Structural Heart最新文献_第4页

Single Leaflet Device Attachment After Pascal Implantation for Transcatheter Edge-to-Edge Repair: Systematic Review and Meta-Analysis 经导管边缘到边缘修复Pascal植入术后单叶装置附着：系统回顾和荟萃分析

IF 2.8

Structural Heart Pub Date : 2025-07-05 DOI: 10.1016/j.shj.2025.100698

Soumya Gupta MD , Devika Aggarwal MBBS , Michael Gao MD , Kirtipal Bhatia MD , Marija Petrovic MD, PhD , Abel Casso Dominguez MD , Stamatios Lerakis MD, PhD , Edgar Argulian MD, MPH

引用次数: 0

Evaluating ChatGPT-4o and OpenEvidence for Structural Heart Disease Support: Insights From Tricuspid Valve Therapies 评估chatgpt - 40和开放证据对结构性心脏病的支持：来自三尖瓣治疗的见解

IF 2.8

Structural Heart Pub Date : 2025-07-05 DOI: 10.1016/j.shj.2025.100696

Joseph Hajj MD , Mohamad Mdaihly MD , Joseph Kassab MD , Rhonda Miyasaka MD , Serge C. Harb MD

引用次数: 0

Echocardiographic Imaging to Guide Tricuspid Interventions 超声心动图成像指导三尖瓣干预

IF 1.4

Structural Heart Pub Date : 2025-07-01 DOI: 10.1016/j.shj.2025.100669

Rebecca T. Hahn MD

引用次数: 0

Understanding Aortic Stenosis and Transcatheter Aortic Valve Replacement in Women 了解女性主动脉瓣狭窄和经导管主动脉瓣置换术

IF 1.4

Structural Heart Pub Date : 2025-07-01 DOI: 10.1016/j.shj.2025.100666

Giulia Masiero MD , Anna Franzone MD, PhD , Valeria Paradies MD , Nicole Karam MD, PhD , Chiara Fraccaro MD, PhD , Chiara De Biase MD , Mirvat Alasnag MD , Giulia Botti MD , Angelicarosa Cascone MD , Ana Belen Cid-Alvarez MD, PhD , Tanja K. Rudolph MD, PhD , Marta Kaluzna-Oleksy MD, PhD , Stephane Manzo-Silberman MD, PhD , Julinda Mehilli MD, PhD , Barbara E. Stähli MD, PhD , Julia Grapsa MD, PhD , Kyriakos Panaou MD , Barbara Bellini MD , Joanna J. Wykrzykowska MD, PhD , Sabine Bleiziffer MD, PhD , Alaide Chieffo MD, PhD

{"title":"Understanding Aortic Stenosis and Transcatheter Aortic Valve Replacement in Women","authors":"Giulia Masiero MD , Anna Franzone MD, PhD , Valeria Paradies MD , Nicole Karam MD, PhD , Chiara Fraccaro MD, PhD , Chiara De Biase MD , Mirvat Alasnag MD , Giulia Botti MD , Angelicarosa Cascone MD , Ana Belen Cid-Alvarez MD, PhD , Tanja K. Rudolph MD, PhD , Marta Kaluzna-Oleksy MD, PhD , Stephane Manzo-Silberman MD, PhD , Julinda Mehilli MD, PhD , Barbara E. Stähli MD, PhD , Julia Grapsa MD, PhD , Kyriakos Panaou MD , Barbara Bellini MD , Joanna J. Wykrzykowska MD, PhD , Sabine Bleiziffer MD, PhD , Alaide Chieffo MD, PhD","doi":"10.1016/j.shj.2025.100666","DOIUrl":"10.1016/j.shj.2025.100666","url":null,"abstract":"<div><div>The impact of sex on the baseline characteristics, morphology, and clinical presentation of degenerative aortic stenosis (AS) is well-documented but remains poorly understood. Unlike valve surgery, for which patients have been predominantly male, percutaneous treatment of AS has shown balanced representation of both sexes, with women demonstrating greater benefit from transfemoral aortic valve replacement compared to surgical treatment. This review explores sex-specific differences in the epidemiology, pathophysiology, diagnostic challenges, treatment approaches, and clinical outcomes of degenerative AS. Furthermore, it addresses technical, sex-specific considerations in transfemoral aortic valve replacement, including preprocedural screening, device selection, implantation strategy, and postprocedural management.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 7","pages":"Article 100666"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pharmacology in Structural Intervention for Valvular Heart Disease: Current Practice and Future Perspectives 瓣膜性心脏病结构干预的药理学：当前实践和未来展望

IF 1.4

Structural Heart Pub Date : 2025-07-01 DOI: 10.1016/j.shj.2024.100360

Francesca Maria Di Muro MD , Birgit Vogel MD , Angelo Oliva MD , Benjamin Bay MD , Mauro Gitto MD , George D. Dangas MD, PhD , Roxana Mehran MD

