https://www.zora.uzh.ch/id/eprint/150846/1/ehx391.pdf

2017 ESC/EACTS Guidelines for the management of valvular heart disease

https://www.medpagetoday.com/upload/2014/3/3/02536-1.pdf

2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease

ACE
: angiotensin-converting enzyme
AF
: atrial fibrillation
aPTT
: activated partial thromboplastin time
AR
: aortic regurgitation
ARB
: angiotensin receptor blockers
AS
: aortic stenosis
AVR
: aortic valve replacement
BNP
: B-type natriuretic peptide
BSA
: body surface area
CABG
: coronary artery bypass grafting
CAD
: coronary artery disease
CMR
: cardiac magnetic resonance
CPG
: Committee for Practice Guidelines
CRT
: cardiac resynchronization therapy
CT
: computed tomography
EACTS
: European Association for Cardio-Thoracic Surgery
ECG
: electrocardiogram
EF
: ejection fraction
EROA
: effective regurgitant orifice area
ESC
: European Society of Cardiology
EVEREST
: (Endovascular Valve Edge-to-Edge REpair STudy)
HF
: heart failure
INR
: international normalized ratio
LA
: left atrial
LMWH
: low molecular weight heparin
LV
: left ventricular
LVEF
: left ventricular ejection fraction
LVEDD
: left ventricular end-diastolic diameter
LVESD
: left ventricular end-systolic diameter
MR
: mitral regurgitation
MS
: mitral stenosis
MSCT
: multi-slice computed tomography
NYHA
: New York Heart Association
PISA
: proximal isovelocity surface area
PMC
: percutaneous mitral commissurotomy
PVL
: paravalvular leak
RV
: right ventricular
rtPA
: recombinant tissue plasminogen activator
SVD
: structural valve deterioration
STS
: Society of Thoracic Surgeons
TAPSE
: tricuspid annular plane systolic excursion
TAVI
: transcatheter aortic valve implantation
TOE
: transoesophageal echocardiography
TR
: tricuspid regurgitation
TS
: tricuspid stenosis
TTE
: transthoracic echocardiography
UFH
: unfractionated heparin
VHD
: valvular heart disease
3DE
: three-dimensional echocardiography

Guidelines summarize and evaluate all evidence available, at the time of the writing process, on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well …

Guidelines on the management of valvular heart disease (version 2012)

Jeffrey L. Anderson, MD, FACC, FAHA, Chair , Jonathan L. Halperin, MD, FACC, FAHA, Chair-Elect , Nancy M. Albert, PhD, CCNS, CCRN, FAHA, Biykem Bozkurt, MD, PhD, FACC, FAHA, Ralph G. Brindis, MD, MPH, MACC, Mark A. Creager, MD, FACC, FAHA[§§][1], Lesley H. Curtis, PhD, FAHA, David DeMets, PhD,

2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

/pdf/2014-aha-acc-guideline-for-the-management-of-patients-with-17ab5yki53.pdf

2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

Prospective Validation of the Prognostic Usefulness of Brain Natriuretic Peptide in Asymptomatic Patients With Chronic Severe Mitral Regurgitation

Objectives The purpose of the study was to determine the independent and additive prognostic value of brain natriuretic peptide (BNP) in patients with severe asymptomatic mitral regurgitation and normal left ventricular function. Background Early surgery could be advisable in selected patients with chronic severe mitral regurgitation, but there are no criteria to identify candidates who could benefit from this strategy. Assessment of BNP has not been studied in asymptomatic patients with severe mitral regurgitation; hence, its prognostic value remains unclear. Methods We prospectively evaluated 269 consecutive patients with severe asymptomatic organic mitral regurgitation and left ventricular ejection fraction above 60%. The first 167 consecutive patients served as the derivatin cohort, and the following 102 patients served as a validation cohort. The combined end point was the occurrence of either symptoms of congestive heart failure, left ventricular dysfunction, or death at follow-up. Results The end point was reached in 35 (21%) patients of the derivation set and in 21 (20.6%) patients of the validation cohort. The receiver-operating characteristics curve yielded and optimal cutoff point of 105 pg/ml of BNP that was able to discriminate patients at higher risk in both cohorts (76% vs. 5.4% and 66% vs. 4.0%, respectively). In both sets, BNP was the strongest independent predictor by multivariate analysis. Conclusions Among patients with severe asymptomatic organic mitral regurgitation, BNP $105 pg/ml discriminates a subgroup of patients at higher risk. Because of its incremental prognostic value, BNP assessment should be considered in clinical routine worhup for risk stratification.

