Focus on Diagnosis and Prognosis to Guide Timing of Intervention in Valvular Heart Disease

Abstract

Purpose of Review The present article reviews the role of multimodality imaging to improve risk stratification and timing of intervention in patients with valvular heart disease (VHD), and summarizes the latest developments in transcatheter valve interventions. Recent Findings Growing evidence suggests that intervention at an earlier stage may improve outcomes of patients with significant VHD. Multimodality imaging, including strain imaging and tissue characterization with cardiac magnetic resonance imaging, has the ability to identify early markers of myocardial damage and can help to optimize the timing of intervention. Transcatheter interventions play an increasing role in the treatment of patients who remain at high surgical risk or present at a late stage of their disease. Summary Multimodality imaging identifies markers of cardiac damage at an early stage in the development of VHD. Together with technological innovations in the field of percutaneous valvular devices, these developments have the potential to improve current management and outcomes of patients with significant VHD.

The right ventricle systolic force ratio could predict the severity of the tricuspid regurgitation‐RIVIERA ratio

“…[10][11][12][13] While the data supporting the reliability of quantitative TR grading as an independent predictor of clinical outcomes, in a recent meta-analysis of 70 studies, just one study reported findings utilizing such grading, which is superior to qualitative assessment. 3,5 The emphasis shifted to the usefulness of the PISA method for TR grade due to the potential underestimating of the TR severity with biplanar measurement of VC. the persistent rise in mortality linked to EROA >20 mm 2 and regurgitant volume (RegV) >20 mL.…”

“…Around 4% of persons 75 and older have moderate or severe TR 1,2 . Recent data from numerous studies suggest that significant TR adversely affects patient prognosis and does so more and more with each increase in severity grade 3–5 . This could make sense given that chronic right ventricle (RV) volume overload brought on by severe self‐perpetuating TR may cause the RV to enlarge and remodel over time, which could then result in gradual, irreversible RV myocardial injury and right heart failure 6 .…”

Exercise as the Key to Improve Cardiopulmonary Function in Patients with Valvular Heart Disease: A Systematic Review and Meta-Analysis

“…Mortality due to AVD has steadily increased from the 1970s to the 2000s, with an annual increase of approximately 1.6% [ 11 ]. In addition, AS prevalence is increasing in ageing populations and carries significant risks [ 12 ]. If left untreated, symptomatic severe AS can have a mortality of 75% at 3.5 years, with up to 50% of those affected dying suddenly [ 13 ].…”