In this podcast Heart editor in chief Catherine Otto, discusses patient prothesis mismatch with Professor Philippe Pibarot, Directeur, Chaire de Recherche du Canada sur les Maladies Valvulaires Cardiaques, after he presented a commentary on the issue at the Transcatheter Valve Therapies meeting in Vancouver, Canada on June 5, 2014.

Aortic valve stenosis is prevalent in the elderly and valve replacement for severe symptomatic obstruction improves symptoms and prolongs life. However, some patients have persistent symptoms after intervention because the functional valve area of the prosthetic valve is too small for the patient’s body size, a situation termed patient-prosthesis mismatch (PPM).

The hemodynamics of PPM have been well described but the actual clinical impact of PPM is controversial. In the June issue of Heart, Dr Price and colleagues (heartjnl-2013-305118) report that PPM was associated with decreased survival and persistent symptoms only in patients with a low left ventricular ejection fraction who were under age 70 years at the time of valve surgery. In older adults, although PPM was associated with impaired regression of LV hypertrophy, PPM was not associated with increased mortality or heart failure symptoms.

This data has important implications for clinical management suggesting that additional procedures to allow implantation of a larger prosthesis may not be necessary in older adults or in younger patients with normal left ventricular function.

See also:

The impact of prosthesis–patient mismatch after aortic valve replacement varies according to age at operation http://goo.gl/JNX42v

Determinants of effective heart failure self-care: a systematic review of patients’ and caregivers’ perceptions http://goo.gl/Lb3adm

This podcast discusses the 3rd Joint British Societies’ (JBS) consensus recommendations, released on 26th March 2014.

These eagerly anticipated guidelines incorporate much of the recent research in primary and secondary prevention of cardiovascular disease, and include a new risk calculator for physicians.

Heart’s social media editor, Dr Alistair Lindsay, discusses the most important points of the recommendations with Dr Iain Simpson, President of the British Cardiovascular Society and a member of the JBS 3 editorial group.

In this podcast, Philip Urban, Cardiovascular Department, Hôpital de La Tour, Geneva, discusses the Charlson Comorbidity Index (CCI).

Read the related paper:

Validity of Charlson Comorbidity Index in patients hospitalised with acute coronary syndrome. Insights from the nationwide AMIS Plus registry 2002–2012 http://goo.gl/Kjpj0l

Coronary heart disease (CHD) is a major public health problem not only in developed but also in developing countries.1 CHD rates in Japan are uniquely low compared to the USA and other developed countries.

In a paper in April's Heart, Akira Sekikawa and colleagues from the University of Pittsburgh looked at whether serum concentrations of long chain n-3 polyunsaturated fatty acids (LCn3PUFAs) contribute to the difference in the incidence rate of coronary artery calcification (CAC) between Japanese men in Japan and white men in the USA.

Alistair Lindsay asks him what they found.

Read the full paper:

Long chain n-3 polyunsaturated fatty acids and incidence rate of coronary artery calcification in Japanese men in Japan and white men in the USA: population based prospective cohort study http://goo.gl/rwKUCW

Catherine Otto, Heart editor, talks to Greg Roth from the Division of Cardiology at University of Washington about his editorial which appears on heart.bmj.com and discusses prescription of statins after an acute myocardial infarction.

Dr Alistair Lindsay speaks to Dr Corina Grey, School of Population Health, University of Auckland, about her recent study looking at long-term adherence to statins in ACS patients.

Read the full paper: http://goo.gl/KF3NAK

Bicuspid aortic valve (BAV) is related to aortic dilatation, but patterns/rates are conflicting with no comparison among aneurysms of different aetiology.

In this podcast Alistair Lindsey talks to Hector Michelena from the Division of Cardiovascular Diseases at the Mayo Clinic about his research published in heart.bmj.com

Read the full research: http://heart.bmj.com/content/100/2/126.full

At the 2013 Uruguayan Society of Cardiology meeting in Montevideo, Dr Robert Bonow, Professor of Cardiology at Northwestern University Feinberg School of Medicine, gave a talk on aortic valve stenosis.

In this podcast he and Catherine Otto, discuss some of the new concepts in diagnosis and management of the condition.

Read the full research onine: http://heart.bmj.com/content/99/22/1675

Dr Joao Lima, from the Division of Cardiology at Johns Hopkins Hospital in Balitmore, and colleagues set out to evaluate the benefit of niacin in addition to statin therapy on plaque regression among older individuals with established atherosclerosis.

They used MRI to more measure the plaque volume, and in this podcast Dr Lima explains to Laura Templer why that's a more accurate measure than the surrogates used in previous studies.