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  1. Article ; Online: Sex Differences in Epidemiology, Morphology, Mechanisms, and Treatment of Mitral Valve Regurgitation

    Gregorio Tersalvi / Lorenzo Gaiero / Michele Capriolo / Yvonne Cristoforetti / Stefano Salizzoni / Gaetano Senatore / Giovanni Pedrazzini / Luigi Biasco

    Medicina, Vol 59, Iss 1017, p

    2023  Volume 1017

    Abstract: Sex-related disparities have been recognized in incidence, pathological findings, pathophysiological mechanisms, and diagnostic pathways of non-rheumatic mitral regurgitation. Furthermore, access to treatments and outcomes for surgical and interventional ...

    Abstract Sex-related disparities have been recognized in incidence, pathological findings, pathophysiological mechanisms, and diagnostic pathways of non-rheumatic mitral regurgitation. Furthermore, access to treatments and outcomes for surgical and interventional therapies among women and men appears to be different. Despite this, current European and US guidelines have identified common diagnostic and therapeutic pathways that do not consider patient sex in decision-making. The aim of this review is to summarize the current evidence on sex-related differences in non-rheumatic mitral regurgitation, particularly regarding incidence, imaging modalities, surgical-derived evidence, and outcomes of transcatheter edge-to-edge repair, with the goal of informing clinicians about sex-specific challenges to consider when making treatment decisions for patients with mitral regurgitation.
    Keywords mitral regurgitation ; sex differences ; transcatheter mitral valve repair ; Medicine (General) ; R5-920
    Subject code 150
    Language English
    Publishing date 2023-05-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: New Echocardiographic Parameters Predicting Successful Trans-Ventricular Beating-Heart Mitral Valve Repair with Neochordae at 3 Years

    Alessandro Vairo / Lorenzo Gaiero / Matteo Marro / Caterina Russo / Marco Bolognesi / Paolo Soro / Guglielmo Gallone / Francesco Fioravanti / Paolo Desalvo / Fabrizio D’Ascenzo / Gianluca Alunni / Viviana Sebastiano / Cristina Barbero / Marco Pocar / Gaetano Maria De Ferrari / Mauro Rinaldi / Stefano Salizzoni

    Journal of Clinical Medicine, Vol 12, Iss 1748, p

    Monocentric Retrospective Study

    2023  Volume 1748

    Abstract: The NeoChord procedure is an echo-guided trans-ventricular beating-heart mitral valve repair technique to treat degenerative mitral regurgitation (MR) due to prolapse and/or flail. The aim of this study is to analyze echocardiographic images to find pre- ... ...

    Abstract The NeoChord procedure is an echo-guided trans-ventricular beating-heart mitral valve repair technique to treat degenerative mitral regurgitation (MR) due to prolapse and/or flail. The aim of this study is to analyze echocardiographic images to find pre-operative parameters to predict procedural success (≤moderate MR) at 3-year follow-up. Seventy-two consecutive patients with severe MR underwent the NeoChord procedure between 2015 and 2021. MV pre-operative morphological parameters were assessed using 3D transesophageal echocardiography with dedicated software (QLAB, Philips). Three patients died during their hospitalization. The remaining 69 patients were retrospectively analyzed. At follow-up, MR > moderate was found in 17 patients (24.6%). In the univariate analysis, end-systolic annulus area (12.5 ± 2.5 vs. 14.1 ± 2.6 cm 2

    p = 0.038), end-systolic annulus circumference (13.2 ± 1.2 vs. 14 ± 1.3 cm; p = 0.042), indexed left atrial volume (59 ± 17 vs. 76 ± 7 mL/m 2

    p = 0.041), and AF (25% vs. 53%; p = 0.042) were lower in the 52 patients with ≤ MR compared to those with > moderate MR. Annular dysfunction parameters were the best predictors of procedural success: 3D early-systolic annulus area (AUC 0.74; p = 0.004), 3D early-systolic annulus circumference (AUC 0.75; p = 0.003), and 3D annulus area fractional change (AUC 0.73; p = 0.035). Patient selection relying on 3D dynamic and static MA dimensions may improve the maintenance of procedural success at follow-up.
    Keywords mitral valve prolapse ; mitral annulus disfunction ; three-dimensional echocardiography ; micro-invasive cardiac surgery ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Acute Modification of Hemodynamic Forces in Patients with Severe Aortic Stenosis after Transcatheter Aortic Valve Implantation

