Valvular Disease- Pubmed

CONCLUSIONS: In this national in-home echocardiography study, VHD was common among older adults, with important age-related and valve-specific patterns. PREVUE-VALVE establishes the feasibility of large-scale decentralized cardiovascular imaging studies and provides a contemporary foundation for clinical and policy planning related to the burden of VHD. (Age- and Sex-Specific Prevalence of Acquired Valvular Heart Disease (PREVUE-VALVE; NCT05357404).

CONCLUSIONS: At the 10-year follow-up, TAVR in intermediate-risk patients with the SAPIEN XT prosthesis compared with surgery was associated with lower survival rates, with differences predominantly observed in the TA/TAo access cohort. TAVR with the XT valve was also associated with significantly higher rates of aortic valve reintervention. (PARTNER II Trial: Placement of AoRTic TraNscathetER Valves II - XT Intermediate and High Risk [PII A]; NCT01314313).

CONCLUSIONS: At 10 years, TAVR with the SAPIEN 3 valve and surgery resulted in similar rates of mortality and aortic valve reintervention, and similar hemodynamics in intermediate-risk patients with symptomatic severe aortic stenosis. This analysis highlights challenges associated with extended long-term follow-up of clinical trials, including differential loss to follow-up and the competing risk of mortality in elderly populations. (PARTNER 2A Trial; NCT01314313; PARTNER 2 SAPIEN 3...

CONCLUSIONS: This 13-year nationwide overview highlights the growing uptake of TAVR in France, likely driven by clinical practice and procedural innovation rather than guidelines. Further analyses will compare efficacy and safety between TAVR and SAVR.

CONCLUSIONS: Findings from the PRIME-MR registry highlight substantial reductions in residual MR severity and complication rates over time in PMR patients undergoing M-TEER.

CONCLUSIONS: A reduction in the mLAP during M-TEER is independently associated with improved clinical outcomes in patients with DMR but not in those with FMR. These findings underscore the importance of real-time haemodynamic assessment - especially in DMR - as a valuable procedural endpoint that may aid in optimising long-term outcomes beyond anatomical MR reduction alone.

CONCLUSIONS: Varying mitral regurgitation severity, heart size and the presence of clinical signs can significantly affect certain brightness, motion and Doppler echocardiographic variables in dogs with myxomatous mitral valve disease (valvular heart disease).

CONCLUSION: INSPIRIS RESILIA aortic valve shows favorable 1-year safety profiles and stable hemodynamics in Chinese patients.

Mitral regurgitation (MR) is a common valvular disorder and associated with adverse outcomes. Echocardiography is the primary imaging modality for MR assessment; however, standard methods rely on geometric assumptions and single-frame analysis, which are especially inaccurate in the setting of eccentric, multiple or non-holosystolic jets. Recent developments in machine learning have enabled automated quantification of MR, which analyse regurgitant flow throughout systole, account for...

The anti-apoptotic genes DAD-1 and HAX-1 and the pro-apoptotic GZMB gene have a significant role in the regulation of apoptosis in heart tissue. However, investigation into these genes and their proteins in the pathogenesis of cardiovascular diseases remains limited. The aim was to characterize the association between the presence and distribution of pro-apoptotic and anti-apoptotic genes and their proteins in the right atrial appendage affected by coronary heart disease (CHD) and aortic valve...

CONCLUSIONS: Assessment of TV morphology by 3D transthoracic echocardiography is feasible and reliable in TGA patients with sRV. In our cohort, some variants were more common than previously described prevalence in the general population. While non-trileaflet morphology is frequent, significant TR is mainly associated with annular dilation, leaflet tenting, and prolapse rather than valve anatomy alone. Further studies are required to investigate the clinical relevance of TV anatomical variants...

Congenital supravalvular aortic stenosis is a rare form of left ventricular outflow-tract obstruction, which is frequently associated with genetic disorders such as Williams-Beuren syndrome, despite spontaneous occurrence still being possible. Over the years, different surgical approaches to relieve the stenosis have been proposed; among them the McGoon, the Doty and the Brom repair are the best-known. Nevertheless, all these techniques especially address a paediatric population, and treatment...

