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306 results for “mitral valve”
Putative Circulating MicroRNAs Are Able to Identify Patients with Mitral Valve Prolapse and Severe Regurgitation
<p>This record contains raw data related to the article “Putative Circulating MicroRNAs Are Able to Identify Patients with Mitral Valve Prolapse and Severe Regurgitation”. Mitral valve prolapse (MVP) associated with severe mitral regurgitation is a debilitating disease with no pharmacological therapies available. MicroRNAs (miRNA) represent an emerging class of circulating biomarkers that have never been evaluated in MVP human plasma. Our aim was to identify a possible miRNA signature that is able to discriminate MVP patients from healthy subjects (CTRL) and to shed light on the putative altered molecular pathways in MVP. We evaluated a plasma miRNA profile using Human MicroRNA Card A followed by real-time PCR validations. In addition, to assess the discriminative power of selected miRNAs, we implemented a machine learning analysis. MiRNA profiling and validations revealed that miR-140-3p, 150-5p, 210-3p, 451a, and 487a-3p were significantly upregulated in MVP, while miR-223-3p, 323a-3p, 340-5p, and 361-5p were significantly downregulated in MVP compared to CTRL (<em>p</em> ≤ 0.01). Functional analysis identified several biological processes possible linked to MVP. In addition, machine learning analysis correctly classified MVP patients from CTRL with high accuracy (0.93) and an area under the receiving operator characteristic curve (AUC) of 0.97. To the best of our knowledge, this is the first study performed on human plasma, showing a strong association between miRNAs and MVP. Thus, a circulating molecular signature could be used as a first-line, fast, and cheap screening tool for MVP identification.</p>
Tricuspid annular dilation in patients undergoing early mitral valve surgery: is it an old story?
<p>This record contains raw data related to the article "Tricuspid annular dilation in patients undergoing early mitral valve surgery: is it an old story?"</p> <p>Patients with mitral valve prolapse (MVP), undergoing early surgery for severe regurgitation, are usually characterized by<br> a low degree of right chambers’ remodeling. In this selected population, the mechanisms leading to tricuspid annular (TA)<br> dilatation (TAD) are not well understood. In this setting, we aimed to evaluate, using three-dimensional echocardiography<br> (3DE), how right chambers affect TA size and might contribute to functional tricuspid regurgitation (FTR) progression.<br> We studied 159 patients treated with early isolated surgery for MVP, characterized by: sinus rhythm; normal biventricular<br> function; normal or elevated pulmonary artery pressure; tricuspid regurgitation (TR) ≤ mild; no concomitant cardiac disease.<br> All patients reached a 3-year echocardiographic follow-up. Based on two-dimensional echocardiography, patients were<br> divided in Group 1 (N = 68, 43%, TAD, TA ≥ 21 mm/m2) and Group 2 (N = 91, 57%, no TAD, TA < 21 mm/m2). By 3DE,<br> Group 1 showed larger TA size, right atrial (RA) volume and right ventricular (RV) conical remodeling compared to Group<br> 2 (p < 0.05). The multivariate analysis revealed that RA volume, RV basal diameter and function were independently correlated<br> to TA size (p < 0.05). At the 3-year follow-up there was a low incidence of FTR, with a trend towards FTR progression<br> in Group 1 (p = 0.07). In patients undergoing early surgery for MVP, TAD seems to result from distinctive early-onset<br> geometrical changes of the right chambers, preceding TR, RV dilatation and pulmonary hypertension at rest. An integrated<br> approach, including right chambers’ assessment by 3DE, might help to better recognized patients at higher risk for TAD<br> and, potentially for FTR.</p>
Partial dataset related to the article "Prognostic Impact of Extra–Mitral Valve Cardiac Involvement in Patients With Primary Mitral Regurgitation"
<p>This record contains partial raw data related to the article "Prognostic Impact of Extra–Mitral Valve Cardiac Involvement in Patients With Primary Mitral Regurgitation"</p> <p>OBJECTIVES The aim of this study was to evaluate the prognostic impact of the presence of extra–mitral valve cardiac</p> <p>involvement (including known risk factors but also severe left atrial [LA] dilatation and right ventricular [RV] dysfunction)</p> <p>in a large multicenter study of patients with primary mitral regurgitation (MR).</p> <p>BACKGROUND In patients with severe primary MR, the indication for surgery is currently based on the presence of</p> <p>symptoms, left ventricular dilatation and dysfunction, atrial fibrillation, and pulmonary hypertension.</p> <p>METHODS Patients with severe primary MR undergoing surgery were included and categorized according to the extent</p> <p>(highest) of cardiac involvement: group 0, no cardiac involvement; group 1, left ventricular involvement; group 2, LA</p> <p>involvement; group 3, pulmonary vasculature or tricuspid valve involvement; or group 4, RV involvement. The outcome</p> <p>was all-cause mortality.</p> <p>RESULTS A total of 1,106 patients were included (mean age 63 12 years, 68% male). In total, 377 patients (34%)</p> <p>were classified in group 0, 239 (22%) in group 1, 213 (19%) in group 2, 180 (16%) in group 3, and 97 (9%) in group 4.</p> <p>Kaplan-Meier curve analysis revealed significantly worse survival (log-rank chi-square ¼ 43.4; P < 0.001) with higher</p> <p>group. On multivariable analysis, age, male sex, chronic obstructive pulmonary disease, kidney function, and group of</p> <p>cardiac involvement were independently associated with all-cause mortality. For each increase in group, a 17% higher risk</p> <p>for all-cause mortality was observed (95% CI: 1.051-1.313; P ¼ 0.005) during a median follow-up time of 88 months.</p> <p>CONCLUSIONS In patients with severe primary MR, a novel classification system based on extra–mitral valve cardiac</p> <p>involvement may help refine risk stratification and timing of surgery, particularly including severe LA dilatation and RV</p> <p>dysfunction in the assessment.</p>
Data set related to the article "Predictors of Prognosis in Patients With Secondary Mitral Regurgitation Undergoing Mitral Valve Transcatheter Edge-to-Edge Repair"
<p>This record contains raw data related to the article <em>Predictors of Prognosis in Patients With Secondary Mitral Regurgitation Undergoing Mitral Valve Transcatheter Edge-to-Edge Repair</em></p>
Data set from Adamo M, Grasso C, Capodanno D, Rubbio AP, Scandura S, Giannini C, Fiorelli F, Fiorina C, Branca L, Brambilla N, Bedogni F, Petronio AS, Curello S, Tamburino C. Five-year clinical outcomes after percutaneous edge-to-edge mitral valve repair: Insights from the multicenter GRASP-IT registry. Am Heart J. 2019 Nov;217:32-41. doi: 10.1016/j.ahj.2019.06.015. Epub 2019 Jul 3. PMID: 31473325.
