The Experts below are selected from a list of 258 Experts worldwide ranked by ideXlab platform

Gosta B Pettersson - One of the best experts on this subject based on the ideXlab platform.

  • understanding right ventricular dysfunction and functional tricuspid regurgitation accompanying Mitral Valve Disease
    The Journal of Thoracic and Cardiovascular Surgery, 2013
    Co-Authors: Lina Vargas M Abello, Allan L Klein, Thomas H Marwick, Edward R Nowicki, Jeevanantham Rajeswaran, Sarinya Puwanant, Eugene H Blackstone, Gosta B Pettersson
    Abstract:

    Objectives The study objective was to correlate the degree of tricuspid regurgitation with clinical indicators of right-sided heart failure and both qualitative and quantitative measures of right-sided heart morphology and function in patients with degenerative Mitral Valve Disease. Methods From 2001 to 2007, 1833 patients with degenerative Mitral Valve Disease, structurally normal tricuspid Valve, and no coronary artery Disease underwent surgery. Right-sided heart morphology (right ventricular base-to-apex length, tethering distance and area, and right atrial systolic area) and right ventricular function (tricuspid annular plane systolic excursion, myocardial performance index, and tricuspid Valve annular shortening) were measured on preoperative transthoracic echocardiograms for 100 randomly selected patients from each of tricuspid regurgitation grades 0, 1+, and 2+, and for all 93 patients with tricuspid regurgitation grade 3+/4+. Multivariable regression was used to evaluate the association of left- and right-sided heart morphology and function with tricuspid regurgitation. Results Increasing tricuspid regurgitation grade was associated with higher right ventricular pressure ( P P  = .008), larger right atrial size ( P  = .0002), and worsening right ventricular function, particularly when 3+/4+ tricuspid regurgitation was present. When tricuspid regurgitation was 3+/4+, both tricuspid annular plane systolic excursion and myocardial performance index were almost certainly abnormal. Changes in right-sided heart morphology and right ventricular dysfunction were synergistic in relation to severity of tricuspid regurgitation. Conclusions Functional tricuspid regurgitation accompanying Mitral Valve Disease is associated with proportional changes in right-sided heart morphology; however, severe tricuspid regurgitation is nearly always associated with right ventricular dysfunction, suggesting a synergistic relationship. Right ventricular dysfunction is likely as important as tricuspid regurgitation because it offers an explanation for the negative prognostic impact of tricuspid regurgitation and has implications for the clinical management of patients.

Philip Greenland - One of the best experts on this subject based on the ideXlab platform.

  • Predictors of left atrial thrombus in Mitral Valve Disease
    Journal of General Internal Medicine, 1991
    Co-Authors: Glenn Davison, Philip Greenland
    Abstract:

    Objective:To determine the risk factors for left atrial thrombus (LAT) and the prevalence of thrombi in cases of Mitral Valve Disease whose severity was fudged to necessitate surgical intervention.

  • Predictors of left atrial thrombus in Mitral Valve Disease
    Journal of General Internal Medicine, 1991
    Co-Authors: Glenn Davison, Philip Greenland
    Abstract:

    Objective: To determine the risk factors for left atrial thrombus (LAT) and the prevalence of thrombi in cases of Mitral Valve Disease whose severity was fudged to necessitate surgical intervention . Design: Hospital record review of all operative cases from 1982 to 1985 . Setting: A community serving a referral population encompassing 1.5 million people. Only two hospitals in the geographic area performed cardiac surgery, and both hospitals’ records were reviewed . Patients: All 372 patients who underwent either Mitral Valve replacement or open Mitral commissurotomy . Main results: Twenty-six patients (7%) were noted to have LAT at surgery. Five preselected factors were significantly (p

Lina Vargas M Abello - One of the best experts on this subject based on the ideXlab platform.

  • understanding right ventricular dysfunction and functional tricuspid regurgitation accompanying Mitral Valve Disease
    The Journal of Thoracic and Cardiovascular Surgery, 2013
    Co-Authors: Lina Vargas M Abello, Allan L Klein, Thomas H Marwick, Edward R Nowicki, Jeevanantham Rajeswaran, Sarinya Puwanant, Eugene H Blackstone, Gosta B Pettersson
    Abstract:

