About this Research Topic
Secondary regurgitation of the atrioventricular valves frequently accompanies heart failure with reduced ventricular function and contributes to clinical deterioration and adverse outcomes. Clinical management of heart failure patients with symptomatic persistent mitral or tricuspid valve regurgitation under GDMT is complex and current therapy strategies primarily target the LV dysfunction as it is considered as a disease of the left ventricle.
Optimizing pharmacological and device therapy is the first guideline step. Further volume and pressure unload with valve-specific approaches requires a careful patient selection based on pathophysiology, anatomy, heart failure status, outcome relevant comorbidities of heart failure with valvular component. Due to the high procedural risk and sparse multi-centric or trial evidence of the clinical benefit, isolated valve surgery of functional etiology is infrequently performed in this patient group. Transcatheter therapy provides a promising alternative, but diverging results in only partially overlapping cohorts of randomized trials with focus on transcatheter valve repair emphasize the importance of accurate patient selection. The innovation of devices for transcatheter atrioventricular valve treatment is excelling with leaflet repair, annuloplasty and replacement options. New evidence leads to changing guidance in heart failure patients to optimize the patient screening, procedural planning, imaging and treatment.
This Research Topic will provide a scientific platform to highlight current challenges and future opportunities on pathophysiology, diagnosis, multimodality imaging, treatment approaches and outcome in heart failure patients with additional atrioventricular valve dysfunction.
Topics proposed include the following:
1) Epidemiology and pathophysiology of the AV valves and valve interaction causing or maintaining heart failure.
2) Role of valve function for cardiac performance.
3) Multimodality imaging as the core in AV valve screening, procedural planning, guidance and heart failure evaluation.
4) Reduction of AV valve regurgitation in the heart failure patient: novel surgical and interventional treatment strategies (technical aspects, perspectives, new data from compassionate and trial experience, transcatheter repair and replacement, specific heart failure patient focus) with predictors of clinical response.
Optimizing pharmacological and device therapy is the first guideline step. Further volume and pressure unload with valve-specific approaches requires a careful patient selection based on pathophysiology, anatomy, heart failure status, outcome relevant comorbidities of heart failure with valvular component. Due to the high procedural risk and sparse multi-centric or trial evidence of the clinical benefit, isolated valve surgery of functional etiology is infrequently performed in this patient group. Transcatheter therapy provides a promising alternative, but diverging results in only partially overlapping cohorts of randomized trials with focus on transcatheter valve repair emphasize the importance of accurate patient selection. The innovation of devices for transcatheter atrioventricular valve treatment is excelling with leaflet repair, annuloplasty and replacement options. New evidence leads to changing guidance in heart failure patients to optimize the patient screening, procedural planning, imaging and treatment.
This Research Topic will provide a scientific platform to highlight current challenges and future opportunities on pathophysiology, diagnosis, multimodality imaging, treatment approaches and outcome in heart failure patients with additional atrioventricular valve dysfunction.
Topics proposed include the following:
1) Epidemiology and pathophysiology of the AV valves and valve interaction causing or maintaining heart failure.
2) Role of valve function for cardiac performance.
3) Multimodality imaging as the core in AV valve screening, procedural planning, guidance and heart failure evaluation.
4) Reduction of AV valve regurgitation in the heart failure patient: novel surgical and interventional treatment strategies (technical aspects, perspectives, new data from compassionate and trial experience, transcatheter repair and replacement, specific heart failure patient focus) with predictors of clinical response.
Keywords: Heart failure, Mitral valve, Tricuspid valve, Transcatheter valve therapy, Valvular imaging
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