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Structural Heart Diseases: State of the Art from Diagnosis to Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (20 July 2023) | Viewed by 10870

Special Issue Editors

Dr. Simona Sperlongano

E-Mail Website
Guest Editor
Division of Cardiology, Department of Traslational Medical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
Interests: echocardiography; stress echocardiography; transesophageal echocardiography; 3D echocardiography; heart valve diseases; structural heart disease
Special Issues, Collections and Topics in MDPI journals
Dr. Adriana Postolache

E-Mail Website
Guest Editor
Department of Cardiology, CHU SartTilman, University of Liège Hospital, GIGA Cardiovascular Sciences, Liège, Belgium
Interests: echocardiography; stress echocardiography; transesophageal echocardiography; 3D echocardiography; heart valve diseases; structural heart disease
Prof. Dr. Patrizio Lancellotti

E-Mail Website
Guest Editor
Department of Cardiology, CHU SartTilman, University of Liège Hospital, GIGA Cardiovascular Sciences, Liège, Belgium
Interests: echocardiography; stress echocardiography; transesophageal echocardiography; 3D echocardiography; heart valve diseases; structural heart disease

Special Issue Information

Dear Colleagues,

“Structural heart disease” is any non-coronary cardiovascular abnormality, congenital or developed with aging, which weakens the heart’s structure. In the last few decades, many significant advances have been achieved in our understanding of the pathological mechanisms which underlie such conditions, and new diagnostic tools and treatment options have been developed.

The scope of this Special Issue is to provide an overview of the latest advances in structural heart diseases’ diagnosis and treatment. Therefore, researchers in the field of structural heart disease are encouraged to submit an original article or review to this Special Issue (case reports and short reviews are not accepted).

Dr. Simona Sperlongano
Dr. Adriana Postolache
Prof. Dr. Patrizio Lancellotti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Aortic stenosis
  • Mitral regurgitation
  • Tricuspid regurgitation
  • Cardiomyopathy
  • Congenital heart disease
  • Patent foramen ovale
  • Left atrial appendage
  • Paravalvular leak

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Published Papers (5 papers)

