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Aortic Valve Calcification

Calcified Aortic Valve


Presentation

  • Mild tricuspid regurgitation was present in 41% of patients vs. 26% of controls (P 0.042), and aortic valve calcification was present in 40% of patients, compared with 18% of controls (P 0.003).[ncbi.nlm.nih.gov]
  • RESULTS: In unselected patients, calcification was present in 25.8% with tricuspid aortic valves (46 of 178) and 75% (three of four) with BAV.[ncbi.nlm.nih.gov]
  • In our present work, complex connections among mechano-response, oxidative stress, inflammation and extracellular remodeling pathways in the etiology of CAVD were revealed.[ncbi.nlm.nih.gov]
  • The scope of the present review is to summarize the clinical data and the pathophysiological mechanisms potentially involved in the link between renal function decline and the progression of aortic valve disease.[ncbi.nlm.nih.gov]
  • CONTEXT: It is unclear whether cardiovascular disease is present in primary hyperparathyroidism (PHPT). OBJECTIVE: Aortic valve structure and function were compared in PHPT patients and population-based controls.[ncbi.nlm.nih.gov]
Turkish
  • PATIENTS AND METHODS: Our study consisted of 305 Turkish patients of European descent (139 male, 166 female; mean plus or minus age, 68 plus or minus 9 years) referred to our echocardiography laboratory for aortic valve evaluation between June 2, 2003[ncbi.nlm.nih.gov]
Heart Disease
  • OBJECTIVE: Treatment with ergot-derived dopamine agonists, pergolide, and cabergoline has been associated with an increased frequency of valvular heart disease in Parkinson's disease.[ncbi.nlm.nih.gov]
  • Aortic valve calcification may be an early sign that you have heart disease, even if you don't have any other heart disease symptoms. Calcification and stenosis generally affects people older than age 65.[mayoclinic.org]
  • METHODS: Eighty patients, aged more than 60 years, without coronary heart disease or diabetes mellitus were included: 40 had AVC without significant stenosis (peak gradient across the valve RESULTS: Mean ages for patients with AVC and controls were 68.9[ncbi.nlm.nih.gov]
  • In 1201 subjects (52% women, 53.6 9.3 years old) without familiar and personal history of coronary heart disease, CAC and AVC were assessed by multidetector-computed tomography.[ncbi.nlm.nih.gov]
  • A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on valvular heart disease. Eur Heart J (2003) 24(13):1231–43. doi:10.1016/S0195-668X(03)00201-X PubMed Abstract CrossRef Full Text Google Scholar 11.[journal.frontiersin.org]
Decreased Renal Function
  • Recently, mechanisms of calcific valve degeneration have been further elucidated and many of the pathways involved could be amplified in patients with decreased renal function.[ncbi.nlm.nih.gov]
Dizziness
  • […] become more severe and cause: chest pain brought on by physical activity (angina) – caused by your heart having to work harder shortness of breath – at first you may only notice this when you exercise, but later you may experience this even when resting dizziness[nhs.uk]
  • Symptoms According to the Cleveland Clinic, a calcified heart valve will lead to valve diseases, which have symptoms such as shortness of breath, fatigue, coughing, heart palpitations, chest pain or tightness and dizziness.[livestrong.com]
  • Most of them are diagnosed because of their symptoms of Syncope (dizziness, fainting), Angina (chest pain) and Congestive Heart Failure (shortness of breath, leg swelling, weakness) or because of an obvious and loud systolic murmur.[heartsurgeryinfo.com]
  • Dizziness, fainting, or loss of consciousness. Signs of heart failure , such as fatigue and shortness of breath with activity. Palpitations (an uncomfortable feeling that your heart is beating rapidly or irregularly).[northshore.org]

