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Background: Little research has been assessed atherosclerotic risk factors at various stages of calcific aortic valve disease. This study sought to determine risk factors of patients with aortic valve sclerosis (AVS) and mild to moderate aortic stenosis (AS).
Methods: The study included 1,007 patients diagnosed with AVS or mild to moderate AS according to echocardiographic criteria. Patients were identified as a rapid progression group if the annualized difference in peak aortic jet velocity (Vmax) between two echocardiographic examinations was >0.08 m/s/yr in AVS and >0.3 m/s/yr in AS, respectively. We used multivariable logistic regression analyses to assess the factors associated with rapid disease progression or progression to severe AS.
Results: Among 526 AVS patients, higher LDL-C level (odds ratio [OR] 1.22/per 25 mg/dl higher LDL-C, 95% confidence interval [CI] 1.05-1.43) was significantly associated with rapid disease progression. Compared to patients with LDL-C level <70 mg/dl, the adjusted OR for rapid progression were 1.32, 2.15, and 2.98 for those with LDL-C level of 70-95 mg/dl, 95-120 mg/dl, and ≥120 mg/dl, respectively. Among 481 mild to moderate AS patients, the baseline Vmax (OR 1.79/per 0.5 m/s higher Vmax, 95% CI 1.18-2.70) was associated with rapid progression. Compared to patients with Vmax 2.0-2.5 m/s, the adjusted OR for rapid progression were 2.47, 2.78, and 3.49 for those with Vmax of 2.5-3.0 m/s, 3.0-3.5 m/s, and 3.5-4.0 m/s, respectively. LDL-C and baseline Vmax values were independently associated with progression to severe AS.
Conclusion: Atherosclerotic risk factors such as LDL-C were significantly associated with the rapid progression in AVS and baseline Vmax was important in the stage of mild to moderate AS.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10390070 | PMC |
http://dx.doi.org/10.3389/fcvm.2023.1171703 | DOI Listing |
Catheter Cardiovasc Interv
December 2024
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Background: Hypoattenuating leaflet thickening (HALT) following transcatheter aortic valve replacement (TAVR) may compromise valve durability, posing a significant barrier to the broader adoption of this technology among younger patients. Self-expanding valves (SEVs) are the most commonly used transcatheter heart valves (THVs) among Chinese patients with aortic stenosis. Understanding the potential mechanisms underlying HALT is, therefore, critical to guide future THV design and development.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2024
Cardiology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Background: The management of Transcatheter Aortic Valve Implantation (TAVI) patients with a small aortic annulus (SAA) postures a substantial challenge, increasing the risk of patient- prosthesis mismatch (PPM) and overall mortality.
Aims: This study aimed to compare the hemodynamic and clinical outcomes of transcatheter balloon-expandable valve (BEV) versus transcatheter self-expandable valve (SEV) in SAA.
Methods: We conducted propensity score matching (PSM) of severe AS patients with SAA who underwent trans-femoral TAVR and enrolled to the Israeli TAVR registry between the years 2008 and 2023.
Front Cardiovasc Med
December 2024
Oxford Heart Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
In patients undergoing transcatheter aortic valve implantation (TAVI), multi-valve disease is common and associated with worse outcomes. Despite multiple emerging transcatheter valve treatment options, no guidelines exist for the transcatheter treatment of multi-valve disease. We present a case of a 76-year-old patient with concomitant severe aortic valve stenosis and severe mitral valve stenosis who underwent concurrent TAVI and transcatheter mitral valve replacement.
View Article and Find Full Text PDFCancer Rep (Hoboken)
December 2024
Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam.
Introduction: Nonbacterial thrombotic endocarditis (NBTE) is a rare cardiac manifestation in patients with advanced malignancies of the lungs, pancreas, gynecological system, and gastrointestinal tract. It is often confirmed postmortem by histopathological evidence of sterile platelet-fibrin deposits attached to the endocardium, most often on heart valves. To the best of our knowledge, our case is the first to report multiple heart lesions caused by the systemic effect of cholangiocarcinoma.
View Article and Find Full Text PDFCan J Anaesth
December 2024
Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Purpose: Safe perioperative management of patients undergoing transcatheter aortic valve implantation (TAVI) is crucial. Remimazolam is a newly developed short-acting benzodiazepine. We hypothesized that combining remimazolam and flumazenil would reduce emergence time compared with sevoflurane in patients undergoing general anesthesia for TAVI.
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