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Research

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12 pages, 825 KiB  
Article
Electrocardiographic Parameters Associated with Adverse Outcomes in Children with Cardiomyopathies
by Katarzyna Luczak-Wozniak, Klaudia Obsznajczyk, Cezary Niszczota and Bożena Werner
J. Clin. Med. 2022, 11(23), 6930; https://doi.org/10.3390/jcm11236930 - 24 Nov 2022
Cited by 2 | Viewed by 1504
Abstract
Cardiomyopathies have a low prevalence in children and thus may lead to malignant ventricular arrhythmias or the progression of heart failure, resulting in death. In adults, the QRS-T angle derived from ECG has been associated with adverse outcomes in patients with hypertrophic and [...] Read more.
Cardiomyopathies have a low prevalence in children and thus may lead to malignant ventricular arrhythmias or the progression of heart failure, resulting in death. In adults, the QRS-T angle derived from ECG has been associated with adverse outcomes in patients with hypertrophic and dilated cardiomyopathies. We aimed to assess the electrocardiographic parameters, including QRS-T angle, associated with adverse cardiac events in children with cardiomyopathies. Forty-two children with cardiomyopathies were included in this study: 19 with dilated cardiomyopathy, 17 with hypertrophic cardiomyopathy, and 6 with left ventricular non-compaction. Additionally, 19 control subjects were recruited. In terms of ECG parameters, the QRS-T angle was significantly greater among patients with adverse outcomes compared to patients without the end points of the study (133° vs. 65°, p < 0.001). On Kaplan–Meier survival curves, QRS-T angle > 120°, increased serum concentrations of NT-proBNP and troponin I levels as well as greater NYHA or Ross scale were associated with the greatest risk of unfavorable outcome. The QRS-T angle appears to be a valuable component of 12-lead ECG interpretation, and might be helpful in outlining patients with the greatest cardiovascular risk. Additionally, serum biomarkers such as NT-proBNP (p = 0.003) and troponin (p < 0.001) are useful in outlining patients with the worst survival. Full article
(This article belongs to the Special Issue Structural Heart Diseases: State of the Art from Diagnosis to Treatment)
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10 pages, 783 KiB  
Article
Non-Invasive Assessment of Right Ventricle to Arterial Coupling for Prognosis Stratification of Fibrotic Interstitial Lung Diseases
by Ciro Santoro, Agostino Buonauro, Angelo Canora, Gaetano Rea, Mario Enrico Canonico, Roberta Esposito, Alessandro Sanduzzi Zamparelli, Giovanni Esposito and Marialuisa Bocchino
J. Clin. Med. 2022, 11(20), 6115; https://doi.org/10.3390/jcm11206115 - 17 Oct 2022
Cited by 2 | Viewed by 1513
Abstract
Background: The coupling of the right ventricle (RV) to the pulmonary circulation is an indicator of RV performance that can be non-invasively estimated by echocardiography. There are no data about its use in patients affected by fibrotic interstitial lung diseases (f-ILD). Methods: Fifty [...] Read more.
Background: The coupling of the right ventricle (RV) to the pulmonary circulation is an indicator of RV performance that can be non-invasively estimated by echocardiography. There are no data about its use in patients affected by fibrotic interstitial lung diseases (f-ILD). Methods: Fifty f-ILD patients, including 27 cases with idiopathic pulmonary fibrosis (IPF) (M = 37; mean age 67 ± 7 years), were studied with standard and speckle-tracking echocardiography and compared with 30 age-matched healthy volunteers. The mean patient follow-up was 70 ± 4 months. Results: Fibrotic ILD patients had a larger right ventricle (RV) and worse diastolic function because the RV global longitudinal strain (GLS) was significantly lower and the systolic pulmonary artery pressure (sPAP) estimates were higher in comparison with those of controls. Conversely, tricuspid annular systolic excursion (TAPSE) did not differ between controls and patients. Median values of TAPSE/sPAP and RV GLS/sPAP were significantly reduced in f-ILD patients (p < 0.0001). Patients with an RV GLS/sPAP below the median value had a shorter survival time (61 vs. 74 months, p = 0.01); this parameter was an independent predictor of a worse outcome. Conclusion: Low estimates of RV GLS/sPAP are predictive of worse outcomes in f-ILD patients. RV coupling seems to be a promising surrogate biomarker of RV performance to discriminate the patient phenotype with significant management and prognosis implications. Full article
(This article belongs to the Special Issue Structural Heart Diseases: State of the Art from Diagnosis to Treatment)
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13 pages, 2706 KiB  
Article
Left Ventricular Mass with Delayed Enhancement as a Predictor of Major Events in Patients with Myocarditis with Preserved Ejection Fraction
by Nicolò Ghionzoli, Annalaura Gismondi, Giulia Elena Mandoli, Lucia Spera, Alex Di Florio, Flavio D’Ascenzi, Matteo Cameli, Luna Cavigli, Carlotta Sciaccaluga, Salvatore Francesco Carbone, Giovanni Donato Aquaro, Serafina Valente and Marta Focardi
J. Clin. Med. 2022, 11(20), 6082; https://doi.org/10.3390/jcm11206082 - 14 Oct 2022
Viewed by 1703
Abstract
Background: Cardiac Magnetic Resonance (CMR) has a key role in subjects presenting with acute myocarditis, independent from left ventricular ejection fraction; it is widely used as a non-invasive imaging test for both diagnostic and prognostic purposes. However, poor data is available about [...] Read more.
Background: Cardiac Magnetic Resonance (CMR) has a key role in subjects presenting with acute myocarditis, independent from left ventricular ejection fraction; it is widely used as a non-invasive imaging test for both diagnostic and prognostic purposes. However, poor data is available about the CMR-derived prognostic parameters of acute myocarditis with preserved ejection fraction (AMpEF). The aim of this study was to investigate the role of CMR in predicting outcomes in patients followed up for AMpEF, using a composite endpoint of all-cause mortality and hospitalization for heart failure (HF). Methods: We retrospectively enrolled 61 patients with diagnosed AMpEF. All patients underwent biohumoral, echocardiographic and CMR evaluation in the acute phase. Myocarditis was confirmed by Lake–Louis criteria assessed on CMR images. Mean follow-up was 4.8 ± 0.6 years during which a composite endpoint of all-cause mortality and hospitalization for HF was investigated. Results: The population was fairly homogeneous regarding baseline clinical features. In particular, no significant differences in age and main cardiovascular risk factors were found between patients with and without events at follow-up. Seven patients met the endpoint. They had significantly higher levels of circulating neutrophils in the acute phase (76 ± 7% vs. 61 ± 11%, p = 0.014) and a higher amount of left ventricular mass with delayed enhancement (DE-LVM, 18 (14–29.5) vs. 12 (8–16) g, p = 0.028). At Cox univariate analysis, DE-LVM was the only significant predictor of endpoint, regardless of the site of inflammation. Conclusions: DE-LVM can predict the composite endpoint of all-cause mortality and hospitalization for HF in a population of patients with AMpEF, representing a new added tool for prognostic stratification. Full article
(This article belongs to the Special Issue Structural Heart Diseases: State of the Art from Diagnosis to Treatment)
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Review

