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Crofton AE, Kovacs SL, Stern JA. Subvalvular Aortic Stenosis: Learning From Human and Canine Clinical Research. Cardiol Res 2023; 14:319-333. [PMID: 37936623 PMCID: PMC10627371 DOI: 10.14740/cr1547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/03/2023] [Indexed: 11/09/2023] Open
Abstract
Subvalvular aortic stenosis (SAS) is the most common congenital heart disease (CHD) in dogs and is also prevalent in human children. A fibrous ridge below the aortic valve narrows the left ventricular outflow tract (LVOT) and increases blood flow velocity, leading to devastating side effects in diseased patients. Due to the similarities in presentation, anatomy, pathophysiology, cardiac development, genomics, and environment between humans and dogs, canine SAS patients represent a critical translational model of human SAS. Potential adverse outcomes of SAS include arrhythmias, left-sided congestive heart failure, endocarditis, exercise intolerance, syncope, and sudden cardiac death. The greatest divergence between canine and human SAS clinical research has been the standard of care regarding treatment of these outcomes, with pharmacological intervention dominating best practices in veterinary medicine and surgical intervention comprising the standard practice for human SAS patients. Regardless of the species, the field has yet to identify a treatment option to prevent disease progression or permanently remove the fibrous ridge, but historical leaps in SAS research support a continued translational approach as the most promising method for achieving this goal.
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Affiliation(s)
- Amanda E. Crofton
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, CA 95616, USA
| | - Samantha L. Kovacs
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, CA 95616, USA
| | - Joshua A. Stern
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
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Das D, Mohanty S, Guru S, Banerjee A, Kumar A, Deb P, Samantray H. A Retrospective Study on Drug and Dietary Patterns in Patients With Severe Rheumatic Valvular Heart Disease in Eastern India. Cureus 2023; 15:e37358. [PMID: 37181974 PMCID: PMC10171875 DOI: 10.7759/cureus.37358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Background India has a high prevalence of rheumatic valvular heart diseases. Empirical treatment in rheumatic heart disease curtails morbidity and mortality. Less is known about the drug and dietary management of severe rheumatic heart disease at the pretertiary care level, which forms the building stone in the management of rheumatic heart disease. The present study was carried out to evaluate the drug and dietary patterns of patients with severe rheumatic valvular heart disease at a pretertiary care level, which is the backbone of the management of rheumatic heart disease. Methodology This cross-sectional study was carried out in a tertiary care center in Eastern India between May 2020 and May 2022 across 1,264 study subjects. The drug and dietary patterns of the patients with severe rheumatic valvular heart disease during their index visit to the cardiac department were studied and analyzed. Patients aged less than 18 years; patients with mild or moderate rheumatic valvular heart diseases; patients with coexisting end-stage organ disease (chronic liver disease and chronic kidney disease), malignancy, and sepsis; and patients not willing to participate in the study were excluded. Results Most of the patients were on diuretic therapy, and diuretic therapy was overprescribed across the patients with mitral regurgitation, aortic stenosis, and aortic regurgitation. Most of the patients across each spectrum of rheumatic valvular heart disease were lacking the cornerstone therapy such as beta-blockers in mitral stenosis and angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) in mitral and aortic regurgitation. The recommended injectable benzathine penicillin prophylaxis was prescribed in a very small number of patients (5%), and most of the patients were on oral penicillin prophylaxis (95%) in spite of its reported high failure rate in prophylaxis. Empirical rationale prescriptions in severe rheumatic valvular heart disease were lacking in the pretertiary care level in Eastern India. Conclusion Each spectrum of severe valvular heart disease was lacking the cornerstone therapy such as beta-blockers in mitral stenosis and ACE inhibitors or angiotensin receptor blockers (ARBs) in mitral and aortic regurgitation along with recommended injectable benzathine penicillin prophylaxis. Diuretics and digoxin were overprescribed across the spectrum of rheumatic heart disease. Improvement of this essential gap in the treatment of severe rheumatic heart disease would bring down morbidity and improve mortality in the future.
