart disease requires a structured approach that incorporates several key factors including symptomatic status, functional capacity, type and nature of the valvular lesion, impact on ventricular structure and function and effect on pulmonary artery pressure. Asymptomatic individuals with minor valvular abnormalities may engage in all forms of competitive sport, whereas those with lesions of moderate severity may exercise intensively if an exercise stress test tailored to the relevant physical activity reveals good functional capacity without myocardial ischaemia, haemodynamic disturbances or arrhythmia. Symptomatic athletes and those with severe valvular heart disease, impaired ventricular function, pulmonary hypertension and arrhythmias should refrain from most competitive sports. Athletes with a bicuspid aortic valve and aortic root diameter >40 mm should avoid sport with a strong isometric component even with minimal valvular dysfunction. There is an association between mitral valve prolapse and sudden cardiac death in the general population; however, there is limited evidence of increased risk with competitive sport. Athletes undergoing corrective surgery may return to exercise after 3 months if ventricular function and exercise capacity are preserved. Individuals anticoagulated for mechanical bioprosthetic valves should avoid contact or collision sport to minimise the risk of bleeding.

P2746Survival of people with valvular heart disease in the community (OxValve-Survive)

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Taylor ◽  
J M Ordonez-Mena ◽  
A K Roalfe ◽  
J Wilson ◽  
S Myerson ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cause Of Death ◽  
Valvular Heart Disease ◽  
Cox Regression ◽  
Severe Disease ◽  
Research Centre ◽  
Mortality Data ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Impact

Abstract Background Valvular heart disease (VHD) occurs commonly in older patients (>65 years) but the majority is mild disease, which is of uncertain importance. Understanding the impact of VHD on mortality in this older group of patients would help determine its relevance and aid the appropriate use of healthcare resources. OxValve is a cohort study in Oxfordshire screening people aged 65 and over for VHD. Over 4,009 participants were recruited between August 2009 and May 2016 and screened using echocardiography to establish the presence and severity of VHD. AIMS To report survival in the OxValve cohort, and to investigate whether people with VHD are at increased risk of death. Methods The OxValve cohort was linked to Office for National Statistics mortality data to obtain date and cause of death. Cox regression was used to investigate the association of any VHD, VHD of significant severity, and VHD subtypes with all-cause and cause-specific mortality, adjusting for potential confounders including age, sex, socioeconomic status, smoking, and comorbidities. Results Linked mortality data was available for 3,511 OxValve participants up to September 2018 (median 5.85 years follow-up). VHD was present in 2,645 (75.3%) participants and of these 288 (8.2%) had significant VHD. In total, 311 (8.9%) participants had died. Cancer was the commonest cause of death (n=135), followed by cardiovascular disease (n=75) and respiratory disease (n=35). After adjustment for age and other covariates, mild to moderate VHD was not associated with increased all-cause mortality (HR 1.16, 95% CI: 0.89 to 1.50). However, VHD of significant severity (moderate or severe disease) was associated with a nearly two-fold higher risk of death overall (HR 1.92, 95% CI: 1:38 to 2.67) including increased CVD mortality (HR 2.25, 95% CI: 1.21 to 4.18). DISCUSSION Mild to moderate VHD was very common, but was not associated with increased mortality. Significant VHD was however associated with a two-fold reduction in survival. Further research is required to understand the natural history of VHD, how to identify those with progressive disease and when to intervene. Acknowledgement/Funding NIHR Biomedical Research Centre, Oxford

The impact of nesiritide in patients with heart failure and significant valvular heart disease

2004 ◽  
Vol 10 (4) ◽  
pp. S116
Author(s):  
Ambika Bhaskaran ◽  
Robert M. Siegel ◽  
Jennifer Vermillion ◽  
Barbara Barker ◽  
Therese Sargent ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Patients With Heart Failure ◽  
The Impact
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