Staging classification of aortic stenosis based on the extent of cardiac damage.
Philippe Généreux,Philippe Généreux,Philippe Pibarot,Björn Redfors,Michael J. Mack,Raj Makkar,Wael A. Jaber,Lars G. Svensson,Samir R. Kapadia,E. Murat Tuzcu,Vinod H. Thourani,Vasilis C. Babaliaros,Howard C. Herrmann,Wilson Y. Szeto,David J. Cohen,Brian R. Lindman,Thomas McAndrew,Maria Alu,Pamela S. Douglas,Rebecca T. Hahn,Susheel Kodali,Craig R. Smith,D. Craig Miller,John G. Webb,Martin B. Leon +24 more
TLDR
This newly described staging classification objectively characterizes the extent of cardiac damage associated with AS and has important prognostic implications for clinical outcomes after AVR.Abstract:
Aims In patients with aortic stenosis (AS), risk stratification for aortic valve replacement (AVR) relies mainly on valve-related factors, symptoms and co-morbidities. We sought to evaluate the prognostic impact of a newly-defined staging classification characterizing the extent of extravalvular (extra-aortic valve) cardiac damage among patients with severe AS undergoing AVR. Methods and results Patients with severe AS from the PARTNER 2 trials were pooled and classified according to the presence or absence of cardiac damage as detected by echocardiography prior to AVR: no extravalvular cardiac damage (Stage 0), left ventricular damage (Stage 1), left atrial or mitral valve damage (Stage 2), pulmonary vasculature or tricuspid valve damage (Stage 3), or right ventricular damage (Stage 4). One-year outcomes were compared using Kaplan-Meier techniques and multivariable Cox proportional hazards models were used to identify 1-year predictors of mortality. In 1661 patients with sufficient echocardiographic data to allow staging, 47 (2.8%) patients were classified as Stage 0, 212 (12.8%) as Stage 1, 844 (50.8%) as Stage 2, 413 (24.9%) as Stage 3, and 145 (8.7%) as Stage 4. One-year mortality was 4.4% in Stage 0, 9.2% in Stage 1, 14.4% in Stage 2, 21.3% in Stage 3, and 24.5% in Stage 4 (Ptrend < 0.0001). The extent of cardiac damage was independently associated with increased mortality after AVR (HR 1.46 per each increment in stage, 95% confidence interval 1.27-1.67, P < 0.0001). Conclusion This newly described staging classification objectively characterizes the extent of cardiac damage associated with AS and has important prognostic implications for clinical outcomes after AVR.read more
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2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.
Piotr Ponikowski,Adriaan A. Voors,Stefan D. Anker,Héctor Bueno,John G.F. Cleland,Andrew J.S. Coats,Volkmar Falk,José Ramón González-Juanatey,Veli-Pekka Harjola,Ewa A. Jankowska,Mariell Jessup,Cecilia Linde,Petros Nihoyannopoulos,John Parissis,Burkert Pieske,Jillian P. Riley,Giuseppe M.C. Rosano,Luis M. Ruilope,Frank Ruschitzka,Frans H. Rutten,Peter van der Meer,Gerasimos Filippatos,John J.V. McMurray,Victor Aboyans,Stephan Achenbach,Stefan Agewall,Nawwar Al-Attar,John Atherton,Johann Bauersachs,A. John Camm,Scipione Carerj,Claudio Ceconi,Antonio Coca,Perry M. Elliott,Çetin Erol,Justin A. Ezekowitz,Covadonga Fernández-Golfín,Donna Fitzsimons,Marco Guazzi,Maxime Guenoun,Gerd Hasenfuss,Gerhard Hindricks,Arno W. Hoes,Bernard Iung,Tiny Jaarsma,Paulus Kirchhof,Juhani Knuuti,Philippe Kolh,Stavros Konstantinides,Mitja Lainscak,Patrizio Lancellotti,Gregory Y.H. Lip,Francesco Maisano,Christian Mueller,Mark C. Petrie,Massimo F Piepoli,Silvia G. Priori,Adam Torbicki,Hiroyuki Tsutsui,Dirk J. van Veldhuisen,Stephan Windecker,Clyde W. Yancy,José Luis Zamorano +62 more
TL;DR: Authors/Task Force Members: Piotr Ponikowski* (Chairperson) (Poland), Adriaan A. Voors* (Co-Chair person) (The Netherlands), Stefan D. Anker (Germany), Héctor Bueno (Spain), John G. F. Cleland (UK), Andrew J. S. Coats (UK)
Journal ArticleDOI
2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure.