{"title":"Pharmacology in Structural Intervention for Valvular Heart Disease: Current Practice and Future Perspectives","authors":"Francesca Maria Di Muro MD , Birgit Vogel MD , Angelo Oliva MD , Benjamin Bay MD , Mauro Gitto MD , George D. Dangas MD, PhD , Roxana Mehran MD","doi":"10.1016/j.shj.2024.100360","DOIUrl":"10.1016/j.shj.2024.100360","url":null,"abstract":"<div><div>Over the past 2 decades, structural heart interventions–including procedures like transcatheter aortic valve replacement, transcatheter mitral or tricuspid valve replacement, and transcatheter edge-to-edge mitral or tricuspid valve repair–have emerged as feasible alternatives to traditional surgery for treating valvular heart diseases. Antithrombotic treatment represents a critical aspect of postoperative care, aiming to balance the thromboembolic risk due to the incorporation of prosthetic materials and the consequently altered hemodynamics within the cardiac chambers with the bleeding risk depending on patients’ and procedural factors. This continuously evolving interplay underscores the importance of personalized, evidence-based approaches to ensure optimal outcomes. This review provides a comprehensive examination of the current knowledge on antithrombotic therapies after structural interventions, offering insights into the evolving field and emphasizing the importance of tailored strategies.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 7","pages":"Article 100360"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mitral Annular Calcification: Understanding the Disease and Treatment Options 二尖瓣环钙化：了解疾病和治疗方案

IF 1.4

Structural Heart Pub Date : 2025-07-01 DOI: 10.1016/j.shj.2025.100668

Marina Urena MD, PhD , John Kikoïne MD , Mayra Guerrero MD

{"title":"Mitral Annular Calcification: Understanding the Disease and Treatment Options","authors":"Marina Urena MD, PhD , John Kikoïne MD , Mayra Guerrero MD","doi":"10.1016/j.shj.2025.100668","DOIUrl":"10.1016/j.shj.2025.100668","url":null,"abstract":"<div><div>Mitral annular calcification (MAC) is a degenerative process that causes calcium deposits along the mitral annulus. The pathophysiological mechanisms contributing to the development of MAC are not fully understood. The main risk factors for MAC are advanced age, female gender, chronic kidney disease, and conditions predisposing to left ventricular hypertrophy, which increases mitral annulus tension and subsequent annular degeneration. The prevalence of MAC varies widely among studies, from 5% to 42%, depending on the characteristics of the study population and the imaging modality used to make the diagnosis, and it is increasing over time. MAC is independently associated with all-cause mortality, cardiovascular mortality, and the occurrence of cardiovascular disease such as atrial fibrillation, conduction abnormalities, or stroke. MAC can progress and involve the mitral valve leaflets, causing mitral stenosis, mitral regurgitation, or both. Patients who develop symptomatic mitral valve dysfunction associated with significant MAC have lower survival when mitral valve intervention is not performed. However, the surgical risk of these patients is often high, precluding surgery in many. Therefore, transcatheter mitral valve implantation is emerging as an alternative in patients with severe MAC and associated symptomatic mitral valve dysfunction. This manuscript summarizes a description of the disease process in MAC and its treatment options.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 7","pages":"Article 100668"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functional Mitral Regurgitation and the Role of Transcatheter Repair 功能性二尖瓣返流及经导管修复的作用

IF 1.4

Structural Heart Pub Date : 2025-07-01 DOI: 10.1016/j.shj.2024.100347

Richa Gupta MD, MPH , Holly Gonzales MD , Stacy Tsai MD , Angela Lowenstern MD , JoAnn Lindenfeld MD

{"title":"Functional Mitral Regurgitation and the Role of Transcatheter Repair","authors":"Richa Gupta MD, MPH , Holly Gonzales MD , Stacy Tsai MD , Angela Lowenstern MD , JoAnn Lindenfeld MD","doi":"10.1016/j.shj.2024.100347","DOIUrl":"10.1016/j.shj.2024.100347","url":null,"abstract":"<div><div>Secondary mitral regurgitation (SMR), classified as ventricular or atrial SMR, is associated with excess mortality, heart failure (HF) hospitalization, and worsening quality of life. Therapy is directed toward the underlying cardiomyopathy first with use of neurohormonal antagonism, cardiac resynchronization therapy and arrhythmia reduction, which can reduce MR severity and improve outcomes, followed by transcatheter therapies. Multimodality imaging in the evaluation of MR is critical to determine the mechanism, severity, and options for intervention. Transcatheter treatment of severe SMR provides a percutaneous option for patients who remain symptomatic despite optimal medical management, and there have been significant advances in the procedural capabilities and devices available for treatment. The Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure trial demonstrated improvement in morbidity and mortality with use of mitral transcatheter edge-to-edge repair (mTEER). The results of this trial suggest that greater proportionate MR, in which the magnitude of MR is accompanied proportionately with a high degree of LV dilation, confers less clinical benefit. A window of opportunity exists during which time mTEER may improve symptoms and prognosis in HF patients as guided by Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure criteria in stage C HF. This review describes our current understanding of the pathophysiology and treatment of SMR. Additionally, it explores several questions as to the optimal timing of transcatheter intervention, the role of mTEER in moderate MR, our understanding of exercise-induced MR, implications for mitral valvular and ventricular remodeling, and whether mTEER may facilitate optimization of medical therapy.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 7","pages":"Article 100347"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Vital Contribution of Women in Structural Heart Disease — Shaping the Future Through Innovation, Imaging, and Insight 女性在结构性心脏病中的重要贡献——通过创新、成像和洞察塑造未来