<p>Data set from Adamo M, Grasso C, Capodanno D, Rubbio AP, Scandura S, Giannini C, Fiorelli F, Fiorina C, Branca L, Brambilla N, Bedogni F, Petronio AS, Curello S, Tamburino C. Five-year clinical outcomes after percutaneous edge-to-edge mitral valve repair: Insights from the multicenter GRASP-IT registry. Am Heart J. 2019 Nov;217:32-41. doi: 10.1016/j.ahj.2019.06.015. Epub 2019 Jul 3. PMID: 31473325.</p> <p> </p> <p>This is the abstract:</p> <p>Limited evidence is available on 5-year clinical outcomes after percutaneous edge-to-edge mitral valve repair.</p> <p><strong>Methods: </strong>The Getting Reduction of mitrAl inSufficiency by Percutaneous clip implantation in ITaly (GRASP-IT) is a multicenter registry including 304 consecutive patients undergoing Mitraclip between October 2008 and October 2013 at 4 Italian centers. Primary end point (all-cause mortality) and secondary end point (all-cause mortality or heart failure [HF] hospitalization) were evaluated up to 5 years and between 1 and 5 years.</p> <p><strong>Results: </strong>Cumulative incidence of the primary and secondary end points at 1, 2, 3, 4, and 5 years were 15.1%, 26.4%, 35.5%, 42.1%, and 47.3% and 29.1%, 41.7%, 49.8%, 56%, and 62.3%, respectively. Landmark analysis between 1 and 5 years showed an incidence of primary and secondary end point of 37.9% and 46.8%, respectively. Five-year event rates were significantly higher in patients with functional ischemic mitral regurgitation (MR) compared to other etiologies. MR recurrence and left ventricular ejection fraction <30% were associated with an increased risk of both primary and secondary end points. EuroSCORE II >5% was associated with an increased risk of 5-year mortality. Ischemic etiology of MR, baseline serum creatinine >1.5 mg/dL, chronic obstructive pulmonary disease, and previous HF hospitalizations were independent predictors of 5-year secondary end point.</p> <p><strong>Conclusions: </strong>At 5-year follow-up after Mitraclip, nearly half of patients died and almost two thirds died or were admitted for HF. MR recurrence, ischemic etiology, high comorbidity burden (ie, EuroSCORE II >5%, chronic obstructive pulmonary disease), and advanced cardiomyopathy (ie, left ventricular ejection fraction <30%, prior HF admission, creatinine >1.5 mg/dL) significantly increase the relative risk of 5-year clinical events.</p>
Influence of chest conformation on myocardial strain parameters in healthy subjects with mitral valve prolapse
<p>Raw data.</p> <p>Abstract<br> Chest shape might affect myocardial strain parameters. However, the relationship between myocardial strain parameters and<br> chest conformation has not been previously investigated in subjects with mitral valve prolapse (MVP). Between April 2019<br> and May 2020, 60 healthy subjects (50.1 ± 8.6 year/old, 46.6% females) with MVP and mild-to-moderate mitral regurgitation,<br> and 60 controls matched by age, sex, and cardiovascular risk factors were consecutively studied. Participants underwent<br> modified Haller index (MHI) assessment (ratio of chest transverse diameter over the distance between sternum and spine),<br> and transthoracic echocardiography implemented with 2D-speckle tracking analysis. MHI was significantly greater in MVP<br> group than controls (2.6 ± 0.35 vs 2.1 ± 0.23, p < 0.0001). Left ventricular (LV) ejection fraction was similar in MVP and<br> controls (63.5 ± 3.7% vs 64.3 ± 3.9%, p = 0.25). LV regional and global longitudinal (GLS), circumferential (GCS) and radial<br> strain (GRS) parameters and LV peak twist were all significantly lower in MVP compared to controls (all p < 0.0001). MVP<br> subjects with a tight chest (MHI > 2.5, n = 30), and those with MHI ≤ 2.5 (n = 30) were then separately analyzed. A significant<br> impairment in myocardial strain parameters and LV peak twist was documented in MVP subjects with MHI > 2.5, but not in<br> those with MHI ≤ 2.5. MHI showed a strong inverse correlation with LV-GLS (r = − 0.85), GCS (r = − 0.84), GRS (r = − 0.84)<br> and LV peak twist (r = − 0.94). In MVP subjects, impairment of myocardial strain parameters is not due to intrinsic reduction<br> of cardiac contractility function, but it appears to be related to the degree of chest deformity.</p>
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