Misconceptions and Facts About Mitral Regurgitation

Comparison of different transcatheter interventions for treatment of mitral regurgitation: A protocol for a network meta-analysis

BACKGROUND

The arrival of transcatheter mitral valve therapies has provided feasible and safe alternatives to medical and surgical treatments for mitral regurgitation. The aim of this study is to estimate the relative efficacy and safety of different transcatheter mitral valve therapies for mitral regurgitation patients through network meta-analysis.

METHODS

A systematic search will be performed using PubMed, EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure to include random controlled trials and nonrandom controlled trials comparing the efficacy and safety of different transcatheter mitral valve techniques. The risk of bias for the included nonrandom controlled studies will be evaluated according to Risk of Bias in Non-randomized Studies - of Interventions. For random controlled trials, we will use Cochrane Handbook version 5.1.0 as the risk of bias tool. A Bayesian network meta-analysis will be conducted using R-4.0.3 software. Grading of recommendations assessment, development, and evaluation will be used to assess the quality of evidence.

RESULTS

The results of this network meta-analysis will be submitted to a peer-reviewed journal for publication.

CONCLUSION

This study will provide broad evidence of efficacy and safety of different transcatheter mitral valve therapies for treatment of mitral regurgitation and provide suggestions for clinical practice and future research.

PROTOCOL REGISTRATION NUMBER

INPLASY2020110034.

Mitral Regurgitation Severity Analysis Based on Features and Optimal HE (OHE) with Quantification using PISA Method

Heart disease is the foremost reason for death and also the main source of incapability in the developed nations. Mitral regurgitation (MR) is a typical heart disease that does not bring about manifestations until its end position. In view of the hidden etiologies of heart distress, functional MR can be partitioned into two subgroups, ischemic and no ischemic MR. A procedure is progressed for jet area separation and quantification in MR evaluation in arithmetical expressions. Thus, a strategy that depends on echocardiography recordings, image processing methods, and artificial intelligence could be useful for clinicians, particularly in marginal cases. In this research paper, MR segmentation is analyzed by the optimal histogram equalization (OHE) system used to segment the jet area. For a better execution of the work, threshold in HE was improved with the help of the krill herd optimization (KHO) strategy. With the MR quantification procedure, this segmented jet area was supported by the proximal isovelocity surface area (PISA); in this procedure, a few parameters in the segmentation were evaluated. From the results, this proposed methodology accomplishes better accuracy in the segmented and quantification method in contrast with the existing examination.

Misconceptions and Facts About Aortic Stenosis

Aortic stenosis is the most common valvular heart disease leading to intervention, and it is typically a disease of the elderly. Recent clinical advances have expanded the role of transcatheter aortic valve intervention in patients with severe aortic stenosis, making aortic valve intervention feasible and effective even in patients at intermediate, high, and prohibitive surgical risk. With the rapid advances in treatment, proper diagnosis becomes crucial for a wide range of patients with aortic stenosis: from "concordant" high-gradient aortic stenosis to "discordant" low-gradient aortic stenosis. The latter group commonly presents a clinical challenge requiring thoughtful and comprehensive evaluation to determine eligibility for aortic valve intervention. Providers at all levels should be familiar with basic diagnostic caveats and misconceptions when evaluating patients with possible aortic stenosis.