CONCLUSIONS: LAMT-PVR is a feasible and safe alternative to redo sternotomy for selected post-TOF patients. This approach provides direct access to the pulmonary artery with reduced surgical trauma and favorable early outcomes.

Hypertrophic cardiomyopathy (HCM) is a common genetic heart disease, with macrophages playing a critical role in its pathological remodeling. Our study aims to investigate the molecular basis of HCM by analyzing macrophage-related gene expression at the single-cell level. Utilizing published scRNA-seq datasets (GSE181764 and GSE161921), we identified macrophages as the key cell cluster most associated with HCM. Integration with bulk RNA-seq data (GSE249925) and differential expression analysis...

CONCLUSION: This study suggests that structured exercise interventions are safe and associated with improvements in cardiorespiratory fitness, left ventricular wall thickness, body mass index, and quality of life physical factor in patients with HCM, without increasing the risk of arrhythmias. Although a lower mortality rate was observed, this finding was mainly driven by observational studies and should therefore be interpreted with caution. Larger randomized controlled trials are needed to...

CONCLUSIONS: Nonrheumatic valvular heart disease burden is rising, especially in aging Asian populations. Despite declining mortality and improved care quality, increasing incidence and slowing quality-of-care index gains may intensify future health system pressures.

CONCLUSIONS: This study suggests a potential association between centrosome duplication-related gene dysregulation and HCM pathogenesis and identifies VPS8 as a key regulator bridging endosomal-lysosomal homeostasis and immune-related remodeling. VPS8 may represent a candidate biomarker and a potential therapeutic target for early diagnosis and intervention in HCM.

Coronary artery obstruction is a potential life-threatening complication of transcatheter aortic valve replacement (TAVR) in all settings including native, valve-in-valve, and redo-TAVR. Risk of obstruction can be identified on preprocedural computed tomography. BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction) effectively prevents TAVR-induced coronary obstruction. Perceived technical complexity, limited availability of...

Leaflet modification is a necessary element in the armamentarium of the structural interventionalist and will remain an area of active investment in the future. Although leaflet splitting is proven, there are limitations in certain extreme cases. Although intraleaflet techniques are emerging and potentially have more broad applicability, there remain safety concerns with these techniques. The proposed systematic algorithms on aortic and mitral leaflet modification procedures can serve as a guide...

CONCLUSIONS: In patients undergoing ViV TAVR, intentional leaflet modification is associated with a significantly reduced incidence of HALT, suggesting a protective association with subclinical leaflet thrombosis. These results support a potentially hemodynamic benefit of leaflet modification beyond coronary obstruction prevention.

CONCLUSIONS: A CT-based algorithm stratifies patients into 3 CO risk categories, though the decision for CP in clinical practice seems to incorporate additional clinical and procedural variables. Although CP reduces CO risk, its efficacy is limited in patients with very small VTCV, which can be predicted preprocedurally via CT. (Leipzig TAVR Registry; NCT05015452).

CONCLUSIONS: BASILICA is technically feasible for both stented and stentless valves. However, stentless valves had a higher rate of partial CAO after BASILICA and TAVR and may therefore require additional or alternative coronary artery protection measures in selected patients.

CONCLUSIONS: Leaflet splay following LM for redo-TAVR is highly dependent on THV type and constraint, implantation of the second THV, laceration pattern, and the nature of index THV degeneration.

CONCLUSIONS: The authors propose a systematic, imaging-guided approach to leaflet modification in redo-TAVR. Further studies are ongoing to evaluate and validate its feasibility and effectiveness.

CONCLUSION: MR appears under-detected among minority patients relative to local demographics and occurs at a younger age and with a greater prevalence of secondary MR and comorbidity. Once identified, clinical factors and socioeconomic deprivation rather than ethnicity itself drive outcomes and treatment access, with no statistically independent association between ethnicity and either mortality or intervention, although modest but clinically relevant differences cannot be excluded given the...

