Publications by authors named "Pibarot P"
Background: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). We evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial.
Methods: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, tri-leaflet AS and were followed for 5 years.
Moderate Aortic Stenosis With Cardiac Damage: A New Type of Severe Aortic Stenosis.
Struct Heart
November 2024
The clinical implications of severe aortic stenosis have been well established. Understanding of moderate aortic stenosis, however, continues to evolve. Athough moderate aortic stenosis may be less clinically impactful in patients with normal ventricular function, it may carry prognostic significance in those patients with a ventricle exhibiting signs of cardiac damage.
View Article and Find Full Text PDFBackground: Current guidelines recommend a strategy of clinical surveillance (CS) for patients with asymptomatic severe aortic stenosis (AS) and a normal left ventricular ejection fraction.
Objectives: The aim of this study was to conduct a study-level meta-analysis of randomized controlled trials (RCTs) evaluating the effect of early aortic valve replacement (AVR) compared with CS in patients with asymptomatic severe AS.
Methods: Studies were quantitatively assessed in a meta-analysis using random-effects modeling.
Article Synopsis
- - The study investigates the relationship between transthyretin wild-type cardiac amyloidosis (TTRwt-CA) and aortic stenosis (AS), proposing a bidirectional connection where each condition may influence the other and lead to systemic manifestations, including carpal tunnel syndrome (CTS).
- - In a sample of 411 TTRwt-CA patients, approximately 70% had CTS, which correlated with younger age, more severe cardiac remodeling, and a higher frequency of extracardiac symptoms, while AS occurred in 21% of those with CTS and 31% without.
- - The research indicates that CTS may differentiate two phenotypes of TTRwt-CA: one associated with systemic involvement and poorly calcified low-flow
Background: Oxidized phospholipids (OxPLs) are carried by apolipoprotein B-100-containing lipoproteins (OxPL-apoB) including lipoprotein(a) (Lp[a]). Both OxPL-apoB and Lp(a) have been associated with calcific aortic valve disease (CAVD).
Objectives: This study aimed to evaluate the associations between OxPL-apoB, Lp(a) and the prevalence, incidence, and progression of CAVD.
Article Synopsis
- - This study examined the effects of transcatheter aortic valve replacement (TAVR) on patients with heart failure and moderate aortic stenosis, comparing TAVR with clinical surveillance followed by valve replacement if the condition worsened.
- - A total of 178 patients were randomly assigned to either TAVR or surveillance, and results indicated that TAVR was associated with better clinical outcomes, though the statistical significance was borderline.
- - TAVR led to a more substantial improvement in heart failure symptoms, as measured by the Kansas City Cardiomyopathy Questionnaire, compared to the surveillance group after one year of follow-up.
Background: For patients with asymptomatic severe aortic stenosis and preserved left ventricular ejection fraction, current guidelines recommend routine clinical surveillance every 6 to 12 months. Data from randomized trials examining whether early intervention with transcatheter aortic-valve replacement (TAVR) will improve outcomes in these patients are lacking.
Methods: At 75 centers in the United States and Canada, we randomly assigned, in a 1:1 ratio, patients with asymptomatic severe aortic stenosis to undergo early TAVR with transfemoral placement of a balloon-expandable valve or clinical surveillance.
Background And Aims: Epicardial adiposity has been positively associated with visceral adipose tissue (VAT). Few studies have examined the association between cardiorespiratory fitness (CRF) and epicardial adiposity. Furthermore, whether this relationship was independent of VAT remains unexplored.
View Article and Find Full Text PDFArticle Synopsis
- Bicuspid aortic valve (BAV) shows increased progression of aorta dilation compared to tricuspid aortic valve (TAV) in patients with aortic stenosis, with a median annualized change of 0.33 mm/year for BAV versus 0.21 mm/year for TAV.
- Factors influencing the dilation rate differ by valve type; BAV patients are more affected by low-density lipoprotein (LDL) levels, while TAV patients are influenced by the apolipoprotein B/A-I ratio and baseline aortic jet velocity.