Workup

  • Further workup revealed distal segmental right lower lobe pulmonary embolus and he was appropriately started on rivaroxaban for pulmonary embolus.[journal.frontiersin.org]
Calcified Aortic Valve
  • OBJECTIVES: To assess the procedural and short-term clinical outcome of performing balloon-expandable TAVR in patients with extremely calcified aortic valves.[ncbi.nlm.nih.gov]
  • Immunohistochemistry (IHC) staining for sclerostin and mRNA sclerostin expression was analyzed in 10 calcified aortic valves and 10 non-calcified age-matched control valves.[ncbi.nlm.nih.gov]
  • APPROACH AND RESULTS: Using immunohistochemistry, real-time qPCR, Western blotting, and tissue culture, we examined the tissue distribution of WNT5a, WNT5b, and WNT11 in noncalcified and calcified aortic valves and their effects on human aortic valve[ncbi.nlm.nih.gov]
  • Furthermore, immunohistochemical staining showed that significantly higher numbers ( 7-9-fold) of CD34-negative compared with CD34-positive MSLCs were localized in calcified aortic valve specimens obtained from calcified aortic stenosis patients.[ncbi.nlm.nih.gov]
  • High gradient severe AS was found among 53.8% (50/93) of the patients with low AVCS vs. 86% (404/470) of the patients with high AVCS (P Conclusion: Balloon-expandable TAVI in patients with a mildly calcified aortic valve was not associated with increased[ncbi.nlm.nih.gov]
Suppression
  • Inhibition of ER stress by either tauroursodeoxycholic acid or 4-phenyl butyric acid could both suppress oxLDL-induced osteoblastic differentiation and inflammatory responses in VICs.[ncbi.nlm.nih.gov]
  • Using conditioned media (CM) from oxLDL-treated VIC, we further identified that oxLDL triggered osteoblastic differentiation of VIC via paracrine pathway, while depletion of apoptotic bodies (ABs) in CM suppressed the effect.[ncbi.nlm.nih.gov]
Lymphocytic Infiltrate
  • Abstract Aortic valve stenosis is a complex inflammatory process, akin to arterial atherosclerosis, involving lymphocytic infiltrates, macrophages, foam cells, endothelial activation and dysfunction, increased cellularity and extracellular matrix deposition[ncbi.nlm.nih.gov]

Treatment

  • OBJECTIVES: This study evaluated the impact of AVC load, absolute and relative to aortic annulus size (AVCdensity), on overall mortality in patients with AS under conservative treatment and without regard to treatment.[ncbi.nlm.nih.gov]
  • Patients were classified according to treatment: patients treated with cabergoline (group 1: n 47) and patients not treated with cabergoline (group 2: n 31).[ncbi.nlm.nih.gov]
  • The aim of this study was to investigate the effect of long-term OAC treatment on circulating MGP levels in humans and on MGP expression in mice.[ncbi.nlm.nih.gov]
  • Thus, statins and angiotensin II antagonists seemed promising treatment options. However, clinical trials failed to support this.[ncbi.nlm.nih.gov]
  • However, the only treatment option currently available is highly invasive cardiac valve replacement. Therefore, clarification of the etiology of calcification is urgently needed to develop drug therapies and prevention methods.[ncbi.nlm.nih.gov]

Prognosis

  • Natural history, epidemiology, and prognosis of aortic stenosis. . Accessed April 18, 2017. Zakkar M, et al. Aortic stenosis: Diagnosis and management. BMJ. 2016;355:1. Dweck M, et al.[mayoclinic.org]
  • See: Statistics from Altmetric.com aortic valve calcification aortic valve stenosis sex prognosis echocardiography Introduction Sex differences in aortic stenosis (AS) have been pointed out both at the valvular and left ventricular (LV) level. 1 From[heart.bmj.com]
  • Although no effective treatment for alkaptonuria exists, prognosis is relatively good (1). However, complications are unavoidable. Arthropathy may be severely debilitating, and cardiovascular or renal impairment can involve vital prognosis.[ctsnet.org]
  • Congestive heart failure [ edit ] Congestive heart failure (CHF) carries a grave prognosis in people with AS.[en.wikipedia.org]
  • Surgical treatment has greatly improved the outlook (prognosis) in most people who have more severe stenosis. Surgery to widen or to replace the valve has a very good success rate.[patient.info]

