Effect of Correction of Anemia on Echocardiographic and Clinical Parameters in Patients With Aortic Stenosis Involving a Three-Cuspid Aortic Valve and Normal Left Ventricular Ejection Fraction

Gómez, Miquel; Blé, Mireia; Cladellas, Mercè; Molina, Luís; Comín‐Colet, Josep; Enjuanes, Cristina; Roqueta, Cristina; Soler, Cristina; Bruguera, Jordi

doi:10.1016/j.amjcard.2015.04.020

Cited by 9 publications

(9 citation statements)

References 21 publications

(17 reference statements)

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“…This prospective study shows that both ID, as defined in patients with HF, and anaemia are common comorbidities in patients with severe AS, with a prevalence of 53% and 20%, respectively. The prevalence of anaemia in our patients was relatively low compared with what has been observed in recent studies on patients with AS mainly referred for TAVI, where the prevalence of anaemia has been reported to be between 22% and 57% 18–21. This is most likely explained by differences in patient characteristics.…”

Section: Discussioncontrasting

confidence: 79%

“…In a study by DeLarochellière et al ,34 anaemia was an independent predictor of a poorer performance in the six-minute walk test and worse QoL in patients scheduled for TAVI. Gómez et al 20 showed in their study that the resolution of anaemia by treating ID was associated with improvements in echocardiographic parameters and functional status. These results suggest that low haemoglobin and maybe also ID limits physical capacity, is associated with reduced QoL and may represent a therapeutic target in patients with severe AS.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with AS typically have numerous comorbidities, including anaemia, which occurs in 22%–57% of patients 18–21. Anaemia in patients with AS is associated with reduced QoL, poorer functional capacity and reduced survival 18 19.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis

et al. 2018

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ObjectiveThe aim of this study was to evaluate the prevalence and prognostic implication of iron deficiency (ID) and anaemia in patients with severe aortic stenosis (AS).MethodsIn an observational study of consecutive patients referred for aortic valve replacement (AVR), we assessed a wide range of biomarkers of iron status, including the definition of ID commonly applied in patients with chronic heart failure (ferritin <100 µg/L or ferritin 100–299 µg/L with a transferrin saturation <20%). The endpoints were short-term (one-year) and long-term (median 4.7 years, IQR: 3.8–5.5) mortality and major adverse cardiovascular events (MACE) within the first year after inclusion.Results464 patients were included in this substudy. 91 patients (20%) received conservative treatment and 373 patients (80%) received AVR. ID was detected in 246 patients (53%). 94 patients (20%) had anaemia. Patients with ID had an overall worse clinical profile than patients without ID. During follow-up, 129 patients (28%) died. Neither ID as defined above, soluble transferrin receptor nor hepcidin were associated with short-term or long-term mortality or MACE independent on treatment allocation. Anaemia was associated with one-year mortality in conservatively treated patients.ConclusionsID and anaemia are prevalent in patients with severe AS. In our cohort, ID did not provide independent prognostic information on top of conventional risk factors. More studies are required to determine how to correctly diagnose ID in patients with AS.Trial registration numberNCT01794832.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis

et al. 2018

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“…34 Anemia falsely increases the velocity owing to reducing the density of blood. 35 Because anemia is common after cardiopulmonary bypass, this may explain why the variability of echocardiography methods increased after cardiopulmonary bypass compared with precardiopulmonary bypass measurements. Of the echocardiography methods, estimation of cardiac output using 2D TEE planimetry of the aortic valve had the closest agreement with thermodilution both before and after separation from cardiopulmonary bypass.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cardiac Output of Both 2-Dimensional and 3-Dimensional Transesophageal Echocardiography With Transpulmonary Thermodilution During Cardiac Surgery

Canty

Kim

Guha

et al. 2020

Journal of Cardiothoracic and Vascular Anesthesia

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“…The majority of all patients with severe AVS and LV systolic dysfunction belong to this category. The transvalvular gradients are exaggerated in settings of elevated cardiac output (e.g., exercise, anemia, serious sepsis) [13, 72]. Aortic valve area planimetry by transesophageal 3D echocardiography affords an anatomic measurement; there is, however, a strong “ orifice” shape- dependence of the ratio of anatomic/effective valve area, and also of the coefficients A and B in Eq.…”

Section: Diagnostic Assessmentmentioning

confidence: 99%

Calcific Aortic Valve Disease: Part 1—Molecular Pathogenetic Aspects, Hemodynamics, and Adaptive Feedbacks

Pasipoularides

2016

J. of Cardiovasc. Trans. Res.

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Aortic valvular stenosis (AVS), produced by calcific aortic valve disease (CAVD) causing reduced cusp opening, afflicts mostly older persons eventually requiring valve replacement. CAVD had been considered “degenerative,” but newer investigations implicate active mechanisms similar to atherogenesis—genetic predisposition and signaling pathways, lipoprotein deposits, chronic inflammation and calcification/osteogenesis. Consequently, CAVD may eventually be controlled/reversed by lifestyle and pharmacogenomics remedies. Its management should be comprehensive, embracing not only the valve but also the left ventricle and the arterial system with their interdependent morphomechanics/hemodynamics, which underlie the ensuing diastolic and systolic LV dysfunction. Compared to even a couple of decades ago, we now have an increased appreciation of genomic and cytomolecular pathogenetic mechanisms underlying CAVD. Future pluridisciplinary studies will characterize better and more completely its pathobiology, evolution and overall dynamics, encompassing intricate feedback processes involving specific signaling molecules and gene network cascades. They will herald more effective, personalized medicine treatments of CAVD/AVS.

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Effect of Correction of Anemia on Echocardiographic and Clinical Parameters in Patients With Aortic Stenosis Involving a Three-Cuspid Aortic Valve and Normal Left Ventricular Ejection Fraction

Cited by 9 publications

References 21 publications

Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis

Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis

Comparison of Cardiac Output of Both 2-Dimensional and 3-Dimensional Transesophageal Echocardiography With Transpulmonary Thermodilution During Cardiac Surgery

Calcific Aortic Valve Disease: Part 1—Molecular Pathogenetic Aspects, Hemodynamics, and Adaptive Feedbacks

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