Percutaneous Valve Interventions in Heart Failure
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(2020) 22:44
Heart Failure (W Tang, Section Editor)
Percutaneous Valve Interventions in Heart Failure Amit Goyal, MD Amar Krishnaswamy, MD* Address * Heart Vascular Institute, Cleveland Clinic Foundation, Mail Code Desk J2-3, 9500 Euclid Avenue, Cleveland, OH, 44195, USA Email: [email protected]
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Heart Failure Keywords Aortic stenosis I Mitral regurgitation I Tricuspid regurgitation I Heart failure I Transcatheter aortic valve replacement
Abstract Purpose of review Heart failure remains a major cause of morbidity and mortality despite advances in guideline directed medical and electrophysiologic device therapies. Valvular heart disease (VHD) is common in heart failure patients and independently associated with poor outcomes. This review provides an update in the rapidly evolving field of transcatheter heart valve interventions (THVI) in the management of heart failure. Recent findings Aortic stenosis (AS) may cause or worsen heart failure. Functional mitral regurgitation (FMR) and functional tricuspid regurgitation (FTR) occur secondary to heart failure and contribute to ongoing adverse remodeling. Each of these valvular lesions is independently associated with worse clinical outcomes including mortality. Transcatheter aortic valve replacement (TAVR) has revolutionized the management of AS. Challenges unique to the mitral and tricuspid valves are being answered by a multitude of different device designs with promising early data, most notably for edge-to-edge leaflet repair. Summary Unbridled innovation in THVI technologies stand to dramatically alter the management of VHD in heart failure patients. Here we will review the complex interactions between VHD and heart failure, appraise the data surrounding THVI devices, and discuss opportunities for future research.
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Curr Treat Options Cardio Med
(2020) 22:44
Introduction Heart failure is a major cause of morbidity and mortality, affecting 6.2 million American adults and responsible for approximately 1 million hospitalizations annually [1••]. Approach to the heart failure patient has undergone several strides in recent times with substantial advances in optimal medical and electrophysiologic device therapies [2]. Despite these laudable achievements, heart failure continues to have an approximately 50% mortality at 5 years [3]. Traditional optimal heart failure therapies (OHFT) target the adverse effects of neurohormonal activation and electrical dyssynchrony; while important, these fail to address the etiologic and prognostic implication of concomitant valvular heart
disease (VHD). Here, we review the epidemiology, pathophysiology, and transcatheter management of VHD specifically in patients with heart failure. Specifically, we discuss transcatheter heart valve interventions (THVI) for aortic stenosis (AS), mitral regurgitation (MR), and tricuspid regurgitation (TR) as well as opportunities for future research. We also review
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