Etiology

  • Therefore, clarification of the etiology of calcification is urgently needed to develop drug therapies and prevention methods.[ncbi.nlm.nih.gov]
  • CI: 2.22 to 10.40; p CONCLUSIONS: Compared to controls, he-FH is associated with a high prevalence and a large extent of subclinical AoVC, especially in patients with LDLR-negative mutations, highlighting the critical role of LDL-C metabolism in AoVC etiology[ncbi.nlm.nih.gov]
  • In our present work, complex connections among mechano-response, oxidative stress, inflammation and extracellular remodeling pathways in the etiology of CAVD were revealed.[ncbi.nlm.nih.gov]
  • Mohler III, University of Pennsylvania Translational Research Center, 3400 Civic Center Boulevard, Building, 421, Room 11-103, Philadelphia, Pennsylvania 19104-5159 Key Words aortic valve calcification endothelial progenitor cell The etiology of calcific[onlinejacc.org]
  • Classification and etiology There are numerous other predisposing factors and causes of aortic stenosis.[radiopaedia.org]

Epidemiology

  • Arfan a ; b ; c Affiliations: Department of Neurology, Erasmus MC, Rotterdam, the Netherlands Department of Epidemiology, Harvard T.H.[content.iospress.com]
  • BACKGROUND: Previous epidemiologic studies have shown that low-density lipoprotein is an independent risk factor for prevalent aortic valve calcification (AVC); however, to our knowledge, the interactions between plasma lipoprotein concentrations and[ncbi.nlm.nih.gov]
  • METHODS: We performed an independent assessment of AVC, CAC, and calcium supplementation among patients enrolled in the Epidemiology of Coronary Artery Calcification study who were 60 years of age and had baseline and 4-year follow-up AVC data.[ncbi.nlm.nih.gov]
  • Natural history, epidemiology, and prognosis of aortic stenosis. . Accessed April 18, 2017. Zakkar M, et al. Aortic stenosis: Diagnosis and management. BMJ. 2016;355:1. Dweck M, et al.[mayoclinic.org]
  • . , a cardiologist and associate professor of medicine and epidemiology at the Johns Hopkins University School of Medicine who is a senior author of the study.[hopkinsmedicine.org]
Sex distribution
Age distribution

Pathophysiology

  • The scope of the present review is to summarize the clinical data and the pathophysiological mechanisms potentially involved in the link between renal function decline and the progression of aortic valve disease.[ncbi.nlm.nih.gov]
  • Hence, the relationship between valvular calcification process and AS severity differs in women and men, warranting further pathophysiological inquiry.[ncbi.nlm.nih.gov]
  • OBJECTIVES: Aortic valve (AV) calcification occurs via a pathophysiological process that includes lipoprotein deposition, inflammation, and osteoblastic differentiation of valvular interstitial cells.[ncbi.nlm.nih.gov]
  • These findings suggest that the pathophysiology of AS and thus potential targets for drug development may be different according to sex. 2016 American Heart Association, Inc.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: The present study provides direct in vivo evidence that catS-induced elastolysis accelerates arterial and aortic valve calcification in CRD, providing new insight into the pathophysiology of cardiovascular calcification.[ncbi.nlm.nih.gov]

Prevention

  • CHOP deficiency prevents oxLDL-induced VIC osteoblastic differentiation via preventing VIC-derived ABs releasing. 2017 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: These data provide novel evidence that ER stress participates in AV calcification development, and suggest that ER stress may be a novel target for AV calcification prevention and treatment.[ncbi.nlm.nih.gov]
  • Therefore, clarification of the etiology of calcification is urgently needed to develop drug therapies and prevention methods.[ncbi.nlm.nih.gov]
  • Hence, the need to elucidate the pathways that contribute to cardiovascular calcification and to develop new therapeutic strategies to prevent or reverse calcification has driven investigations into the use of molecular imaging.[ncbi.nlm.nih.gov]
  • This challenge motivates the elucidation of the mechanisms involved in calcification, with the eventual goal of alternative preventative and therapeutic strategies.[ncbi.nlm.nih.gov]

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