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Affiliation(s)
- Debasish Das
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Satyapriya Mohanty
- Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Satyabrata Guru
- Trauma and Emergency/Internal Medicine, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Anindya Banerjee
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Abhinav Kumar
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Pranjit Deb
- Cardiology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Humshika Samantray
- Cardiothoracic Surgery, All India Institute of Medical Sciences, Bhubaneswar, IND
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Shnayien S, Beetz NL, Bressem KK, Hamm B, Niehues SM. Comparison of a High-Pitch Non-ECG-Gated and a Prospective ECG-Gated Protocol for Preprocedural Computed Tomography Imaging Before TAVI/TAVR. ROFO-FORTSCHR RONTG 2023; 195:139-147. [PMID: 36063835 DOI: 10.1055/a-1898-6504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Preprocedural computed tomography (CT) imaging before transcatheter aortic valve implantation/replacement (TAVI/TAVR) requires high diagnostic accuracy without motion artifacts. The aim of this retrospective study is to compare the image quality of a high-pitch non-electrocardiography (ECG)-gated CT protocol used in patients with atrial tachyarrhythmias with a prospectively ECG-gated CT protocol used in patients with sinus rhythm. MATERIALS AND METHODS We retrospectively included 108 patients who underwent preprocedural CT imaging before TAVI/TAVR. 52 patients with sinus rhythm were imaged using a prospectively ECG-gated protocol (Group A), and 56 patients with atrial tachyarrhythmias were imaged using the high-pitch non-ECG-gated protocol (Group B). Image quality was rated subjectively by two experienced radiologists and assessed by objective parameters including radiation dose, image noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) at the levels of the aortic root and abdominal aorta. RESULTS Subjective image quality was equally good with both CT protocols, and interrater agreement was substantial in both groups but tended to be higher in Group B at the level of the aortic root (Group A: κw = 0.644, Group B: κw = 0.741). With the high-pitch non-ECG-gated CT protocol, image noise was significantly increased (p = 0.001), whereas the SNR, CNR, and radiation dose were significantly decreased (p = 0.002, p = 0.003, and p < 0.001, respectively) at the level of the aortic root compared to the prospectively ECG-gated CT protocol. CONCLUSION The high-pitch non-ECG-gated protocol yields images with similar subjective image quality compared with the prospectively ECG-gated CT protocol and allows motion-free assessment of the aortic root for accurate TAVI/TAVR planning. The high-pitch non-ECG-gated protocol may be used as an alternative for preprocedural CT imaging in patients with atrial tachyarrhythmias. KEY POINTS · In patients with atrial tachyarrhythmias, a high-pitch non-ECG-gated CT protocol achieves similar subjective image quality compared to a prospective ECG-gated CT protocol.. · At the level of the aortic root, image noise is significantly increased, whereas SNR and CNR are significantly decreased using the high-pitch non-ECG-gated protocol.. · Radiation dose is reduced by 55 % using the high-pitch non-ECG-gated protocol.. CITATION FORMAT · Shnayien S, Beetz N, Bressem KK et al. Comparison of a High-Pitch Non-ECG-Gated and a Prospective ECG-Gated Protocol for Preprocedural Computed Tomography Imaging Before TAVI/TAVR. Fortschr Röntgenstr 2023; 195: 139 - 147.