Myocarditis and valvulitis are inflammatory diseases affecting myocardium and heart valves. Myocarditis, a viral-induced disease of myocardium, may lead to dilated cardiomyopathy and loss of heart function, and valvulitis leads to deformed heart valves and altered blood flow in rheumatic heart disease. Animal models recapitulating these diseases are important for understanding the human conditions. Cardiac myosin is a major autoantigen in heart tissue, and antibodies and T cells to cardiac...

CONCLUSIONS: In the Netherlands, mavacamten + BB/CCB is a cost-effective treatment strategy for symptomatic obstructive HCM compared to BB/CCB monotherapy.

Despite growing interest in tricuspid regurgitation (TR), evidence remains insufficient to define the optimal timing of intervention and therapeutic strategies, highlighting the need for robust experimental models. Existing large animal models of TR use diverse approaches and can be grouped into two categories: direct valvular interventions targeting the tricuspid leaflets, annulus, or chordae, and indirect induction through mechanisms such as increased right ventricular loading, pulmonary...

CONCLUSION: SA is highly prevalent in HCM, and HCM patients with comorbid SA exhibit distinct baseline characteristics, cardiac structure and drug application.

CONCLUSIONS: AI demonstrates promising diagnostic accuracy for TR, potentially standardizing early detection and triage. However, heterogeneity and methodological gaps necessitate larger prospective, multicenter studies with standardized reporting (e.g., TRIPOD-AI) to confirm clinical utility.

Purpose To develop a machine learning-based model to identify patients with hypertrophic cardiomyopathy (HCM) at high risk of major adverse cardiac events (MACEs) and key predictors of model performance. Materials and Methods This retrospective cohort study included patients who underwent cardiac MRI for HCM evaluation between September 2015 and December 2022. Cardiac MRI included balanced cine steady-state free precession, native T1 and T2 mapping, and late gadolinium enhancement. MACEs were...

As the number of mitral valve transcatheter edge-to-edge repair procedures increases, there are catheter operators and interventional echocardiography operators performing these procedures with variable expertise. Expert imaging is paramount for the success of these procedures and requires knowledge of mitral valve anatomy, the ability to quickly manipulate two-dimensional (2D) and three-dimensional (3D) images in real time, and sufficient procedural experience to anticipate challenges and offer...

Calcific aortic valve disease is common in older adults and a major cause of aortic stenosis. Despite its clinical impact, there are still no effective drugs that slow disease progression, and treatment largely relies on surgical or transcatheter valve replacement once stenosis becomes severe and symptomatic. Beyond established roles for inflammation and tissue remodeling, recent evidence suggests that chemical modifications of RNA may influence how valve cells shift toward fibro-calcific...

We aimed to establish a rat TR model to further investigate the mechanisms of right heart remodeling and organ damage induced by TR. Intervention group rats (n = 6) underwent coronary stent system implantation via transjugular approach. The control group (n = 6) underwent the same procedure, except for coronary stent implantation. All rats survived at 8 weeks follow-up postoperatively. TR occurred immediately after the implantation of coronary stent in the intervention group. The right...

CONCLUSIONS: MAD is common and prognostically neutral after adjustment. However, larger disjunction distances are associated with higher native T1 relaxation time values at the annulus, suggesting local subclinical myocardial remodelling.

CONCLUSION: In this large multicentre cohort of adults with MFS, cardiac surgery was common, and redo sternotomy occurred frequently among operated patients. These findings provide a contemporary description of the long-term need for cardiac surgery in adults with MFS managed at tertiary referral centres.

CONCLUSIONS: Redo-TAVI with a balloon-expandable SAPIEN 3 THV platform is a safe and effective reintervention strategy across diverse failed THV types, when guided by the Heart Team, standardised procedural planning, and comprehensive imaging.

CONCLUSION: Our data show a significant remaining symptom burden and healthcare resource utilization (HCRU), as well as impact on HRQoL, work productivity, and daily activities, despite treatment intervention across a commonly applied measure of disease severity in HCM. These findings underscore the need for new treatments that can reduce HCRU and improve HRQoL of patients with HCM.

Transcatheter aortic valve implantation (TAVI) has become the preferred treatment for severe aortic stenosis. Nonetheless, interplay between aortic valve disease, transcatheter valve implantation, and the coronary arteries is frequent and clinically relevant. Coronary intervention in the context of TAVI encompasses distinct but interrelated scenarios, including the management of concomitant coronary artery disease and the prevention or treatment of coronary artery obstruction. These aspects...

