Materiały źródłowe

• #1 Valvular Heart Disease Epidemiology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9228968/

  Valvular heart disease is a rapidly growing cause of global cardiovascular morbidity and mortality with diverse and evolving geographic distribution. […] Aortic valve stenotic disease is the most commonly occurring valvular pathology in developed nations (afflicting 9 million people worldwide) and its prevalence has been increasing with population aging and the increased prevalence of atherosclerosis. […] A prospective population-based study of 3273 participants, including 164 subjects with ASVD, showed that the prevalence of AS increases with age. […] An estimated 9.4 million patients worldwide had calcific AVSD in 2019. […] Rates of AVSD are highly correlated with old age and are the greatest in North America, Europe, and Australasia. […] AVSD was estimated to be responsible for approximately 127,000 global deaths in 2019 and an associated loss of 1.8 million DALYs (disability-adjusted life-years).

• #2 Valvular Heart Disease Epidemiology

  https://www.mdpi.com/2076-3271/10/2/32

  Valvular heart disease is a rapidly growing cause of global cardiovascular morbidity and mortality with diverse and evolving geographic distribution. […] Aortic valve stenotic disease is the most commonly occurring valvular pathology in developed nations (afflicting 9 million people worldwide) and its prevalence has been increasing with population aging and the increased prevalence of atherosclerosis. […] A prospective population-based study of 3273 participants, including 164 subjects with ASVD, showed that the prevalence of AS increases with age. […] An estimated 9.4 million patients worldwide had calcific AVSD in 2019. […] Rates of AVSD are highly correlated with old age and are the greatest in North America, Europe, and Australasia. […] A lack of access to echocardiography among developing nations may also explain the discrepancies in the reported AVSD rates.

• #3 Epidemiology of aortic valve stenosis (AS) and of aortic valve incompetence (AI): is the prevalence of AS/AI similar in different parts of the world?

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/epidemiology-of-aortic-valve-stenosis-as-and-of-aortic-valve-incompetence-ai

  There are large differences in the epidemiology of aortic valve disease between high-income and low-income countries. Rheumatic valvulopathy is most commonly seen in low-income countries. The prevalence is between 46 per 100,000 in northern India and 2,400 per 100,000 in the Solomon Islands. Infective endocarditis is most common in low-income countries and in Africa; whereas, degenerative calcific aortic valve stenosis is common (prevalence of 12.4%) in high-income countries. The prevalence of severe aortic stenosis in those aged 75 years is 3.4% in Europe and the USA. The epidemiology of aortic valve disease varies enormously between high-income and low-income countries. The majority of morbidity and mortality attributable to aortic valve disease worldwide is due to infectious disease. The number of cases of aortic valvular disease will increase because of the strong association between valvular disease and age, combined with the rapid ageing of populations worldwide. The burden of rheumatic heart disease (RHD) falls disproportionately on low-income countries and in low-income groups in high-income countries. The incidence of acute rheumatic fever has been difficult to establish globally. Estimates range from 10 cases per 100,000 to as high as 374 cases per 100,000 in Pacific and indigenous Australian and New Zealand communities. In Africa, ARF is still seen regularly in its most fulminant form, affecting children as young as six years old. The highest prevalence of RHD is in sub-Saharan Africa with a prevalence of 5.7 per 1,000, compared with 1.8 per 1,000 in North Africa, and 0.3 per 1,000 in economically developed countries was established. A review of recent studies predominantly using echocardiography for the diagnosis of chronic RHD shows wide global variations in prevalence, between 46 per 100,000 in northern India and 2,400 per 100,000 in the Solomon Islands. Aortic stenosis (AS) is, therefore, relatively uncommon in those aged under 65 years in the absence of a congenital abnormality. Aortic stenosis is the second most common valvular lesion in the United States. It is present in about 5% of the population at age 65 with increasing prevalence with advancing age. A meta-analysis of predominantly older studies conducted in Europe, the USA and Taiwan found a population prevalence of AS of 12.4%, and a prevalence of 3.4% of severe AS in those aged 75 years and older. Projections in high-income countries uniformly predict an increase in the burden of disease. Numbers of elderly patients with an indication for treatment (severe symptomatic AS aged 75 years and older), which is the most important group for healthcare systems due to the complexity and cost of management, are projected to more than double by 2050 in both the USA and Europe. Once RHD prevalence begins to decrease, CAVD can be expected to play a relatively more important role as a cause of AS in low-income countries. The high prevalence of risk factors for CAVD such as hypertension and increasing life expectancy, mean that there is likely to be a substantial future burden of CAVD in low-income countries. Epidemiologic studies have established equal rates of AS among men and women; however, important sex differences exist. In general, women are also more likely to have smaller annular sizes and left ventricular (LV) outflow tract dimensions associated with concentric LV hypertrophy. In developing countries, aortic valvular stenosis or regurgitation are typically caused by rheumatic heart disease or infective endocarditis. On the other hand, in industrialised countries, valvular diseases are mostly degenerative. The magnitude of cardiovascular disease is vastly different in different countries (Africa, Asia, Europe or North America) and it shows differences according to sex.

