Transcatheter aortic valve implantation (TAVI) is a recent revolutionary treatment for high-risk patients with severe aortic stenosis who are not suitable for surgery, expanding to intermediate and low-risk patients. Valve leaflet thrombosis (LT) is a potentially fatal complication after TAVI. The incidence of subclinical LT is as high as 25% among patients in the first year after TAVI. Subclinical LT may evolve into symptomatic thrombosis or lead to premature bioprosthesis degeneration, increasing the risk of neurological complications. Because imaging-based methods have limited sensitivity to detect subclinical LT, there is an urgent need for predictors and biomarkers that would make it possible to predict LT after TAVI. Here, we summarize recent data regarding (i) patient-related, (ii) procedure-related, (iii) blood-based and (iv) imaging predictors and biomarkers which might be useful for the early diagnosis of subclinical LT after TAVI. Prevention of LT might offer an opportunity to improve risk stratification and tailor therapy after TAVI.
Heart failure, a leading cause of hospitalizations and deaths, is a major clinical problem. In recent years, the increasing incidence of heart failure with preserved ejection fraction (HFpEF) has been observed. Despite extensive research, there is no efficient treatment for HFpEF available. However, a growing body of evidence suggests stem cell transplantation, due to its immunomodulatory effect, may decrease fibrosis and improve microcirculation and therefore, could be the first etiology-based therapy of the disease. In this review, we explain the complex pathogenesis of HFpEF, delineate the beneficial effects of stem cells in cardiovascular therapy, and summarize the current knowledge concerning cell therapy in diastolic dysfunction. Furthermore, we identify outstanding knowledge gaps that may indicate directions for future clinical studies.
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