    Alessandro Vairo / Lorenzo Zaccaro / Andrea Ballatore / Lorenzo Airale / Fabrizio D’Ascenzo / Gianluca Alunni / Federico Conrotto / Luca Scudeler / Daniela Mascaretti / Davide Miccoli / Michele La Torre / Mauro Rinaldi / Gianni Pedrizzetti / Stefano Salizzoni / Gaetano Maria De Ferrari

    Journal of Clinical Medicine, Vol 12, Iss 1218, p

    2023  Volume 1218

    Abstract: Transcatheter aortic valve implantation (TAVI) is the established first-line treatment for patient with severe aortic stenosis not suitable for surgery. Echocardiographic evaluation of hemodynamic forces (HDFs) is a growing field, holding the potential ... ...

    Abstract Transcatheter aortic valve implantation (TAVI) is the established first-line treatment for patient with severe aortic stenosis not suitable for surgery. Echocardiographic evaluation of hemodynamic forces (HDFs) is a growing field, holding the potential to early predict improvement in LV function. A prospective observational study was conducted. Transthoracic echocardiography was performed before and after TAVI. HDFs were analyzed along with traditional left ventricular (LV) function parameters. Twenty-five consecutive patients undergoing TAVI were enrolled: mean age 83 ± 5 years, 74.5% male, mean LV Ejection Fraction (LVEF) at baseline 57 ± 8%. Post-TAVI echocardiographic evaluation was performed 2.4 ± 1.06 days after the procedure. HDF amplitude parameters improved significantly after the procedure: LV Longitudinal Forces (LF) apex-base [mean difference (MD) 1.79%; 95% CI 1.07–2.5; p -value < 0.001]; LV systolic LF apex-base (MD 2.6%; 95% CI 1.57–3.7; p -value < 0.001); LV impulse (LVim) apex-base (MD 2.9%; 95% CI 1.48–4.3; p -value < 0.001). Similarly, HDFs orientation parameters improved: LVLF angle (MD 1.5°; 95% CI 0.07–2.9; p -value = 0.041); LVim angle (MD 2.16°; 95% CI 0.76–3.56; p -value = 0.004). Conversely, global longitudinal strain and LVEF did not show any significant difference before and after the procedure. Echocardiographic analysis of HDFs could help differentiate patients with LV function recovery after TAVI from patients with persistent hemodynamic dysfunction.
    Keywords TAVI ; echocardiography ; hemodynamic forces ; predictors ; Medicine ; R
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Echocardiographic Parameters to Predict Malignant Events in Arrhythmic Mitral Valve Prolapse Population

    Alessandro Vairo / Paolo Desalvo / Andrea Rinaudo / Francesco Piroli / Anna Tribuzio / Andrea Ballatore / Gianluca Marcelli / Lorenzo Pistelli / Veronica Dusi / Nicolò Montali / Gianluca Alunni / Cristina Barbero / Stefano Salizzoni / Marco Pocar / Mauro Rinaldi / Fiorenzo Gaita / Gaetano Maria De Ferrari / Carla Giustetto

    Journal of Clinical Medicine, Vol 12, Iss 1232, p

    2023  Volume 1232

    Abstract: Bileaflet Mitral Valve Prolapse (bMVP) has been linked to major arrhythmic events and sudden cardiac death (SCD). Consistent predictors in this field are still lacking. Echocardiography is the best tool for the analysis of the prolapse and its impact on ... ...

    Abstract Bileaflet Mitral Valve Prolapse (bMVP) has been linked to major arrhythmic events and sudden cardiac death (SCD). Consistent predictors in this field are still lacking. Echocardiography is the best tool for the analysis of the prolapse and its impact on the ventricular mechanics. The aim of this study was to find new echocardiographic predictors of malignant events within an arrhythmic MVP population. We evaluated 22 patients with arrhythmic bMVP with a transthoracic echocardiogram focused on mitral valve anatomy and ventricular contraction. Six of them had major arrhythmic events that required ICD implantation (ICD-MVP group), while sixteen presented with a high arrhythmic burden without major events (A-MVP group). The best predictors of malignant events were the Anterior Mitral Leaflet (AML) greater length and greater Mechanical Dispersion (MD) of basal and mid-ventricular segments, while other significant predictors were the larger mitral valve annulus (MVA) indexed area, lower MVA anteroposterior diameter/AML length ratio, higher inferolateral basal segment S3 velocity.
    Keywords mitral valve prolapse ; echocardiography ; ventricular arrhythmia ; sudden cardiac death ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

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