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Affiliation(s)
- Seyd Shnayien
- Department of Radiology, Charite University Hospital Berlin, Germany
| | - Nick Lasse Beetz
- Department of Radiology, Charite University Hospital Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Bernd Hamm
- Department of Radiology, Charite University Hospital Berlin, Germany
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Wu M, Gu P, Cao Q, Gong A, Tan W, Hong D. Antihypertensive treatment and risk factors for syncope in asymptomatic aortic stenosis patients with hypertension. Clin Exp Hypertens 2021; 44:191-197. [PMID: 34872422 DOI: 10.1080/10641963.2021.1883047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Evidence for treating hypertension in patients with asymptomatic aortic valve stenosis(AS) is scarce. OBJECTIVES Given the paucity of data on the relationship between syncope and antihypertensive treatment in aortic stenosis. This study sought to investigate this association in patients admitted to our hospital. METHODS A total of 158 patients with asymptomatic moderate or severe aortic stenosis were analyzed. Follow-up was conducted by clinic visit, telephone contact, or review of electronic medical records. Outcomes were syncope. RESULTS Hypertension were documented in 90 of the 158 patients with moderate or severe AS, and 77 of them received antihypertensive medications. During an average 28 months follow-up period, the occurrence of syncope was observed in 13 patients. Among them, 8 were in antihypertensive group (n = 77) and 5 in normotensive group (n = 68). There was no significant difference in incidence of syncope between the two groups. Patients with treated hypertension and syncope had a lower stroke volume index (SVi), a higher valve arterial impedance (ZVA), a smaller SAC than those without. Kaplan-Meier analysis showed that there was no significant difference in syncope cumulative incidence between antihypertensive group and normotensive group (log rank P = .478). Multivariate cox regression analysis showed that both ZVA (hazard ratio:19.006, 95% confidence interval: 4.664 to77.448;P = .002) and LVMI (hazard ratio:1.484, 95% confidence interval: 1.427 to 5.157;P = .016) were associated with development of syncope, whereas hypertension were not related independently to syncope (hazard ratio:0.935, 95% confidence interval: 0.786 to3.173; P = .869). CONCLUSIONS In patients with moderate or severe AS, concomitant hypertension, and antihypertensive treatment didn't increase the occurrence of syncope, whereas higher ZVA was independently associated with greater risk of syncope.
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Affiliation(s)
- Meihua Wu
- Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Jiangxi, China
| | - Ping Gu
- Echocardiography Laboratory, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Jiangxi, China
| | - Qianqiang Cao
- Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Jiangxi, China
| | - Aibin Gong
- Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Jiangxi, China
| | - Wenliang Tan
- Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Jiangxi, China
| | - Dezhi Hong
- Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Jiangxi, China
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El Hussein MT, Harvey G, Bueckert A. Antihypertensive therapy in patients with moderate to severe aortic stenosis. Nurse Pract 2021; 46:14-22. [PMID: 34424881 DOI: 10.1097/01.npr.0000769732.71640.4c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
ABSTRACT Patients with aortic stenosis are at risk for developing hypertension. The selection of antihypertensives is a topic of debate due to a lack of consensus regarding their safety. This article provides an overview of antihypertensives used in patients with aortic stenosis, focusing on renin-angiotensin system inhibitors, beta-blockers, diuretics, and vasodilators.
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Ngiam JN, Chew NWS, Pramotedham T, Tan BYQ, Sim HW, Ruan W, Sia CH, Kong WKF, Yeo TC, Poh KK. Low Relative Valve Load is Associated With Paradoxical Low-Flow Aortic Stenosis Despite Preserved Left Ventricular Ejection Fraction and Adverse Clinical Outcomes. Heart Lung Circ 2021; 31:128-135. [PMID: 34116941 DOI: 10.1016/j.hlc.2021.05.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 03/03/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Paradoxical low-flow (LF) severe aortic stenosis (AS) despite preserved left ventricular (LV) ejection fraction (LVEF) has been shown to be distinct from normal-flow (NF) AS, with a poorer prognosis. Relative valve load (RVL) is a novel echocardiographic haemodynamic index based on the ratio of transaortic mean pressure gradient to the global valvulo-arterial impedance (Zva) in order to estimate the contribution of the valvular afterload to the global LV load. We aimed to determine the usefulness of RVL in LF AS versus NF AS. METHOD A total of 450 consecutive patients with medically managed severe AS (aortic valve area <1.0 cm2) with preserved LVEF (>50%) were studied. Patients were divided into LF (stroke volume index <35 mL/m2) or NF, and high RVL or low RVL. Baseline clinical and echocardiographic profiles, as well as clinical outcomes, were compared. RESULTS There were 149 (33.1%) patients with LF. Despite higher global impedance in LF (Zva 6.3±2.4 vs 3.9±0.9 mmHg/mL/m2; p<0.001) compared with NF, the RVL in LF AS was significantly lower (5.4±2.7 vs 9.8±5.1 mL/m2; p<0.001). On multivariable analysis, low RVL (≤7.51) remained independently associated with poor clinical outcomes on Cox regression (hazard ratio, 1.31; 95% confidence interval, 1.03-1.68), with 53.2% sensitivity and 70.3% specificity. This was comparable to other prognostic indices in AS. Kaplan-Meier curves demonstrated that low RVL was associated with increased mortality. CONCLUSIONS Increased systemic arterial afterload may be important in the pathophysiology of LF AS. Low RVL was an independent predictor of poor clinical outcomes in medically managed severe AS. There may be a greater role in the attenuation of systemic arterial afterload in AS to improve outcomes.
