Heart : official journal of the British Cardiac Society
-
On echocardiography approximately one-third of patients with severe aortic valve stenosis based on aortic valve area (AVA<1.0 cm(2)) demonstrate a non-severe mean pressure gradient (DeltaPm; < or =40 mm Hg) despite apparently normal left ventricular function. It has been suggested that inconsistent echocardiographic grading may be due to 'paradoxical' low stroke volume. However, the correct echocardiographic assessment of stroke volume hinges on the often problematic measurement of the left ventricular outflow tract (LVOT) diameter. ⋯ In the framework of current guidelines inconsistent grading of aortic valve stenosis is common, extends to cardiac catheterisation and is only partially explained by low stroke volume despite apparently normal left ventricular systolic function.
-
We sought to evaluate prognostic markers of clinical outcome in asymptomatic patients with moderate to severe aortic stenosis (AS). ⋯ In asymptomatic patients with moderate to severe AS, measurements that integrate the ventricular, vascular and valvular components of the disease improve risk stratification.
-
Vasoreactivity testing is recommended in the management of pulmonary arterial hypertension (PAH), but its clinical relevance in congenital heart disease (CHD)-associated PAH has not been established. ⋯ Pulmonary vasoreactivity is a significant predictor of clinical worsening in patients with CHD-PAH.
-
To evaluate the predictors of pulmonary artery systolic pressure (PASP) in organic mitral regurgitation (MR) and its prognostic value after surgery. ⋯ In organic MR, mitral deceleration time, mitral E/E' and left atrial volume correlate with PASP. Pulmonary artery systolic pressure > or = 50 mmHg is an independent predictor of overall and cardiovascular mortality after surgery in organic MR.