ESC working group on valvular heart disease position paper-heart valve clinics: organization, structure, and experiences

in European Heart Journal (2013)

Echocardiographic integrated backscatter for detecting progression and regression of aortic valve calcifications in rats.

in Cardiovascular Ultrasound (2013), 11(1), 4

ABSTRACT: BACKGROUND: Calcification is an independent predictor of mortality in calcific aortic valve disease (CAVD). The aim of this study was to evaluate the use of non-invasive, non-ionizing ... [more ▼]

ABSTRACT: BACKGROUND: Calcification is an independent predictor of mortality in calcific aortic valve disease (CAVD). The aim of this study was to evaluate the use of non-invasive, non-ionizing echocardiographic calibrated integrated backscatter (cIB) for monitoring progression and subsequent regression of aortic valvular calcifications in a rat model of reversible renal failure with CAVD, compared to histology. METHODS: 28 male Wistar rats were prospectively followed during 21 weeks. Group 1 (N=14) was fed with a 0.5% adenine diet for 9 weeks to induce renal failure and CAVD. Group 2 (N=14) received a standard diet. At week 9, six animals of each group were killed. The remaining animals of group 1 (N=8) and group 2 (N=8) were kept on a standard diet for an additional 12 weeks. cIB of the aortic valve was calculated at baseline, 9 and 21 weeks, followed by measurement of the calcified area (Ca Area) on histology. RESULTS: At week 9, cIB values and Ca Area of the aortic valve were significantly increased in the adenine-fed rats compared to baseline and controls. After 12 weeks of adenine diet cessation, cIB values and Ca Area of group 1 decreased compared to week 9, while there was no longer a significant difference compared to age-matched controls of group 2. CONCLUSIONS: cIB is a non-invasive tool allowing quantitative monitoring of CAVD progression and regression in a rat model of reversible renal failure, as validated by comparison with histology. This technique might become useful for assessing CAVD during targeted therapy. [less ▲]

EuroEcho and other imaging modalities: highlights

in European Journal of Echocardiography (2013)

Left ventricular contractile reserve in asymptomatic primary mitral regurgitation

in European Heart Journal (2013)

non invasive estimation of left atrial pressure and mitral valve area waveforms during an entire cardiac cycle

in proceeding of 11th national day of the National Committee on Biomedical Engineering (2012, December 07)

Structural model of the mitral valve included in a cardiovascular closed loop model. Static and dynamic validation

in proceedings of 8th IFAC Symposium on Biological and Medical Systems, Budapest 29-31 août 2012 (2012, August 31)

A prospective study of cardiac valvular status in patients treated with cabergoline for Endocrine Disease

in Endocrine abstracts - May 2012, volume 29 (2012, May)

Low-Flow, Low-Gradient Severe Aortic Stenosis Despite Normal Ejection Fraction Is Associated With Severe Left Ventricular Dysfunction as Assessed by Speckle-Tracking Echocardiography: A Multicenter Study.

in Circulation: cardiovascular imaging (2012)

Background- Low-flow low-gradient (LFLG) is sometimes observed in severe aortic stenosis (AS) despite normal ejection fraction, but its frequency and mechanisms are still debated. We aimed to describe the ... [more ▼]

Background- Low-flow low-gradient (LFLG) is sometimes observed in severe aortic stenosis (AS) despite normal ejection fraction, but its frequency and mechanisms are still debated. We aimed to describe the characteristics of patients with LFLG AS and assess the presence of longitudinal left ventricular dysfunction in these patients. Methods and Results- In a multicenter prospective study, 340 consecutive patients with severe AS and normal ejection fraction were studied. Longitudinal left ventricular function was assessed by 2D-strain and global afterload by valvulo-arterial impedance. Patients were classified according to flow and gradient: low flow was defined as a stroke volume index ≤35 mL/m(2), low gradient as a mean gradient ≤40 mm Hg. Most patients (n=258, 75.9%) presented with high-gradient AS, and 82 patients (24.1%) with low-gradient AS. Among the latter, 52 (15.3%) presented with normal flow and low gradient and 30 (8.8%) with LFLG. As compared with normal flow and low gradient, patients with LFLG had more severe AS (aortic valve area=0.7±0.12 cm(2) versus 0.86±0.14 cm(2)), higher valvulo-arterial impedance (5.5±1.1 versus 4±0.8 mm Hg/mL/m(2)), and worse longitudinal left ventricular function (basal longitudinal strain=-11.6±3.4 versus -14.8±3%; P<0.001 for all). Conclusions- LFLG AS is observed in 9% of patients with severe AS and normal ejection fraction and is associated with high global afterload and reduced longitudinal systolic function. Patients with normal-flow low-gradient AS are more frequent and present with less severe AS, normal afterload, and less severe longitudinal dysfunction. Severe left ventricular longitudinal dysfunction is a new explanation to the concept of LFLG AS. [less ▲]

Prognostic importance of exercise brain natriuretic peptide in asymptomatic degenerative mitral regurgitation

in European Journal of Heart Failure (2012), 14(11), 1293-1302

Determinants and prognostic significance of exercise pulmonary hypertension in asymptomatic severe aortic stenosis

in Circulation (2012), 126(7), 851-859