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Affiliation(s)
- Jinghao N Ngiam
- Department of Medicine, National University Health System, Singapore
| | - Nicholas W S Chew
- Department of Medicine, National University Health System, Singapore
| | | | - Benjamin Y Q Tan
- Department of Medicine, National University Health System, Singapore
| | - Hui-Wen Sim
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore
| | - Wen Ruan
- National Heart Centre Singapore, Singapore
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - William K F Kong
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tiong-Cheng Yeo
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kian-Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Medical management of symptomatic severe aortic stenosis in patients non-eligible for transcatheter aortic valve implantation. J Geriatr Cardiol 2020; 17:704-709. [PMID: 33343649 PMCID: PMC7729185 DOI: 10.11909/j.issn.1671-5411.2020.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Sen J, Chung E, Neil C, Marwick T. Antihypertensive therapies in moderate or severe aortic stenosis: a systematic review and meta-analysis. BMJ Open 2020; 10:e036960. [PMID: 33020089 PMCID: PMC7537451 DOI: 10.1136/bmjopen-2020-036960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 08/19/2020] [Accepted: 08/25/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Hypertension confers a poor prognosis in moderate or severe aortic stenosis (AS), however, antihypertensive therapy (AHT) is often not prescribed due to the perceived deleterious effects of vasodilation and negative inotropes. OBJECTIVE To assess the efficacy and safety outcomes of AHT in adults with moderate or severe AS. DESIGN Systematic review and meta-analysis. DATA SOURCES The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and grey literature were searched without language restrictions up to 9 September 2019. STUDY ELIGIBILITY CRITERIA, APPRAISAL AND SYNTHESIS METHODS Two independent reviewers performed screening, data extraction and risk of bias assessments from a systematic search of observational studies and randomised controlled trials comparing AHT with a placebo or no AHT in adults with moderate or severe AS for any parameter of efficacy and safety outcomes. Conflicts were resolved by the third reviewer. Meta-analysis with pooled effect sizes using random-effects model, were estimated in R. MAIN OUTCOME MEASURES Mortality, Left Ventricular (LV) Mass Index, systolic blood pressure, diastolic blood pressure and LV ejection fraction RESULTS: From 3025 publications, 31 studies (26 500 patients) were included in the qualitative synthesis and 24 studies in the meta-analysis. AHT was not associated with mortality when all studies were pooled, but heterogeneity was substantial across studies. The effect size of AHT differed according to drug class. Renin-angiotensin-aldosterone system inhibitors (RAASi) were associated with reduced risk of mortality (Pooled HR 0.58, 95% CI 0.43 to 0.80, p=0.006), The differences in changes of haemodynamic or echocardiographic parameters from baseline with and without AHT did not reach statistical significance. CONCLUSION AHT appears safe, is well tolerated. RAASi were associated with clinical benefit in patients with moderate or severe AS.