IF 1.4

Structural Heart Pub Date : 2025-07-01 DOI: 10.1016/j.shj.2025.100670

Anita W. Asgar MD

引用次数: 0

Staging Aortic Stenosis Based on Cardiac Damage: A New Tool for Risk Prediction, Clinical Decision-Making, and Trial Design 基于心脏损伤的主动脉瓣狭窄分期：风险预测、临床决策和试验设计的新工具

IF 1.4

Structural Heart Pub Date : 2025-07-01 DOI: 10.1016/j.shj.2025.100424

Linda D. Gillam MD, MPH, Philippe Généreux MD

{"title":"Staging Aortic Stenosis Based on Cardiac Damage: A New Tool for Risk Prediction, Clinical Decision-Making, and Trial Design","authors":"Linda D. Gillam MD, MPH, Philippe Généreux MD","doi":"10.1016/j.shj.2025.100424","DOIUrl":"10.1016/j.shj.2025.100424","url":null,"abstract":"<div><div>Staging based on extra-valvular cardiac damage is an intuitive approach to categorizing patients with aortic stenosis (AS) that is easily applied using widely available echocardiographic tools. As discussed in this review, it has been shown to be a powerful tool for risk stratification that complements conventional approaches. The original and most widely used framework identifies stage 0 when there is AS without additional cardiac damage; stage 1 when there is left ventricular damage (hypertrophy, systolic or diastolic dysfunction with evidence of elevated filling pressures); stage 2 when there is mitral dysfunction (moderate or greater mitral regurgitation, typically secondary) or left atrial abnormalities (left atrial enlargement or atrial fibrillation); stage 3 when there is pulmonary hypertension and/or moderate or greater tricuspid regurgitation (typically secondary); and stage 4 when there is moderate or greater right ventricular dysfunction. In a series of studies that have collectively evaluated damage before and after aortic valve replacement in patients with moderate and severe AS, as well as with and without symptoms, cardiac damage has been shown to predict all-cause and cardiovascular mortality and other outcomes. These observations support the design of trials to reevaluate thresholds for aortic valve replacement in AS and approaches that consider cardiac damage stage in clinical decision-making for individual patients (valve replacement vs. medical therapy).</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 7","pages":"Article 100424"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advancing the Contemporary Multidisciplinary Heart Valve Team: Update on Priorities for Clinicians and Programs 推进当代多学科心脏瓣膜团队：临床医生和项目优先事项的更新

IF 1.4

Structural Heart Pub Date : 2025-07-01 DOI: 10.1016/j.shj.2025.100490

Sandra B. Lauck PhD , Connie Clark MSN , Sophie Offen MD, PhD , Erin Tang MSN , Stephanie Sellers PhD

{"title":"Advancing the Contemporary Multidisciplinary Heart Valve Team: Update on Priorities for Clinicians and Programs","authors":"Sandra B. Lauck PhD , Connie Clark MSN , Sophie Offen MD, PhD , Erin Tang MSN , Stephanie Sellers PhD","doi":"10.1016/j.shj.2025.100490","DOIUrl":"10.1016/j.shj.2025.100490","url":null,"abstract":"<div><div>The multidisciplinary heart team (MDT) has been foundational to the rapid advancement of treatment options for valvular heart disease (VHD). Initially designed to guide treatment decisions for patients with aortic stenosis and procedural success of transcatheter aortic valve implantation, the MDT was intended to provide a responsive mechanism to meet the needs of patients and programs. Some of the unintended consequences of guideline endorsement and regulatory requirements have diminished the perceived value and threatened the engagement of team members. To maintain its impact, the VHD MDT must evolve to reflect contemporary priorities. For patients with aortic stenosis, the concept of the MDT must expand to address the significant barriers to timely detection, diagnosis, and referral and leverage its expertise to increase program capacity to accelerate access to care. The comprehensive mitral and tricuspid valve clinical pathway is in its infancy. For this patient group, the membership of the core MDT must be strengthened by the addition of expertise to support imaging diagnostics and procedural guidance, specialty team members who can guide the individualized clinical management of complex VHD, enhanced coordination of care and patient-centered processes, and consideration of unanswered clinical concerns. A recalibrated perspective on the key principles guiding the MDT for clinicians and programs offers opportunities to make the most of lessons learned by promoting quality of care and building a VHD collective and culture that can meet patients’ needs along their journey of care while prioritizing a nimble, tailored, efficient, and high-impact approach.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 7","pages":"Article 100490"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0