Journal ArticleDOI
Quantitative determinants of the outcome of asymptomatic mitral regurgitation
Maurice Enriquez-Sarano,Jean François Avierinos,David Messika-Zeitoun,Delphine Detaint,Maryann Capps,Vuyisile T. Nkomo,Christopher G. Scott,Hartzell V. Schaff,A. Jamil Tajik +8 more
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TLDR
Quantitative grading of mitral Regurgitation is a powerful predictor of the clinical outcome of asymptomatic mitral regurgitation and patients with an effective regurgitant orifice of at least 40 mm2 should promptly be considered for cardiac surgery.Abstract:
background The clinical outcome of asymptomatic mitral regurgitation is poorly defined, and the treatment is uncertain. We studied the effect on the outcome of quantifying mitral regurgitation according to recent guidelines. methods We prospectively enrolled 456 patients (mean [±SD] age, 63±14 years; 63 percent men; ejection fraction, 70±8 percent) with asymptomatic organic mitral regurgitation, quantified according to current recommendations (regurgitant volume, 66±40 ml per beat; effective regurgitant orifice, 40±27 mm 2 ). results The estimated five-year rates (±SE) of death from any cause, death from cardiac causes, and cardiac events (death from cardiac causes, heart failure, or new atrial fibrillation) with medical management were 22±3 percent, 14±3 percent, and 33±3 percent, respectively. Independent determinants of survival were increasing age, the presence of diabetes, and increasing effective regurgitant orifice (adjusted risk ratio per 10-mm 2 increment, 1.18; 95 percent confidence interval, 1.06 to 1.30; P<0.01), the predictive power of which superseded all other qualitative and quantitative measures of regurgitation. Patients with an effective regurgitant orifice of at least 40 mm 2 had a five-year survival rate that was lower than expected on the basis of U.S. Census data (58±9 percent vs. 78 percent, P=0.03). As compared with patients with a regurgitant orifice of less than 20 mm 2 , those with an orifice of at least 40 mm 2 had an increased risk of death from any cause (adjusted risk ratio, 2.90; 95 percent confidence interval, 1.33 to 6.32; P<0.01), death from cardiac causes (adjusted risk ratio, 5.21; 95 percent confidence interval, 1.98 to 14.40; P<0.01), and cardiac events (adjusted risk ratio, 5.66; 95 percent confidence interval, 3.07 to 10.56; P<0.01). Cardiac surgery was ultimately performed in 232 patients and was independently associated with improved survival (adjusted risk ratio, 0.28; 95 percent confidence interval, 0.14 to 0.55; P<0.01). conclusions Quantitative grading of mitral regurgitation is a powerful predictor of the clinical outcome of asymptomatic mitral regurgitation. Patients with an effective regurgitant orifice of at least 40 mm 2 should promptly be considered for cardiac surgery.read more
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Determinants of reduced tricuspid annular plane systolic excursion in patients with severe systolic left ventricular dysfunction.
Egle Ereminiene,Jolanta Vaskelyte,Neris Stoskute,A Kavoliuniene,Monika Bieseviciene,Rasa Ordiene,Irena Nedzelskiene +6 more
TL;DR: Multivariate analysis revealed that LVEF, deceleration time (DT) of early mitral infl ow E wave and the RV end-diastolic diameter are independent determinants of reduced TAPSE (≤ 14 mm) in pts with severe LV systolic dysfunction.
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Exercise echocardiography for structural heart disease
Masaki Izumo,Yoshihiro J. Akashi +1 more
TL;DR: The clinical usefulness and prognostic impact of exercise echocardiography on structural heart disease, particularly on AS and MR is reviewed.
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The Role of Echocardiography in the Management of Patients with Myxomatous Disease
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Book
Valvular Heart Disease
TL;DR: Approach to the patient Cardiac murmurs Prevention of valvular heart disease Aortic stenosis Chronic aortic Regurgitation Acute aorti regurgitation Mitral stenosis Mitral valve prolapse Chronic mitral regurgitations Pulmonic stenotic Pulmono-regurgitation Tricuspid stenosis Tric Suspid regurgitate Mixed single valve disease Multiple valve disease Infective endocarditis Drug induced valvULAR heart disease
Srce i krvni Sudovi
Branko Beleslin,Marina Deljanin,Vladimir Kanjuh,Biljana Parapid,Vojislav Giga,Milica Prostran,Lazar Angelkov,Jovan Balinovac,Miroslav Bikicki,G. Ambrosio,G. Athannasopolos,J. Bartunek,R. Bugiardini,A. Colombo,I. Durand-Zaleski,F. Eberli,R. Erbel,L. Finci,Alfredo R. Galassi,J. Ge,R. Halti Cabral,G. Karatasakis,Osamu Katoh,A. Lazarević,Bernhard Maisch,A. Manginas,L. Michalis +26 more
References
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Journal ArticleDOI
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Journal ArticleDOI
Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms.
Nelson B. Schiller,P. M. Shah,Michael H. Crawford,Anthony N. DeMaria,Richard B. Devereux,Harvey Feigenbaum,H. Gutgesell,Nathaniel Reichek,David J. Sahn,Ingela Schnittger +9 more
TL;DR: It is the opinion that current technology justifies the clinical use of the quantitative two-dimensional methods described in this article and the routine reporting of left ventricular ejection fraction, diastolic volume, mass, and wall motion score.
Journal ArticleDOI
Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and doppler echocardiography
William A. Zoghbi,Maurice Enriquez-Sarano,Elyse Foster,Paul A. Grayburn,Carol D. Kraft,Robert A. Levine,Petros Nihoyannopoulos,Catherine M Otto,Miguel A. Quinones,Harry Rakowski,William J. Stewart,Alan D. Waggoner,Neil J. Weissman +12 more
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Journal ArticleDOI
Survival after the onset of congestive heart failure in Framingham Heart Study subjects.
TL;DR: Advances in the treatment of hypertension, myocardial ischemia, and valvular heart disease during the four decades of observation did not translate into appreciable improvements in overall survival after the onset of CHF in this large, unselected population.
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