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Affiliation(s)
- Jonathan Sen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Erin Chung
- Graduate Department of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Christopher Neil
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Thomas Marwick
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Guo Z, Chen G, Fu L, Zhang X. Echocardiographic Analysis of Correlation Between Right Ventricle Load and Function and Left Ventricle Diastolic Malfunction in Symptomless Valvular Cardiovascular Disease Patients. MEDICAL SCIENCE MONITOR : INTERNATIONAL MEDICAL JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2020; 26:e920982. [PMID: 32127512 PMCID: PMC7071735 DOI: 10.12659/msm.920982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Left ventricle diastolic malfunction (LVDMf) is a valvular cardiovascular disease. Here, we assessed the correlation between right ventricle (RV) load and function (L&F) and diastolic malfunction (DMf) in symptomless valvular cardiovascular disease patients. Material/Methods We enrolled 59 subjects who underwent right-heart catheterization, assessing their echocardiographic analysis results while performing exercises in supine position, comparing results at rest and during maximum exercise. Subjects were furthermore stratified according to resting DMf. Using cardiac resonance imaging (CRM), we assessed cardiac morphology and chamber size. RV stroke, pulmonary artery conformation, pulmonary artery elastance, pulmonary artery pulsatility, and right atrial (pRA) pressure were indexed for supine exercises. Results We observed that DMf grade 1 (G-1) and grade 2 (G-2) were present in 28 patients and 16 patients, respectively, while the remaining 15 patients had a normal filling pattern in the left ventricle. In comparison to patients with DMf of G-1, patients with normal diastolic filling pattern had higher volume index for RV end-diastolic (endD) (81±14 mL/m2vs. 68±12 mL/m2, P=0.08) and for RV end-systolic (endS) (34±11 mL/m2vs. 27±8 mL/m2, P=0.07). We also observed that in G-2 DMf pulmonary artery, pressure and elastance of the pulmonary artery were enhanced and were correlated with optimum oxygen intake and RV volume (r=−0.69, P<0.001). Conclusions We found that enhancement in RV afterload, which returns to normal at rest, is correlated with mild DMf. Additionally, despite maximum exercise, it is reciprocally associated with maximum oxygen intake and right atrial pressure.
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Affiliation(s)
- Zhiying Guo
- Department of Ultrasound, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China (mainland)
| | - Guihuan Chen
- Functional Examination Section, Inner Mongolia International Mongolian Hospital, Hohhot, Inner Mongolia, China (mainland)
| | - Lin Fu
- Departmentof Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China (mainland)
| | - Xiaoshan Zhang
- Departmentof Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China (mainland)
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Muiesan ML, Paini A, Salvetti M. Antihypertensive drugs and outcome in aortic stenosis. Int J Cardiol 2020; 298:126-127. [DOI: 10.1016/j.ijcard.2019.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 10/07/2019] [Accepted: 10/11/2019] [Indexed: 11/16/2022]
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Abstract
ZusammenfassungErhöhter Blutdruck bleibt eine Hauptursache von kardiovaskulären Erkrankungen, Behinderung und frühzeitiger Sterblichkeit in Österreich, wobei die Raten an Diagnose, Behandlung und Kontrolle auch in rezenten Studien suboptimal sind. Das Management von Bluthochdruck ist eine häufige Herausforderung für Ärztinnen und Ärzte vieler Fachrichtungen. In einem Versuch, diagnostische und therapeutische Strategien zu standardisieren und letztendlich die Rate an gut kontrollierten Hypertoniker/innen zu erhöhen und dadurch kardiovaskuläre Erkrankungen zu verhindern, haben 13 österreichische medizinische Fachgesellschaften die vorhandene Evidenz zur Prävention, Diagnose, Abklärung, Therapie und Konsequenzen erhöhten Blutdrucks gesichtet. Das hier vorgestellte Ergebnis ist der erste Österreichische Blutdruckkonsens. Die Autoren und die beteiligten Fachgesellschaften sind davon überzeugt, daß es einer gemeinsamen nationalen Anstrengung bedarf, die Blutdruck-assoziierte Morbidität und Mortalität in unserem Land zu verringern.
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