• #4 The modern epidemiology of heart valve disease | Heart

  https://heart.bmj.com/content/102/1/75

  In this review, we will discuss the current knowledge of heart valve disease (HVD) epidemiology, how it has changed over time and possible future trends. […] The majority of morbidity and mortality attributable to HVD worldwide is due to rheumatic heart disease (RHD), which is most commonly seen in low-income countries. In high-income countries, the greatest burden of HVD referred to hospital is due to calcific aortic valve disease (CAVD). […] The strong association between HVD and age, combined with the rapid ageing of populations worldwide, means that HVD has been described as the next cardiac epidemic.

• #5 Changing epidemiology of calcific aortic valve disease: 30-year trends of incidence, prevalence, and deaths across 204 countries and territories | Aging

  https://www.aging-us.com/article/202942/text

  Calcific aortic valve disease (CAVD) is associated with increased morbidity and mortality. We aimed to elucidate the 30-year epidemiology of CAVD globally. Global CAVD incidence, prevalence, and deaths increased 3.51-, 4.43-, and 1.38-fold from 1990 to 2019, respectively, without any decreasing trends, even after age standardization. In 2019, Slovenia had the highest age-standardized rate (ASR) of CAVD incidence (62.21/100,000 persons) and prevalence (1,080.06/100,000) whereas Cyprus had the highest ASR of deaths (8.20/100,000). Population aging was an important contributor to incidence. Compared with women, more men had CAVD and men had earlier peaks in disease prevalence. High systolic blood pressure, diet high in sodium, and lead exposure were the main risk factors for deaths owing to CAVD. The estimated annual percentage change, a measure to estimate the variation of ASR, was significantly associated with the ASR and sociodemographic index (SDI) in 2019 for incidence and prevalence across all 204 countries and territories (all p0.0001). With increased lifespan and risk factors, the overall burden of CAVD is high and remains on the rise, with differences by sex, age, and SDI level. Our findings serve to sound the alarm for organizations, institutions, and resources whose primary purpose is to improve human health.

• #6 Aortic Valve Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK542205/

  Aortic stenosis is a condition more prevalent in the elderly population (fifth through eighth decades). According to a prospective population-based study, the incidence of aortic stenosis was 0.2% during the fifth decade of life, 1.3% during the sixth, 3.9% during the seventh, and 9.8% during the eighth. […] Aortic regurgitation has an estimated prevalence of 4.9%, increasing with age until the sixth decade when incidence decreases. However, this number may be artificially low because up to 75% of aortic stenosis patients may have some degree of regurgitation that goes unreported.

• #7 Heart valve disease module 1: epidemiology – The British Journal of Cardiology

  https://bjcardio.co.uk/2016/03/heart-valve-disease-module-1-epidemiology-2/

  Heart valve disease is as common as heart failure. The population prevalence is 2.5% rising to over 10% in people aged more than 75. […] In industrially developed countries, the incidence of rheumatic disease declined after the second half of the 20th century. With increased longevity, valve conditions characteristic of old-age now predominate. The most common are calcific aortic stenosis and functional mitral regurgitation. […] There has also been a rise in new diseases induced by drugs or therapeutic irradiation, an increase in endocarditis related to intravenous drug use, device implantation and haemodialysis and a rise in the number of operations as a result of failing replacement heart valves.