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12 pages, 256 KiB  
Review
TAVI after More Than 20 Years
by Adriana Postolache, Simona Sperlongano and Patrizio Lancellotti
J. Clin. Med. 2023, 12(17), 5645; https://doi.org/10.3390/jcm12175645 - 30 Aug 2023
Cited by 8 | Viewed by 2725
Abstract
It has been more than 20 years since the first in man transcatheter aortic valve intervention (TAVI), and during this period we have witnessed an impressive evolution of this technique, with an extension of its use from non-operable patients to high-, intermediate- and [...] Read more.
It has been more than 20 years since the first in man transcatheter aortic valve intervention (TAVI), and during this period we have witnessed an impressive evolution of this technique, with an extension of its use from non-operable patients to high-, intermediate- and even low-risk patients with aortic stenosis, and with a decrease in the incidence of complications. In this review, we discuss the evaluation of patients before TAVI, the procedure and the changes it has seen over time, and we present the current main complications and challenges of TAVI. Full article
(This article belongs to the Special Issue Structural Heart Diseases: State of the Art from Diagnosis to Treatment)
9 pages, 448 KiB  
Review
Pathophysiology, Functional Assessment and Prognostic Implications of Nutritional Disorders in Systemic Amyloidosis
by Francesca Dongiglio, Emanuele Monda, Giuseppe Palmiero, Federica Verrillo, Marta Rubino, Gaetano Diana, Annapaola Cirillo, Adelaide Fusco, Erica Vetrano, Michele Lioncino, Martina Caiazza, Giuseppe Cerciello, Laura Capodicasa, Flavia Chiosi, Vincenzo Simonelli, Maria Luisa De Rimini, Francesco Natale, Alessandro Di Santo, Elisabetta Moscarella, Paolo Calabrò and Giuseppe Limongelliadd Show full author list remove Hide full author list
J. Clin. Med. 2023, 12(2), 528; https://doi.org/10.3390/jcm12020528 - 9 Jan 2023
Cited by 2 | Viewed by 1637
Abstract
Gastrointestinal involvement is a common clinical feature of patients with systemic amyloidosis. This condition is responsible for invalidating gastrointestinal symptoms, a significant macro and micronutrient deficit, and is a marker of disease severity. Gastrointestinal involvement should be actively sought in patients with systemic [...] Read more.
Gastrointestinal involvement is a common clinical feature of patients with systemic amyloidosis. This condition is responsible for invalidating gastrointestinal symptoms, a significant macro and micronutrient deficit, and is a marker of disease severity. Gastrointestinal involvement should be actively sought in patients with systemic amyloidosis, while its diagnosis is challenging in patients with isolated gastrointestinal symptoms. The nutritional status in systemic amyloidosis plays an essential role in the clinical course and is considered a significant prognostic factor. However, the definition of nutritional status is still challenging due to the lack of internationally accepted thresholds for anthropometric and biochemical variables, especially in specific populations such as those with systemic amyloidosis. This review aims to elucidate the fundamental steps for nutritional assessment by using clinical and instrumental tools for better prognostic stratification and patient management regarding quality of life and outcomes. Full article
(This article belongs to the Special Issue Structural Heart Diseases: State of the Art from Diagnosis to Treatment)
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