Aortic stenosis and Heyde’s syndrome: A comprehensive review

Lourdusamy, Dennisdhilak; Mupparaju, Vamsee Krishna; Sharif, Navila; Ibebuogu, Uzoma N.

doi:10.12998/wjcc.v9.i25.7319

Cited by 18 publications

(24 citation statements)

References 69 publications

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“…This resulted in three studies being eliminated, and ultimately 18 studies were included in this systematic review. Table 1 shown below is a summary of the pertinent findings of the 18 studies that were included in this systematic review [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The aim of this prospective cohort was to ascertain the link between Von Willebrand factor levels and patients undergoing TAVI.…”

Section: Resultsmentioning

confidence: 99%

“…GIB: gastrointestinal bleeding; VWF: Von Willebrand factor; VWS: Von Willebrand factor syndrome; MGUS: monoclonal gammopathy of undetermined significance; NH-L: non-Hodgkin's lymphoma Angiodysplasia: Angiodysplasia refers to an acquired vascular aberration in which the blood vessels of the GI tract form pathological tortuous arteriovenous (AV) malformations in the mucosa and submucosa [1,2,9]. It is the second most common cause of developing a lower GI bleed in patients over the age of 60 years [10].…”

Section: Pathophysiologymentioning

confidence: 99%

“…For GI bleeding, the approach may vary depending on whether the patient is actively bleeding or not. Asymptomatic patients in which incidental angiodysplasia signs are found have a low risk of developing a bleed in the future and, as a result, do not need to undergo treatment [1,11]. However, treatment can be considered in patients with a history of angiodysplasia who present with symptoms of occult GI bleeding [1,11].…”

Section: Gi Bleedingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Heyde's syndrome has been defined as the characteristic association between aortic stenosis (AS), gastrointestinal bleeding stemming from angiodysplasia, and acquired Von Willebrand's disease (aVWD) [1,2]. The relationship between aortic stenosis and gastrointestinal (GI) bleeding was first reported by Dr. Edward Heyde in 1958 [1]. Dr. Heyde wrote a letter to the New England Journal of Medicine, wherein he reported 10 cases of large-scale gastrointestinal bleeding in patients with concomitant calcific aortic valve stenosis [3].…”

Section: Introductionmentioning

confidence: 99%

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Multimodal Treatment and Diagnostic Modalities in the Setting of Heyde’s Syndrome: A Systematic Review

Jamil¹,

Tran²,

Mansoor³

et al. 2022

Cureus

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Heyde's syndrome encompasses the triad of aortic stenosis (AS), angiodysplasia, and acquired Von Willebrand's disease (aVWD). The disease itself is a rare association that affects a small subset of patients who suffer from aortic stenosis. Nonetheless, it represents a vital area of clinical interest and is woefully underreported in the literature. Patients with Heyde's syndrome develop gastrointestinal bleeding (GI) as a result of angiodysplasia and due to lack of adequate hemostasis, they tend to be positively predisposed toward developing gastrointestinal hemorrhage. Due to the glaring lack of comprehensive literature on Heyde's syndrome, this systematic review aims to bridge the gap by elucidating the various diagnostic and treatment options available to clinicians for Heyde's syndrome patients as well as to give a detailed account of the pathophysiology of the disease. This systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Google Scholar, Gulf Medical University (GMU) e-library, and PubMed were thoroughly searched for studies done in the last 10 years, which corresponds with our outlined inclusion and exclusion criteria. Relevant studies were then selected on the basis of their abstracts and titles. These studies then underwent a comprehensive quality assessment in which any papers which did not meet this study's eligibility criteria were omitted. Overall, 18 studies fulfilled the criteria of this systematic review.

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Section: Resultsmentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Section: Gi Bleedingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Multimodal Treatment and Diagnostic Modalities in the Setting of Heyde’s Syndrome: A Systematic Review

Jamil¹,

Tran²,

Mansoor³

et al. 2022

Cureus

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Prediction model for leaflet thrombosis in patients undergoing transcatheter aortic valve implantation: the EFFORT study

Steiner-Gager,

Rogozarski,

Kronberger

et al. 2024

Clin Res Cardiol

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Background Leaflet thrombosis (LT) is a multifaceted and underexplored condition that can manifest following transcatheter aortic valve implantation (TAVI). The objective of this study was to formulate a prediction model based on laboratory assessments and clinical parameters, providing additional guidance and insight into this relatively unexplored aspect of post-TAVI complications. Methods The present study was an observational prospective hypothesis-generating study, including 101 patients who underwent TAVI and a screening for LT (the primary endpoint) by multidetector computed tomography (MDCT). All images were acquired on a third-generation dual-source CT system. Levels of von Willebrand factor (vWF) activity, hemoglobin (Hb), and lactate dehydrogenase (LDH) were measured among other parameters. A predictive score utilizing binary logistic regression, Kaplan–Meier time-to-event analysis, and receiver operating characteristics (ROC) analysis was established. Results LT (11 subclinical and 2 clinical) was detected in 13 of 101 patients (13%) after a median time to screening by MDCT of 105 days (IQR, 98–129 days). Elevated levels of vWF activity (> 188%) pre-TAVI, decreased Hb values (< 11.9 g/dL), as well as increased levels of LDH (> 312 U/L) post-TAVI and absence of oral anticoagulation (OAC) were found in patients with subsequent LT formation as compared to patients without LT. The established EFFORT score ranged from − 1 to 3 points, with an increased probability for LT development in patients with ≥ 2 points (85.7% of LT cases) vs < 2 points (14.3% of LT cases; p < 0.001). Achieving an EFFORT score of ≥ 2 points was found to be significantly associated with a 10.8 times higher likelihood of developing an LT (p = 0.001). The EFFORT score has an excellent c-statistic (area under the curve (AUC) = 0.89; 95% CI 0.74–1.00; p = 0.001) and a high negative predictive value (98%). Conclusion An EFFORT score might be a helpful tool to predict LT development and could be used in risk assessment, if validated in confirmatory studies. Therefore, the score has the potential to guide the stratification of individuals for the planning of subsequent MDCT screenings. Graphical abstract Central illustration. Created with BioRender.com

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Safe Aortic Valve Intervention to Very Severe Aortic Stenosis

Fukumoto

2023

The American Journal of Cardiology

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Aortic stenosis and Heyde’s syndrome: A comprehensive review

Cited by 18 publications

References 69 publications

Multimodal Treatment and Diagnostic Modalities in the Setting of Heyde’s Syndrome: A Systematic Review

Multimodal Treatment and Diagnostic Modalities in the Setting of Heyde’s Syndrome: A Systematic Review

Prediction model for leaflet thrombosis in patients undergoing transcatheter aortic valve implantation: the EFFORT study

Safe Aortic Valve Intervention to Very Severe Aortic Stenosis

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