cardiovascular-agents and Mitral-Valve-Stenosis

Background Patients with mitral valve stenosis have increased heart rate. HR reduction is known as an important treatment and therapy strategy for patients with mitral valve stenosis. Aim of the review The aim of this systematic review and meta-analysis was to compare the efficacy of ivabradine versus beta-blockers in patients with mitral stenosis in sinus rhythm. Methods Randomized controlled trials were searched in Cochrane Library, PubMed, Web of Science, CRD, Scopus, and Google Scholar with no start time limitation and ending June 2018. Risk of bias across was assessed by the Cochrane Risk of Bias Assessment tool. Fixed effects models were used to combine the results and the mean difference with a 95% confidence interval. This meta-analysis was performed using Meta Package in R software. Results Five studies entered meta-analysis. The total number of patients treated with ivabradine and beta-blockers was 178 and 178 respectively. The results showed that the mean of maximum HR and HR at rest was lower at about 5.03 units and upper 4.32 units respectively with use of ivabradine compared with the use of beta-blockers. These values were statistically significant. Conclusion It seems that the efficacy of ivabradine is good in comparison with betablockers, but it still requires more clinical trials.

Topics: Adrenergic beta-Antagonists; Arrhythmias, Cardiac; Cardiovascular Agents; Heart Rate; Humans; Ivabradine; Mitral Valve Stenosis; Randomized Controlled Trials as Topic; Treatment Outcome

Topics: Antihypertensive Agents; Aortic Valve Insufficiency; Aortic Valve Stenosis; Cardiac Catheterization; Cardiology; Cardiovascular Agents; Disease Management; Echocardiography; Evidence-Based Medicine; Exercise Test; Heart Defects, Congenital; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Hemodynamics; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Mitral Valve Insufficiency; Mitral Valve Stenosis; Patient Care Team; Pharyngitis; Referral and Consultation; Rheumatic Fever; Secondary Prevention; Severity of Illness Index; Streptococcal Infections; United States; Vasodilator Agents; Ventricular Dysfunction, Left

Topics: Aortic Valve Insufficiency; Aortic Valve Stenosis; Calcinosis; Cardiovascular Agents; Heart Valve Diseases; Humans; Mitral Valve Insufficiency; Mitral Valve Stenosis; Risk Factors

Primary care physicians have an important role in timely diagnosis and appropriate treatment of gravid patients with cardiac disorders. Health of the mother and child can be optimized with thorough understanding of the pathophysiology of cardiac disorders during pregnancy, especially those with potentially serious effects, such as peripartum cardiomyopathy and acute myocardial infarction. Mitral stenosis often manifests for the first time during pregnancy. Mitral valve prolapse is usually benign but in some cases necessitates antibiotic prophylaxis for delivery. Pregnancy in women with prosthetic cardiac valves may expose mother and child to risks that can be minimized with appropriate safeguards.

Topics: Cardiomyopathies; Cardiovascular Agents; Contraindications; Female; Heart Diseases; Humans; Mitral Valve Stenosis; Myocardial Ischemia; Pregnancy; Pregnancy Complications, Cardiovascular

Pregnancy in the patient with mitral stenosis may be complicated by pulmonary congestion/edema, atrial fibrillation, thromboembolic events, and intrauterine growth retardation. Combining both cardiac and obstetric principles with the bio/psycho/social focus of nursing is a challenge in the antepartum intrapartum and postpartum periods.

Topics: Cardiac Output; Cardiovascular Agents; Female; Humans; Mitral Valve Stenosis; Pregnancy; Pregnancy Complications, Cardiovascular

Severe mitral stenosis is usually symptomatic and is treated by BMV or surgery, whereas mild to moderate mitral stenosis is usually asymptomatic or mildly symptomatic and managed medically. Patients in the later group may become symptomatic during episodes of exercise and increased heart rate. Beta-blockers are frequently used in patients with mitral stenosis to control the heart rate and alleviate exercise-related symptoms. The objective of our study was to investigate the comparative efficacy of ivabradine versus metoprolol in patients with mitral stenosis in sinus rhythm.. We studied 97 patients of mitral stenosis in sinus rhythm presented with exertional symptoms. The effectiveness of Metoprolol was compared with ivabradine in alleviating these exertional symptoms in a randomized, open label non crossover study. We also assessed various stress ECG parameters, 24 hour Holter parameters and 2D Echo parameters to objectively compare the effects of ivabradine and metoprolol in these patients.. Ivabradine and metoprolol both were effective in controlling exertional symptoms. Significant improvement in objective parameters like TMT (work capacity, baseline heart rate and maximal heart rate) and 2D echocardiography (right ventricular systolic pressure) are seen with both drugs. Ivabradine controls the exertional symptoms significantly more than metoprolol. On head to head comparison there was a significant benefit of working capacity and heart rate at maximal exercise in favour of ivabradine.. Ivabradine should be strongly considered in medical management of mitral stenosis patients where beta blockers are contraindicated such as reactive airway disease. The cost of ivabradine is higher than metoprolol which might possess constraints as most of the rheumatic heat disease patients belong to low socio economic status.

