Diagnosis and Management of Valvular Heart Disease

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 247

Special Issue Editors


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Guest Editor
Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
Interests: cardiovascular medicine; valvular heart disease; aortic stenosis

E-Mail Website
Guest Editor
Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
Interests: cardiovascular medicine; valvular heart disease; aortic stenosis

Special Issue Information

Dear Colleagues,

The diagnosis of valvular heart disease (VHD) often involves a combination of clinical evaluation, imaging studies such as echocardiography, and sometimes more advanced techniques like cardiac MRI or CT scans.

Management strategies for VHD depend on the specific affected valve, the severity of the disease, and the patient's overall clinical picture. Treatment options may include lifestyle modifications, medical management, and transcatheter and surgical interventions, such as valve repair or replacement. Advances in technology and interventional techniques have improved outcomes and broadened the scope of options available for patients.

Our intention is to open a Special Issue about the “Diagnosis and Management of Valvular Heart Disease”, with a particular emphasis on the integration of new technologies and innovative approaches. Despite advancements in our understanding and treatment of valvular heart disease, many doubts and challenges persist regarding the optimal evaluation and management of patients.

In this Special Issue, we aim to explore the latest evidence-based practices and technological advancements that can enhance diagnostic accuracy, improve interventional outcomes, and ultimately optimize patient quality of life. We encourage contributions that examine clinical trials, case studies, and expert opinions on the future of VHD management, focusing on how these innovations can address persistent uncertainties and improve the overall standard of care for patients suffering from VHD.

We look forward to receiving your contributions.

Dr. Roney Orismar Sampaio
Dr. Joao Ricardo Fernandes
Guest Editors

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Keywords

  • valvular heart disease
  • aortic stenosis
  • mitral stenosis
  • cardiovascular imaging
  • biomarker

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Published Papers (1 paper)

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Research

13 pages, 2894 KiB  
Article
Impact of a New Preoperative Stratification Based on Cardiac Structural Compromise in Patients with Severe Aortic Stenosis Undergoing Valve Replacement Surgery
by Cristhian Espinoza Romero, Vitor Emer Egypto Rosa, Sérgio Octavio Kormann, Bryan Nicolalde, Antonio Sérgio de Santis Andrade Lopes, Guilherme Sobreira Spina, João Ricardo Cordeiro Fernandes, Flavio Tarasoutchi and Roney Orismar Sampaio
Diagnostics 2024, 14(19), 2250; https://doi.org/10.3390/diagnostics14192250 - 9 Oct 2024
Abstract
Introduction and objectives: Aortic valve replacement surgery (SAVR) remains a recommended indication, though its pre-surgical stratification is an ongoing challenge. Despite the widespread use of scores like the STS and EuroSCORE II, they have a number of limitations, while often neglecting structural parameters [...] Read more.
Introduction and objectives: Aortic valve replacement surgery (SAVR) remains a recommended indication, though its pre-surgical stratification is an ongoing challenge. Despite the widespread use of scores like the STS and EuroSCORE II, they have a number of limitations, while often neglecting structural parameters like left ventricular hypertrophy or left atrium volume. This study aimed to evaluate whether a new adaptation of the Généreux classification in the preoperative risk stratification of severe aortic stenosis (AS) is associated with the primary outcome, and to compare it with the original classification versus the traditional scores in short- and long-term follow-up. Methods: We conducted a retrospective, single-center study involving patients with confirmed severe AS who underwent SAVR. The new stratification categorized patients into three stages. Cox regression analyses were conducted to identify factors associated with mortality, with survival analysis performed using Kaplan–Meier curves. A p-value < 0.05 was considered statistically significant. Results: A total of 508 patients were included. Stage 3 patients had a lower median age (67 years). The median EuroSCORE II and STS scores were 2.75 and 2.62%, respectively (p ≤ 0.001). Over a median follow-up of 81 months, 56 deaths occurred (11%). Kaplan–Meier curve analysis revealed significant differences in all-cause mortality among the three groups (HR 4.073, log-rank p ≤ 0.001). Multivariable analysis identified the three preoperative stages (HR 3.22, [95% CI 1.44–7.20], p = 0.004) and mean transaortic gradient (HR 0.96, [95% CI 0.92–0.99], p = 0.021) as independent variables of mortality. The original Généreux scale AUC was higher (AUC: 0.760, 95% CI: 0.692–0.829) compared to the modified Généreux scale (AUC: 0.758, 95% CI: 0.687–0.829). However, no statistical differences were found between the different scales. Conclusions: Preoperative three-stage classification and low transaortic gradient are factors associated with increased all-cause mortality in patients undergoing SAVR. The proposed staging system performed better in the mortality analysis than EuroSCORE II and STS and was similar to the original classification. Full article
(This article belongs to the Special Issue Diagnosis and Management of Valvular Heart Disease)
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