Theresa McDonagh,Marco Metra,Marianna Adamo,Roy S. Gardner,Andreas Baumbach,Michael Böhm,Haran Burri,Javed Butler,Jelena Čelutkienė,Ovidiu Chioncel,John G F Cleland,A J S Coats,Maria G Crespo-Leiro,Dimitrios Farmakis,Martine Gilard,Stephane Heymans,Arno W. Hoes,Tiny Jaarsma,Ewa A. Jankowska,Mitja Lainscak,Carolyn S.P. Lam,Alexander R. Lyon,John J.V. McMurray,Alexandre Mebazaa,Richard Mindham,Claudio Muneretto,Massimo F Piepoli,Susanna Price,Giuseppe M.C. Rosano,Frank Ruschitzka,Anne Kathrine Skibelund +30 more
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2021 ESC/EACTS Guidelines for the management of valvular heart disease.
Alec Vahanian,Friedhelm Beyersdorf,Fabien Praz,Milan Milojevic,Stephan Baldus,Johann Bauersachs,Davide Capodanno,Lenard Conradi,Michele De Bonis,Ruggero De Paulis,Victoria Delgado,Nick Freemantle,Martine Gilard,Kristina H. Haugaa,Anders Jeppsson,Peter Jüni,Luc Pierard,Bernard Prendergast,J. Rafael Sadaba,Christophe Tribouilloy,Wojtek Wojakowski +20 more
Journal ArticleDOI
2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Theresa McDonagh,Marco Metra,Marianna Adamo,Roy S. Gardner,Andreas Baumbach,Michael Böhm,Haran Burri,Javed Butler,Jelena Čelutkienė,Ovidiu Chioncel,John G.F. Cleland,Andrew J.S. Coats,María G. Crespo-Leiro,Dimitrios Farmakis,Martine Gilard,Stephane Heymans,Arno W. Hoes,Tiny Jaarsma,Ewa A. Jankowska,Mitja Lainscak,Carolyn S.P. Lam,Alexander R. Lyon,John J.V. McMurray,Alexandre Mebazaa,R.H.S Mindham,Claudio Muneretto,Massimo Francesco Piepoli,Susanna Price,Giuseppe M.C. Rosano,Frank Ruschitzka,Anne Kathrine Skibelund +30 more
TL;DR: De Boer et al. as mentioned in this paper reviewed the work of as mentioned in this paper and found that the authors of the paper were concerned with the authorship of the document and not the content of the documents.
Journal ArticleDOI
2021 ESC/EACTS Guidelines for the management of valvular heart disease.
Alec Vahanian,Friedhelm Beyersdorf,Fabien Praz,Milan Milojevic,Stephan Baldus,Johann Bauersachs,Davide Capodanno,Lenard Conradi,Michele De Bonis,Ruggero De Paulis,Victoria Delgado,Nick Freemantle,Martine Gilard,Kristina H. Haugaa,Anders Jeppsson,Peter Jüni,Luc Pierard,Bernard Prendergast,J. Rafael Sadaba,Christophe Tribouilloy,Wojtek Wojakowski +20 more
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Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients.
Martin B. Leon,Craig R. Smith,Michael J. Mack,Michael J. Mack,Rajendra Makkar,Lars G. Svensson,Susheel Kodali,Vinod H. Thourani,Murat Tuzcu,D. Craig Miller,Howard C. Herrmann,Darshan Doshi,David J. Cohen,Augusto D. Pichard,Samir R. Kapadia,Todd M. Dewey,Vasilis Babaliaros,Wilson Y. Szeto,Mathew R. Williams,Dean J. Kereiakes,Alan Zajarias,Kevin L. Greason,Brian Whisenant,Robert W. Hodson,Jeffrey W. Moses,Alfredo Trento,David L. Brown,William F. Fearon,Philippe Pibarot,Rebecca T. Hahn,Wael A. Jaber,William N. Anderson,Maria Alu,John G. Webb +33 more
TL;DR: In intermediate-risk patients, TAVR was similar to surgical aortic-valve replacement with respect to the primary end point of death or disabling stroke; surgery resulted in fewer major vascular complications and less paravalvular aorta regurgitation.
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Alec Vahanian,Ottavio Alfieri,Felicita Andreotti,Manuel J. Antunes,Gonzalo Barón-Esquivias,Helmut Baumgartner,Michael A. Borger,Thierry Carrel,Michele De Bonis,Arturo Evangelista,Volkmar Falk,Bernard Iung,Patrizio Lancellotti,Luc Pierard,Susanna Price,Hans-Joachim Schäfers,Gerhard Schuler,Janina Stępińska,Karl Swedberg,Johanna J.M. Takkenberg,Ulrich O. von Oppell,Stephan Windecker,José Luis Zamorano,Marian Zembala +23 more
TL;DR: Guidelines summarize and evaluate all evidence available 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.
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