Topics: Adolescent; Adult; Benzazepines; Cardiovascular Agents; Drug Monitoring; Echocardiography; Electrocardiography, Ambulatory; Exercise Test; Exercise Tolerance; Female; Heart Rate; Humans; Ivabradine; Male; Metoprolol; Mitral Valve Stenosis; Symptom Assessment; Treatment Outcome

Topics: Adolescent; Adult; Aged; Anti-Arrhythmia Agents; Atrial Fibrillation; Benzazepines; Cardiovascular Agents; Electrocardiography; Female; Follow-Up Studies; Humans; Ivabradine; Male; Metoprolol; Middle Aged; Mitral Valve Stenosis; Retrospective Studies; Treatment Outcome; Young Adult

The management of pregnancy in patients with mitral valve stenosis disease continues to pose a challenge to the clinician.. The aim of study was to evaluate the association between mitral valve stenosis and maternal and fetal out come.. Eighty-three pregnant women with mitral valve disease, followed-up from 2009 to 2012, were prospectively evaluated medical history, NYHA class assessment, ECG and echocardiography were performed during pregnancy and after delivery.. Women with mitral stenosis had significantly clinical higher incidence of complications deterioration of clinical status was observed (44.57%, P=0.0001) congestive heart failure had observed (27.71%, P=0.0001), hospitalization (33.73%, P=0.0001), need of cardiac medications (53.75%, P=0.009), arrhythmias (16%, P<0.05), New born outcome, mitral stenosis had an effect on fetal outcome. We had increasing preterm, delivery (17.50%, P=0.018), hypotrophy (20.48%, P=0.001), intra-uterine growth retardation (12.04%, P=0.011) new born hospitalizations (13.25%, P=0.03) Increased maternal morbidity and unfavorable fetal outcome was seen mostly in patients with moderate and severe mitral stenosis.. Pregnant with critical mitral stenosis form a high-risk groups of life-threatening complications. There is need for close maternal follow-up and fetal surveillance and repair of mitral stenosis should be performed before pregnancy.

Topics: Adult; Algeria; Arrhythmias, Cardiac; Cardiovascular Agents; Drug Utilization; Female; Fetal Growth Retardation; Heart Failure; Hospitalization; Hospitals, University; Humans; Infant, Newborn; Middle Aged; Mitral Valve Stenosis; Pregnancy; Pregnancy Complications, Cardiovascular; Premature Birth; Prospective Studies; Young Adult

Severe inoperable aortic stenosis is a challenge for clinicians. Management of symptoms with traditional antianginal agents, which exert hemodynamic changes often may not be possible in such patient groups. We report the first known case of the safe use of ranolazine with good symptomatic relief of angina in an 88-year-old lady with isolated severe aortic stenosis (without significant coronary disease) who was not suitable for surgical or percutaneous valve replacement due to medical comorbidity.

Topics: Acetanilides; Aged, 80 and over; Angina Pectoris; Aortic Valve Stenosis; Cardiovascular Agents; Female; Humans; Mitral Valve Stenosis; Piperazines; Ranolazine; Severity of Illness Index; Treatment Outcome

Topics: Aortic Valve Insufficiency; Aortic Valve Stenosis; Cardiac Valve Annuloplasty; Cardiovascular Agents; Combined Modality Therapy; Endovascular Procedures; Heart Valve Diseases; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Mitral Valve Insufficiency; Mitral Valve Stenosis; Tricuspid Valve Insufficiency; Tricuspid Valve Stenosis

Surgical treatment of mitral stenosis (MS) usually consists of open mitral commissurotomy (MC) or percutaneous balloon MC, which require a cardiopulmonary bypass or transseptal approach, respectively. We describe here the first surgical management of congenital MS in a dog using a less invasive procedure, a surgical closed MC under direct echo guidance. A 5-year-old female Cairn terrier was referred for ascites, weakness, and marked exercise intolerance for 2 months, which was refractory to medical treatment. Diagnosis of severe MS associated with atrial fibrillation (AF) was confirmed by echo-Doppler examination and electrocardiography. Poor response to medical treatment suggested a corrective procedure on the valve was indicated. However, due to the cost and high mortality rate associated with cardiopulmonary bypass, a hybrid MC was recommended. A standard left intercostal thoracotomy was performed and three balloon valvuloplasty catheters of differing diameters were sequentially inserted through the left atrium under direct echo guidance. Transesophageal echocardiography revealed a 62% reduction in the pressure half-time compared to the pre-procedure. Thirteen months after surgery the dog is still doing well with resolution of ascites and a marked improvement of most echo-Doppler variables.

Topics: Animals; Arrhythmias, Cardiac; Cardiac Surgical Procedures; Cardiovascular Agents; Dog Diseases; Dogs; Echocardiography; Female; Mitral Valve Stenosis

Topics: Body Fluids; Body Water; Cardiovascular Agents; Dyspnea; Heart; Heart Failure; Humans; Lung; Lung Diseases; Mitral Valve Stenosis; Pleural Effusion; Positive-Pressure Respiration; Pulmonary Edema

Topics: Cardiovascular Agents; Humans; Hypertension; Hypertension, Pulmonary; Mitral Valve Stenosis; Muscle Relaxants, Central