Prospective validation of the prognostic usefulness of brain natriuretic peptide in asymptomatic patients with chronic severe mitral regurgitation. J Am Coll Cardiol 2009; 54: 1099-106

shedeveloped typical chest pain with ST-segment elevation inDI, DII, and the anterior leads with ventricular bigeminy(Figure 1B and 1C). The echocardiogram showed apical andmid-wall myocardial segment akinesis with basal hyperkine-sis and left outflow tract gradient obstruction of 60 mm Hg.The ejection fraction was estimated to be 34%, and severemitral regurgitation was found with no organic valvulardisease (Figure 2 and Movie I in the online-only DataSupplement). Troponin I, creatinine kinase, and brain natri-uretic peptide levels were 2.4 ng/dL (normal value, 0.04ng/dL), 80 mg/dL (within normal range), and 928 pg/dL,respectively.Emergent cardiac catheterization showed mild stenosis inthe left anterior descending coronary artery with no signs ofplaque rupture while the patient was still having chest painand ST elevation. Left ventriculography displayed hyperdy-namic basal myocardial segments with cavity obliteration andapical akinesis (Figure 3 and Movie II in the online-only DataSupplement).Cardiac magnetic resonance depicted findings similar tothe echocardiogram with no late gadolinium enhancement(Figure 4 and Movie III in the online-only Data Supplement).The rest single-photon emission computed tomographysestamibi revealed a great perfusion defect that extendedbeyond the left anterior descending coronary artery territory(Figure 5A).The patient made favorable progress and was dischargedwith -blockers, aspirin, and simvastatin. Repeated echocar-diography after 7 days demonstrated normal left ventricularwall motion, the ejection fraction was 55% (Figure 6 andMovie IV in the online-only Data Supplement), and single-photon emission computed tomography 3 months latershowed normal perfusion (Figure 5B).Dobutamine-precipitated takotsubo cardiomyopathy is anunusual presentation of this disease,

Images in Cardiovascular Medicine Dobutamine-Precipitated Takotsubo Cardiomyopathy Mimicking Acute Myocardial Infarction A Multimodality Image Approach

A 77-year-old woman was referred for a dobutamine stress test. She had a prior history of hypertension. Basal ECG was normal (Figure 1A). At 40 μg · kg−1 · min−1 she developed typical chest pain with ST-segment elevation in DI, DII, and the anterior leads with ventricular bigeminy (Figure 1B and 1C). The echocardiogram showed apical and mid-wall myocardial segment akinesis with basal hyperkinesis and left outflow tract gradient obstruction of 60 mm Hg. The …

Dobutamine-Precipitated Takotsubo Cardiomyopathy Mimicking Acute Myocardial Infarction A Multimodality Image Approach

A 25-year-old man arrived at the emergency room of his community hospital complaining of abdominal pain, headaches, and palpitations that had appeared suddenly while he was playing soccer. He had no history of hypertension. An abdominal ultrasound revealed a tumor located in the right adrenal gland.

He was subsequently transferred to our hospital for further evaluation. On admission, he presented acute pulmonary edema with severe hypertension (blood pressure, 220/120 mm Hg). He was admitted to the coronary care unit. Intravenous vasodilators and loop diuretics were administered, with rapid recovery of clinical status.

ECG showed sinus rhythm, a heart rate of 80 bpm, and T-wave inversion in the DI, DII, and AVL leads. Transthoracic echocardiography revealed left …

Aníbal Arias

Papers

Prospective Validation of the Prognostic Usefulness of Brain Natriuretic Peptide in Asymptomatic Patients With Chronic Severe Mitral Regurgitation

Prospective validation of the prognostic usefulness of brain natriuretic peptide in asymptomatic patients with chronic severe mitral regurgitation. J Am Coll Cardiol 2009; 54: 1099-106

Images in Cardiovascular Medicine Dobutamine-Precipitated Takotsubo Cardiomyopathy Mimicking Acute Myocardial Infarction A Multimodality Image Approach

Dobutamine-Precipitated Takotsubo Cardiomyopathy Mimicking Acute Myocardial Infarction A Multimodality Image Approach

Catecholamine-Induced Myocarditis in Pheochromocytoma