Mitral regurgitation (MR) and hypoalbuminemia are prevalent in patients with end-stage kidney disease who are initiating hemodialysis (HD) and are associated with adverse cardio-vascular outcomes. However, the combined impact of serum albumin levels and MR severity on cardiac prognosis in this population remains unclear. This study aimed to investigate the influence of serum albumin level on cardiac-related outcomes in incident HD with MR. This single-center retrospective study enrolled 217...

Valvular heart disease (VHD) affects millions worldwide and remains a major cause of morbidity and mortality, placing a substantial and growing burden on healthcare systems. Over the past two decades, transcatheter therapies have emerged to meet this challenge, transforming the management of aortic, mitral, and tricuspid valve disease. Initially developed for inoperable or high-risk surgical patients, procedures such as transcatheter aortic valve implantation (TAVI) and mitral transcatheter...

INTRODUCTION: Aortic valve sclerosis (AVSc) is an active pathological process driven by extracellular matrix remodeling, consistent with a potentially reversible early stage of aortic valve disease.

CONCLUSION: This case underscores the challenges of managing native valve infective endocarditis caused by Achromobacter xylosoxidans in medically fragile patients. The disease may progress despite appropriate antimicrobial therapy, particularly when surgical intervention is not feasible. Therefore, multidisciplinary evaluation and individualized management are essential in such high-risk cases.

CONCLUSION: Preoperative LVEDD dilation is an independent influencing factor for poor postoperative prognosis in patients. It helps predict poor prognosis within 1 year postoperatively.

Valvular heart dysfunction-related cardiogenic shock (VCS) is complex, with high rates of in-hospital mortality. Early recognition with timely intervention is paramount to preserving life. However, treatment of VCS remains clinically challenging. Appropriate use of mechanical circulatory support (MCS) devices may halt disease progression and improve morbidity and mortality. Optimal MCS device selection for VCS remains complex, but evidence supporting its use continues to grow. Following an...

CONCLUSIONS: Disruption of myosin super‑relaxation emerges as a central cellular defect in G-T2D HCM myocardium and can be mechanistically linked to site‑specific myosin hyperacetylation at K847, providing a potential therapeutic target for genotype‑negative HCM with T2D.

Aortic valve stenosis (AS) is assessed by echocardiography in clinical practice. Conventionally, the aortic valve area, peak transaortic valve velocity/gradient and the mean transvalvular gradient determine if the AS is categorized as mild, moderate or severe. Recently, the entity of paradoxical low-flow, low-gradient AS despite normal left ventricular ejection fraction (LVEF) was described and flow (as determined by stroke volume indexed to body surface area) was used to further categorize AS....

Background and Objectives: Recent studies have focused on evaluating the hemodynamic results in patients undergoing transcatheter aortic valve implantation (TAVI) with small aortic annuli. There is limited data on the incidence, clinical characteristics, and mortality of prosthesis-patient mismatch (PPM) in patients undergoing TAVI with large aortic annuli. Materials and Methods: This is a retrospective analysis of consecutive patients with severe aortic stenosis and large annuli who underwent...

Background and Objectives: Transcatheter edge-to-edge repair (TEER) has emerged as an effective treatment option for patients with severe mitral regurgitation who are at high surgical risk. However, clinical outcomes after TEER remain heterogeneous and are influenced not only by cardiac parameters but also by systemic comorbidities and multiorgan dysfunction. The albumin-bilirubin (ALBI) score, derived from serum albumin and bilirubin levels, has recently been proposed as a simple marker of...

New-onset left bundle branch block (LBBB) following transcatheter aortic valve implantation (TAVI) is a common conduction disorder, sometimes transient. Conversely, the development of sustained ventricular tachycardia (VT) after TAVI is rare and its management is challenging. We report the case of a female patient with aortic stenosis treated with transcatheter self-expandable aortic valve implantation, who developed new-onset LBBB post-procedure. Several days later, the patient experienced...