The Year In Cardiology 2015: Valvular Heart Disease

Valvular heart disease is a subject of growing interest due to its prevalence and difficult issues in decision-making in the rapidly moving field of percutaneous interventions. During this year, a number of interesting articles addressed the topic of valvular heart disease with a special emphasis on imaging, interventions, and the publication of the new European Society of Cardiology (ESC) guidelines on the management of infective endocarditis (IE). We present here a selection of the most recent and particularly relevant papers. A population study was performed to explore the hypothesis that a link may exist between aortic stenosis (AS) and psoriasis due to shared inflammatory pathways.1 The study comprised the entire Danish population aged >18 years followed up until diagnosis of AS or death. The overall incidence rates for AS were 8, 16, and 20 per 10 000 person-years for the reference population, mild psoriasis, and severe psoriasis, respectively. The results indicate a disease severity-dependent increased risk of new-onset AS in patients with psoriasis. This association with increased risk of AS was independent of age, gender, comorbidity, and socioeconomic status. These findings expand the current knowledge of psoriasis as a clinically relevant risk factor for a range of cardiovascular diseases such as coronary artery disease or heart failure. The evaluation of the severity of AS remains a challenge. The largest source of error in the measurement of aortic valve area (AVA) is the variability in the measurement of left ventricular outflow tract (LVOT) area and the assumption that LVOT is circular whereas it is elliptical. The group from Leiden studied 191 patients who underwent transcatheter aortic valve implantation (TAVI) with indexed AVA (AVAi) <0.6 cm …