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Current Concepts in Diagnosis and Therapy of Aortic Valve Disease
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Current Concepts in Diagnosis and Therapy of Aortic Valve Disease

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

Deadline for manuscript submissions: closed (31 January 2025) | Viewed by 1132

Special Issue Editors

Dr. Robert Zilberszac

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Guest Editor
Department of Cardiology, Medical University of Vienna, 1090 Vienna, Austria
Interests: cardiac intensive care; echocardiography; valvular heart disease
Dr. Lore Schrutka

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Guest Editor
Department of Cardiology, Medical University of Vienna, 1090 Vienna, Austria
Interests: acute coronary syndrome; acute myocardial infarction; cardiovascular disease

Special Issue Information

Dear Colleagues,

This Special Issue on "Current Concepts in Diagnosis and Therapy of Aortic Valve Disease" aims to encapsulate the latest advancements and ongoing challenges in the field. With the rapid evolution of diagnostic imaging techniques and therapeutic interventions, this issue seeks to provide a comprehensive overview of current research and clinical practices. Our primary goal is to bridge the gap between innovative research findings and clinical applications, thereby enhancing patient outcomes.

The core problems to be addressed include improving the accuracy of early diagnosis, including the problem of low-flow stenosis, novel insights into prevention strategies, optimizing patient-specific treatment plans, optimizing procedural outcomes, and minimizing procedural risks. The scope of this Special Issue will encompass a wide range of topics, including imaging modalities, advancements in surgical and transcatheter interventions, and long-term management strategies.

We aim to mobilize contributions from leading researchers, clinicians, and interdisciplinary teams to foster a robust discussion and dissemination of cutting-edge knowledge. By gathering a diverse array of perspectives, this Special Issue will serve as a critical resource for healthcare professionals and researchers dedicated to advancing the understanding and treatment of aortic valve disease.

Dr. Robert Zilberszac
Dr. Lore Schrutka
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 valve disease
  • echocardiography and other imaging modalities
  • transcatheter aortic valve replacement (TAVR)
  • surgical aortic valve replacement (SAVR)
  • prevention
  • patient-specific treatment

