scholarly journals Exercise Right Heart Catheterisation in Cardiovascular Diseases: A Guide to Interpretation and Considerations in the Management of Valvular Heart Disease

2021 ◽  
Vol 16 ◽  
Author(s):  
Felipe H Valle ◽  
Basma Mohammed ◽  
Stephen P Wright ◽  
Robert Bentley ◽  
Neil P Fam ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Valvular Heart Disease ◽  
Heart Diseases ◽  
Pulmonary Resistance ◽  
Right Heart ◽  
Heart Catheterisation ◽  
Right Heart Catheterisation ◽  
Valvular Heart Diseases ◽  
Transcatheter Interventions

The use of exercise right heart catheterisation for the assessment of cardiovascular diseases has regained attention recently. Understanding physiologic haemodynamic exercise responses is key for the identification of abnormal haemodynamic patterns. Exercise total pulmonary resistance >3 Wood units identifies a deranged haemodynamic response and when total pulmonary resistance exceeds 3 Wood units, an exercise pulmonary artery wedge pressures/cardiac output slope >2 mmHg/l/min indicates the presence of underlying exercise-induced pulmonary hypertension related to left heart disease. In the evolving field of transcatheter interventions for valvular heart disease, exercise right heart catheterisation may objectively unmask symptoms and underlying haemodynamic abnormalities. Further studies are needed on the use of the procedure to inform the selection of patients who might receive the most benefit from transcatheter interventions for valvular heart diseases.

Abstract 163: High Burden of Valvulopathy in Heart Failure: A Moving Target

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Enoch Agunanne ◽  
Aamer Abbas ◽  
Debabrata Mukherjee
Keyword(s):  
United States ◽  
Heart Failure ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Heart Diseases ◽  
Medical Center ◽  
Care Facility ◽  
The United States ◽  
Study Objective ◽  
Valvular Heart Diseases

Background: The lifetime risk of developing Heart Failure (HF) is 20% for Americans ≥40 years of age. In the United States, greater than 650,000 new HF cases are diagnosed annually. About 5.1 million persons in the United States have clinically manifest HF. Additionally, HF has high absolute mortality rates of approximately 50% within 5 years of diagnosis. HF carries substantial health and economic burden. It is the primary diagnosis in >1 million hospitalizations annually. Patients hospitalized for HF are at high risk for all-cause re hospitalization. The total cost of HF care in the United States exceeds $30 billion annually. Objective: The study objective was to investigate the prevalence of valvular heart disease among patients hospitalized for HF in a largely Hispanic population. Methods: This is a retrospective study with aims inclusive of: analyzing the hospitalization and 4 months, 6 months, 2 year- re-hospitalization rates of HF in University Medical Center between Oct 2010 and Oct 2013; evaluating the association between valvular heart disease and hospitalizations for HF. Inclusion criteria were: admission/re hospitalizations with HF (with reduced, preserved and borderline EF). Echocardiographic determination of at least moderate valvular disease was utilized in this study as significant. Exclusion criteria were: patients lost to follow-up, death in hospital, transfer to another acute care facility, and discharge against medical advice. Demographics were also collected. Results: Hospitalizations involving 195 patients (120 men and 75 women) were randomly analyzed. The racial spread showed 77.4% (151 of 195) Hispanics and 22.6% (44 of 195) non-Hispanics. Out of the 195 index hospitalizations, the 4 month, 6 months and 2 years rehospitalization visits were 17.4% (34 of 195), 22.5% (44 of 195) and 38.5% (75 of 195) respectively. The prevalence of significant valvular heart disease was 45.9% (90 of 195), while the prevalence of no valvular heart disease was 54.1% (105 of 195) (p < 0.05). Conclusion: Multiple, prior studies have shown that valvular heart diseases have a comparatively low association with clinical Heart Failure. This study raises a valid point that in some population groups (the Hispanic), the burden of valvular heart disease may be greater than has been published in other groups. This calls for more studies, and has lots of potential implications in Heart Failure management.

scholarly journals Critical study of valvular heart diseases W. S. R. to Ayurvedokta Shatkriyakala

2019 ◽  
Vol 7 (06) ◽  
Author(s):  
Subhash Waghe
Keyword(s):  
Heart Disease ◽  
Therapeutic Intervention ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Heart Diseases ◽  
Point Of View ◽  
Critical Study ◽  
Throat Infection ◽  
Valvular Heart Diseases ◽  
Principles Of Treatment