    Objectives The study objective was to correlate the degree of tricuspid regurgitation with clinical indicators of right-sided heart failure and both qualitative and quantitative measures of right-sided heart morphology and function in patients with degenerative Mitral Valve Disease. Methods From 2001 to 2007, 1833 patients with degenerative Mitral Valve Disease, structurally normal tricuspid Valve, and no coronary artery Disease underwent surgery. Right-sided heart morphology (right ventricular base-to-apex length, tethering distance and area, and right atrial systolic area) and right ventricular function (tricuspid annular plane systolic excursion, myocardial performance index, and tricuspid Valve annular shortening) were measured on preoperative transthoracic echocardiograms for 100 randomly selected patients from each of tricuspid regurgitation grades 0, 1+, and 2+, and for all 93 patients with tricuspid regurgitation grade 3+/4+. Multivariable regression was used to evaluate the association of left- and right-sided heart morphology and function with tricuspid regurgitation. Results Increasing tricuspid regurgitation grade was associated with higher right ventricular pressure ( P P  = .008), larger right atrial size ( P  = .0002), and worsening right ventricular function, particularly when 3+/4+ tricuspid regurgitation was present. When tricuspid regurgitation was 3+/4+, both tricuspid annular plane systolic excursion and myocardial performance index were almost certainly abnormal. Changes in right-sided heart morphology and right ventricular dysfunction were synergistic in relation to severity of tricuspid regurgitation. Conclusions Functional tricuspid regurgitation accompanying Mitral Valve Disease is associated with proportional changes in right-sided heart morphology; however, severe tricuspid regurgitation is nearly always associated with right ventricular dysfunction, suggesting a synergistic relationship. Right ventricular dysfunction is likely as important as tricuspid regurgitation because it offers an explanation for the negative prognostic impact of tricuspid regurgitation and has implications for the clinical management of patients.

Patrick Bruneval - One of the best experts on this subject based on the ideXlab platform.

  • Mitral Valve Disease—morphology and mechanisms
    Nature Reviews Cardiology, 2015
    Co-Authors: Robert A Levine, Albert A. Hagége, Muralidhar Padala, Nabila Bouatia-naji, Jonathan Beaudoin, Joyce Bischoff, Daniel P. Judge, Elena Aikawa, Jacob P. Dal-bianco, Patrick Bruneval
    Abstract:

    Mitral Valve Disease is a common cause of heart failure and death. In this Review from members of the Leducq Transatlantic Network, Levine and colleagues extensively summarize the molecular and cellular mechanisms underlying the dynamic changes that occur during progression of Mitral Valve Disease, and indicate how improved understanding of the pathophysiology might lead to the discovery of novel therapeutic options.

  • Mitral Valve Disease-morphology and mechanisms
    Nature Reviews Cardiology, 2015
    Co-Authors: Robert A Levine, Albert A. Hagége, Muralidhar Padala, Jacob P. Dal-bianco, Nabila Bouatia-naji, Jonathan Beaudoin, Joyce Bischoff, Daniel P. Judge, Elena Aikawa, Patrick Bruneval
    Abstract:

    Mitral Valve Disease is a frequent cause of heart failure and death. Emerging evidence indicates that the Mitral Valve is not a passive structure, but-even in adult life-remains dynamic and accessible for treatment. This concept motivates efforts to reduce the clinical progression of Mitral Valve Disease through early detection and modification of underlying mechanisms. Discoveries of genetic mutations causing Mitral Valve elongation and prolapse have revealed that growth factor signalling and cell migration pathways are regulated by structural molecules in ways that can be modified to limit progression from developmental defects to Valve degeneration with clinical complications. Mitral Valve enlargement can determine left ventricular outflow tract obstruction in hypertrophic cardiomyopathy, and might be stimulated by potentially modifiable biological valvular-ventricular interactions. Mitral Valve plasticity also allows adaptive growth in response to ventricular remodelling. However, adverse cellular and mechanobiological processes create relative leaflet deficiency in the ischaemic setting, leading to Mitral regurgitation with increased heart failure and mortality. Our approach, which bridges clinicians and basic scientists, enables the correlation of observed Disease with cellular and molecular mechanisms, leading to the discovery of new opportunities for improving the natural history of Mitral Valve Disease.

Glenn Davison - One of the best experts on this subject based on the ideXlab platform.

  • Predictors of left atrial thrombus in Mitral Valve Disease
    Journal of General Internal Medicine, 1991
    Co-Authors: Glenn Davison, Philip Greenland
    Abstract:

    Objective:To determine the risk factors for left atrial thrombus (LAT) and the prevalence of thrombi in cases of Mitral Valve Disease whose severity was fudged to necessitate surgical intervention.

  • Predictors of left atrial thrombus in Mitral Valve Disease
    Journal of General Internal Medicine, 1991
    Co-Authors: Glenn Davison, Philip Greenland
    Abstract:

    Objective: To determine the risk factors for left atrial thrombus (LAT) and the prevalence of thrombi in cases of Mitral Valve Disease whose severity was fudged to necessitate surgical intervention . Design: Hospital record review of all operative cases from 1982 to 1985 . Setting: A community serving a referral population encompassing 1.5 million people. Only two hospitals in the geographic area performed cardiac surgery, and both hospitals’ records were reviewed . Patients: All 372 patients who underwent either Mitral Valve replacement or open Mitral commissurotomy . Main results: Twenty-six patients (7%) were noted to have LAT at surgery. Five preselected factors were significantly (p