- The study highlights that men and women have different predictors for AA dilation; men’s dilation relates to baseline jet velocity and aortic diameter, while
Article Synopsis
- * This study used cardiac magnetic resonance (CMR) imaging to evaluate myocardial health and found that increased interstitial fibrosis (measured by extracellular volume fraction, ECV%) correlates with worse health outcomes in these patients.
- * Over a median follow-up of 5.7 years, higher ECV% was linked to increased mortality and heart failure admissions, indicating that ECV% could be a valuable tool for identifying patients needing closer monitoring.
Background: Residual mitral regurgitation (MR) is associated with worse outcomes after transcatheter edge-to-edge mitral valve repair (TEER). Shear stress induced by MR leads to altered von Willebrand factor activity (vWF:Act) and increased closure time with adenosine diphosphate (CT-ADP).
Objectives: The purpose of this study was to investigate the use of CT-ADP to monitor MR during TEER and the association between the vWF, residual MR, and clinical events post-TEER.
Article Synopsis
- Aortic valve stenosis (AS) is a chronic disease that progresses at different rates among patients, making it challenging to predict its progression.* -
- This study utilized machine and deep learning algorithms on data from 303 patients to forecast AS progression over the next 2 and 5 years, showing that the LightGBM model yielded the best predictive performance.* -
- The findings suggest that using AI in clinical settings can improve the risk assessment of AS, effectively predicting the disease progression and outcomes for patients with mild-to-moderate AS.*
Deep Learning Model of Diastolic Dysfunction Risk Stratifies the Progression of Early-Stage Aortic Stenosis.
JACC Cardiovasc Imaging
September 2024
Article Synopsis
- The study explores how a deep learning model can predict the risk of developing aortic stenosis (AS) from the early stage of aortic valve sclerosis by assessing diastolic dysfunction (DD).
- Researchers evaluated data from 898 participants in the ARIC cohort and validated their findings in two other groups, showing a significant correlation between high DD risk and the development of AS or related health interventions.
- The results indicate that using deep learning to measure DD effectively stratifies risk in patients, providing a better understanding of how AS progresses.
Background: Little is known about the effect of sex on functional status decline in aortic valve stenosis (AS) patients.
Objectives: The purpose of this study was to examine the changes in functional status according to sex in patients with mild-to-moderate AS and its association with the composite of death or aortic valve replacement (AVR).
Methods: We included patients with mild-to-moderate AS prospectively recruited in the PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) study (NCT01679431).
Background: In patients with low-gradient (LG) aortic stenosis (AS), confirming disease severity and indication of intervention often requires dobutamine stress echocardiography (DSE) or aortic valve calcium scoring by computed tomography. We hypothesized that the mean transvalvular pressure gradient to effective orifice area ratio (MG/EOA, in mm Hg/cm) measured during rest echocardiography identifies true-severe AS (TSAS) and is associated with clinical outcomes in patients with low-flow, LG-AS.
Objectives: The purpose of this study was to evaluate the diagnostic and prognostic value of MG/EOA ratio.
Management of Pulmonary Congestion in Patients With Aortic Stenosis: A Need for Improvement.
JACC Cardiovasc Interv
September 2024
Article Synopsis
- * Waist circumference (WC) and insulin-like growth factor-binding protein 2 (IGFBP-2) levels were analyzed to determine their effectiveness in identifying individuals with liver fat exceeding 5%.
- * The results show that high WC and low IGFBP-2 are linked to a significantly higher risk of MASLD, suggesting these markers could be valuable for early detection in at-risk individuals.
Background: The best management of symptomatic patients with low-gradient (LG) severe aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF) has not been established. The Randomised study for the Optimal Treatment of symptomatic patients with low-gradient severe Aortic valve Stenosis (ROTAS) trial aimed to assess the superiority of aortic valve replacement (AVR) versus medical treatment (MT) in this specific group of AS patients.
Methods: Patients with symptomatic LG severe AS and preserved LVEF (>50%) underwent dobutamine stress echocardiography and/or CT-aortic calcium score to confirm AS severity and were then randomised 1:1 to AVR or MT.
Longitudinal systolic function following aortic valve replacement in the PARTNER 2 trial and registry.
Eur Heart J Cardiovasc Imaging
November 2024