• #8 Valvular Heart Disease Epidemiology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9228968/

  Mortality rates have decreased in developed countries with the advent of new interventions, though no therapies are currently available to prevent the disease. […] Aortic valve stenotic disease (AVSD) is the most prevalent valvular disease in the developed world. […] The relative frequency of the causes of ASVD varies geographically. […] The age-standardized AVSD mortality rate per 100,000 people is highest in Western Europe, North America, South America, and Australasia.

• #9 Valvular Heart Disease Epidemiology

  https://www.mdpi.com/2076-3271/10/2/32

  AVSD was estimated to be responsible for approximately 127,000 global deaths in 2019 and an associated loss of 1.8 million DALYs (disability-adjusted life-years). […] Mortality rates have decreased in developed countries with the advent of new interventions, though no therapies are currently available to prevent the disease.

• #10 About Heart Valve Disease | Heart Disease | CDC

  https://www.cdc.gov/heart-disease/about/heart-valve-disease.html

  Heart valve disease is when any valve in the heart has damage or is diseased. […] Any valve in the heart can become diseased, but the aortic valve is most commonly affected. […] More than 5 million people in the U.S. are diagnosed with heart valve disease each year. […] More than 25,000 deaths in the U.S. each year are due to heart valve disease. […] Heart valve disease is underdiagnosed and undertreated, especially in African American, Hispanic, and Asian populations. […] Early diagnosis, treatment, and routine monitoring of heart valve disease are critical to helping patients live healthy lives. […] Screenings such as stethoscope checks, echocardiograms, and timely referrals to cardiologists can help ensure that heart valve disease does not go unmanaged. […] As with any heart condition, continued care and regular screenings to monitor disease progression are needed for people who are living with heart valve disease.

• #11 Heart Valve Disease Facts and Statistics: What You Need to Know

  https://www.verywellhealth.com/heart-valve-disease-facts-and-statistics-6504264

  According to the Centers for Disease Control and Prevention, 2.5% of Americans have valvular heart disease, and it is even more commonly seen in older adults. […] Aortic stenosis is one of the more common forms of heart valve disease. In the U.S., aortic stenosis affects 5% of people over the age of 65. […] As people have been living to older age in the U.S., the country is seeing more cases of degenerative valve diseases. […] 61% of deaths are due to aortic valve disease.

• #12 Changing epidemiology of calcific aortic valve disease: 30-year trends of incidence, prevalence, and deaths across 204 countries and territories | Aging

  https://www.aging-us.com/article/202942/text

  Globally, a total of 126,827 patients (male 54,175 and female 72,652) died from CAVD in 2019, a 1.38-fold rise from 1990. […] Our study used the most up-to-date information to demonstrate that (i) the spatial and temporal patterns of incidence, prevalence, and deaths owing to CAVD varied considerably across 204 nation-level units from 1990 to 2019, according to GBD 2019 findings; (ii) population aging contributed more to the CAVD incidence than population growth, according to decomposition analysis; (iii) the sex-age patterns of prevalence suggested that more men had CAVD and reached the highest prevalence at younger ages than women; (iv) CAVD deaths were mainly attributable to high SBP, diet high in sodium, and lead exposure, based on GBD 2019; and (v) the ASIR EAPC had an important correlation with the ASPR EAPC and ASDR EAPC whereas the ASIR and ASPR EAPC was significantly associated with ASR and SDI in 2019 throughout the 204 countries and territories. […] A high SBP, a diet high in sodium, and exposure to lead were the main risk factors of CAVD deaths. Moreover, the EAPC was significantly related to the ASR and SDI in 2019 for incidence and prevalence.

• #13 Changing epidemiology of calcific aortic valve disease: 30-year trends of incidence, prevalence, and deaths across 204 countries and territories | Aging

  https://www.aging-us.com/article/202942/text

  The global number of newly diagnosed cases of CAVD increased 3.51-fold from 1990, with 589,638 in 2019, including 313,805 male and 275,833 female patients. […] The disease burden of CAVD globally, and in five SDI quintiles from 1990 to 2019. (A) Incident cases; (B) ASIR; (C) prevalent cases; (D) ASPR; (E) deaths; (F) ASDR. […] The incidence of CAVD varied significantly from nation to nation. In 2019, the highest number of incident cases (117,080) was recorded in the United States, followed by Japan (71,837), China (54,965), and the Russian Federation (54,152). […] The most CAVD deaths in 2019 were recorded in the United States, followed by Germany and Japan (248,256, 13,154, and 12,868, respectively). […] Since 1990, no SDI or GBD regions have shown a decreasing trend in CAVD deaths or ASDR.