Valvular heart diseases leads to definite death by various complications if not treated early. Although it may start as the simple throat infection but eventually it may affect the heart valves if not treated early. Shatkriya Kala is a unique pathological concept in Ayurveda developed with aim of treating the diseases at various stages of pathogenesis. Ancient Ayurvediac acharyas had stated 6 such stages of therapeutic intervention with reference to six stages of pathogenesis namely sanchaya, prakopa, prasara, sthansanshraya, vyakti and bheda.. If disease is treated in early stages, it does not lead to complications. There are vishahra a,d aamhar drugs in Ayurveda which could be potentially used to treat valvular affections. Hence, it is essential to apply the Ayurvedic concept of pathogenesis like ‘Shat Kriyakala’  to valvular heart disease so as to study it from Ayurvedic pathological point of view and to evolve a strategy to deal with it based on the Ayurvedokta principles of treatment particularly in terms of shatkriyakalas. The study of valvular heart disease with reference to Shat Kriyakala, showed that the pathogenesis of valvular heart disease can very well be arranged in Ayurvedokta  six stages of Shat Kriyakala and treatment could be framed as per different stages. With the help of modern investigations, these six stages could be diagnostically confirmed.

scholarly journals The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry: a descriptive study from single-center hospital registry of adult congenital heart disease and pulmonary hypertension in Indonesia

2019 ◽  
Author(s):  
Lucia Kris Dinarti ◽  
Anggoro Budi Hartopo ◽  
Arditya Damar Kusuma ◽  
Muhammad Gahan Satwiko ◽  
Muhammad Reyhan Hadwiono ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Congenital Heart ◽  
Clinical Presentation ◽  
Walking Distance ◽  
Single Center ◽  
Right Heart ◽  
Heart Catheterisation ◽  
Right Heart Catheterisation

Abstract Backgrounds: The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry is the first congenital heart disease (CHD) and CHD-related pulmonary hypertension (PH) in adults registry in Indonesia. The study aims to describe prevalence, characteristics, and hemodynamic the demographics, clinical presentation, and hemodynamics data of adult CHD and CHD-related PH in Indonesia. Methods: The COHARD-PH registry is a hospital-based, single-center, and prospective registry which includes adult patients with CHD and CHD-related PH. The patients were enrolled consecutively. For this study, we evaluated the registry patients from July 2012 until July 2018 2019. The enrolled patients underwent clinical examination, electrocardiography, chest x-ray, 6 minute walking test, laboratory measurement, and transthoracic and transoesofageal echocardiography. Right heart catheterisation was performed to measure hemodynamics and confirmed the diagnosis of pulmonary artery hypertension (PAH). Results: We registered 803 1012 patients during the study. The majority were young-adult females. The majority of CHD was secundum ASD (79.0%) (73.4%). The main symptom was dyspneu on effort. The majority of patients (78.1%) (77.1%) had already developed signs of PH assessed by echocardiography. The Eisenmenger syndrome was encountered in 17.3% 18.7% patients. Based on the right heart catheterisation, 67.8% 66.9% patients had developed PAH. Patients with PAH were significantly older, had lower peripheral oxygen saturation, had lower 6 minute walking distance, and had higher NTproBNP. There was an increased of proportion of PAH prevalence according to age range, with the highest prevalence between 51 and 60 years old. Conclusions: The COHARD-PH registry is the first Indonesian adult-CHD and CHD-related PH registry. The prevalence, characteristics, and hemodynamics data demographics, clinical presentation, and hemodynamics data of this registry reflects situation in developing countries which need to be compared with similar registries from developed countries.

scholarly journals Structural Heart Diseases during Pregnancy: Part 1—Valvular Heart Diseases

2018 ◽  
Vol 03 (02/03) ◽  
pp. 108-114
Author(s):  
Amar Patnaik
Keyword(s):  
Heart Disease ◽  
Pregnant Woman ◽  
Pregnant Women ◽  
Valvular Heart Disease ◽  
Heart Diseases ◽  
Medical Science ◽  
Morbidity And Mortality ◽  
Team Approach ◽  
Echocardiographic Evaluation ◽  
Valvular Heart Diseases

AbstractIt is estimated that about 3% pregnancies can have cardiac disease. There is wide variation in the spectrum of heart diseases. Pregnant women in India and other developing countries continue to show high prevalence of rheumatic heart disease (RHD). Pre-conception counseling based on a good echocardiographic evaluation is the most cost-effective method to prevent morbidity and mortality due to valvular heart disease. With advances in medical science, many with valvular heart disease are living to adulthood and undergoing successful pregnancy. Symptoms of a pregnant woman with a valvular disease depend on the altered hemodynamics of the specific valvular lesion in combination with the physiologic changes inherent to the pregnancy itself. A good echocardiographic evaluation of all pregnant women on their first visit to an obstetrician’s office is an effective strategy to prevent morbidity and mortality from valvular heart diseases. In general, the regurgitant lesions are well tolerated during pregnancy and labor. Asymptomatic but significant valve lesions can be decompensated by many factors. Severely stenosed mitral and, sometimes, aortic valve may have to be balloon-dilated by trained experts in midterm taking due care to avoid excess radiation. Valve surgery is rarely performed in absence of any other safer option. A multidisciplinary team approach is required to manage a pregnant woman with significant cardiac lesion with high-risk features and patients having mechanical valves that require continuous anticoagulation.

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