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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14 pages, 934 KiB  
Article
Biomarkers of Inflammation and Association with Cardiovascular Magnetic Resonance Imaging for Risk Stratification and Outcome in Patients with Severe Aortic Stenosis
by Matthias Koschutnik, Christina Brunner, Christian Nitsche, Carolina Donà, Varius Dannenberg, Kseniya Halavina, Sophia Koschatko, Charlotte Jantsch, Katharina Mascherbauer, Christina Kronberger, Michael Poledniczek, Caglayan Demirel, Dietrich Beitzke, Christian Loewe, Christian Hengstenberg, Andreas A. Kammerlander and Philipp E. Bartko
J. Clin. Med. 2025, 14(7), 2512; https://doi.org/10.3390/jcm14072512 - 7 Apr 2025
Viewed by 434
Abstract
Background: Inflammatory indices have been proposed as simple and routinely obtainable markers of systemic inflammation in cardiac disease. This study investigated whether the neutrophil-to-lymphocyte ratio (NLR), the monocyte-to-lymphocyte ratio (MLR), and the pan-immune inflammation value (PIV) serve as biomarkers for risk stratification [...] Read more.
Background: Inflammatory indices have been proposed as simple and routinely obtainable markers of systemic inflammation in cardiac disease. This study investigated whether the neutrophil-to-lymphocyte ratio (NLR), the monocyte-to-lymphocyte ratio (MLR), and the pan-immune inflammation value (PIV) serve as biomarkers for risk stratification and outcomes measures in patients with severe aortic stenosis (AS) following valve replacement (AVR). Methods: In this retrospective analysis (January 2017–June 2022), patients with AS underwent pre-procedural cardiovascular magnetic resonance (CMR) imaging and were assigned a treatment strategy by a multidisciplinary Heart Team: (1) transcatheter AVR, (2) surgical AVR, or (3) no valvular intervention. Kaplan–Meier estimates and regression analyses were used to demonstrate associations between the NLR, MLR, and PIV with myocardial fibrosis—assessed by late gadolinium enhancement (LGE) and extracellular volume (ECV) on CMR—and a combined endpoint of heart failure hospitalizations and all-cause mortality. Results: A total of 356 patients (median age: 80 years, 50% male) were followed for a median of 40 months, during which 162 (46%) reached the combined endpoint. Linear regression identified C-reactive protein, but not the presence of LGE or elevated ECV, as the only independent predictor of all three inflammatory indices (p for all <0.001). After multivariable adjustment for clinical (EuroSCORE II), laboratory (baseline N-terminal prohormone of brain natriuretic peptide [NT-proBNP] and C-reactive protein), and imaging parameters (AV mean pressure gradient, right ventricular ejection fraction, and ECV), the above-the-upper-quartile NLR (adjusted hazard ratio [aHR]: 1.45, 95%-confidence interval [CI]: 1.01–1.92, p = 0.042), MLR (aHR: 1.48, 95%-CI: 1.05–2.09, p = 0.025), and PIV (aHR: 1.56, 95%-CI: 1.11–2.21, p = 0.011) remained significantly associated with adverse outcomes. Following AVR, the median NLR (3.5 to 3.4) and PIV (460 to 376) showed a significant post-procedural decline compared to baseline (p ≤ 0.019 for both). Conclusions: Inflammatory indices are readily available biomarkers independently associated with adverse outcomes in severe AS following AVR. However, no significant relationship was observed between the NLR, MLR, PIV, and myocardial fibrosis on CMR. Full article
(This article belongs to the Special Issue Current Concepts in Diagnosis and Therapy of Aortic Valve Disease)
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11 pages, 900 KiB  
Article
Aortic Valve Replacement with Rapid-Deployment Bioprostheses: Long-Term Single-Center Results After 1000 Consecutive Implantations
by Iuliana Coti, Paul Werner, Alexandra Kaider, Jasmine El-Nashar, Alfred Kocher, Guenther Laufer, Daniel Zimpfer and Martin Andreas
J. Clin. Med. 2025, 14(5), 1552; https://doi.org/10.3390/jcm14051552 - 26 Feb 2025
Viewed by 338
Abstract
Introduction: This study aimed to analyze long-term survival and valve-related adverse events after 1000 consecutive rapid-deployment surgical aortic valve replacements (RD-SAVRs) in a single center. Methods: A total of 1000 patients following RD-SAVR at our institution were included in a prospective database. Median [...] Read more.
Introduction: This study aimed to analyze long-term survival and valve-related adverse events after 1000 consecutive rapid-deployment surgical aortic valve replacements (RD-SAVRs) in a single center. Methods: A total of 1000 patients following RD-SAVR at our institution were included in a prospective database. Median follow-up was 68 months (IQR: 37–91). Preoperative and operative parameters, survival and valve-related adverse events were assessed. Results: Mean age was 73 ± 7 years (45% female). Median EuroSCORE II was 2.7% (IQR: 1.4–5.5). Concomitant procedures were performed in 50% of patients. In the case of isolated SAVR, minimally invasive access was conducted in 415 patients (83%). New early pacemaker implantation was required in 9.1%. Perioperative stroke was observed in 1.6%, and the cumulative incidence of thromboembolic and major bleeding events at 10 years was 8.1% (95% CI: 6.2–10.4%). The 5- and 10-year incidences of severe structural valve degeneration were 0.8% (95% CI: 0.3–2.1%) and 9.2% (95% CI: 4.5–15.9%). Overall re-intervention or re-operation with valve explantation occurred in 38 cases, with a 10-year incidence of 7.7% (95% CI: 5.0–11.2%). Overall 30-day mortality was 0.3% (n = 3) and survival at 1, 5 and 10 years FU was 95% (95% CI: 93–96%), 81% (95% CI: 78–84%) and 58% (95% CI: 51–64%). Age, diabetes, COPD and creatinine, concomitant procedures and acute indication were independent predictive factors of mortality. Conclusions: Rapid-deployment valves appear to support minimally invasive access and can be potentially used with low operative mortality in a real-world collective. Favorable durability with acceptable valve-related event rates and mortality were observed at long-term follow-up. Full article
(This article belongs to the Special Issue Current Concepts in Diagnosis and Therapy of Aortic Valve Disease)
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