• #14

  https://link.springer.com/article/10.1007/s11936-023-01020-4

  The prevalence of aortic stenosis continues to increase, and so does the burden of treatable disease. […] The global prevalence of AS continues to steadily increase. […] The age-standardized prevalence of calcific aortic valve disease was 116.3 cases per 100,000 people in 2019, more than doubling since 1990. […] AS is particularly prevalent in high-income countries, partly driven by its strong correlation with age; pooled meta-data suggest contemporary prevalence exceeds 10% in the population aged over 75 years. […] This creates significant challenges for healthcare infrastructure and resource allocation, given the growing treatable burden of disease. […] With advancements in economies in developing nations, the prevalence of age-related AS will increase. […] Replacement of the aortic valve, either surgically or via the transcatheter approach, is the only treatment which improves survival.

• #15 Aortic Stenosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/150638-overview

  Severe aortic stenosis is rare in infancy, occurring in 0.33% of live births, and is due to a unicuspid or bicuspid valve. Most patients with a congenitally bicuspid aortic valve who develop symptoms do not do so until middle age or later. Patients with rheumatic aortic stenosis typically present with symptoms after the sixth decade of life. […] Aortic sclerosis (aortic valve calcification without obstruction to blood flow, considered a precursor of calcific degenerative calcific aortic stenosis) increases in incidence with age and is present in 29% of individuals older than 65 years and in 37% of individuals older than 75 years. In elderly persons, the prevalence of aortic stenosis is between 2% and 9%. […] Degenerative calcific aortic stenosis usually manifests in individuals older than 75 years and occurs most frequently in males.

• #16 Surveillance in heart valve disease – British Heart Valve Society

  https://bhvs.org/surveillance-in-heart-valve-disease/surveillance-in-heart-valve-disease/

  Heart valve disease is a condition that you will carry with you for your whole life. You are therefore likely to remain under the care of a valve surveillance programme, undergoing regular clinical review and sometimes echocardiograms, depending on the type of valve operation you had. […] For people with moderate or severe valve disease follow-up is typically every 6 months to 2 years depending on the severity, but might be more frequent if close to agreed thresholds for surgery. […] Because slowing down can disguise the development of symptoms and may be hard to detect, exercise testing is recommended in most patients with severe valve disease who are symptom-free. Between a third and a half of people with severe aortic stenosis have symptoms revealed by an exercise test.

• #17 2020 ACC/AHA Heart Valve Disease Guideline: Key Perspectives, Part 3

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2020/12/16/22/01/2020-ACC-AHA-VHD-GL-Pt-3-GL-VHD

  Following an initial post-procedure transthoracic echocardiogram (TTE), surveillance imaging is recommended at 5 and 10 years, then annually. […] When there is a change in clinical symptoms or signs suggesting valve dysfunction, additional imaging such as transesophageal echocardiography (TEE), fluoroscopy, or cardiac computed tomography (CT) is recommended. […] For high surgical risk patients with prosthetic valve dysfunction (stenosis or valve regurgitation), a transcatheter valve-in-valve procedure is reasonable at a Comprehensive Valve Center (Class 2a). […] For high surgical risk patients with paravalvular regurgitation with intractable hemolysis or New York Heart Association (NYHA) class III or IV symptoms, a catheter-based percutaneous repair is reasonable (Class 2a).

• #18 Appropriate Follow-Up Is Key to Aortic Valve Replacement

  https://consultqd.clevelandclinic.org/why-appropriate-follow-up-is-key-to-successful-aortic-valve-replacement

  Frequent monitoring to enable early identification and treatment of potential abnormalities is key to the long-term success of aortic valve replacement (AVR), whether surgical (SAVR) or transcatheter (TAVR), say Cleveland Clinic heart valve specialists. […] As a large referral center for valvular heart disease, we see a substantial number of patients who develop valvular stenosis, valvular regurgitation or paravalvular regurgitation soon after SAVR or TAVR, says Amar Krishnaswamy, MD, Section Head of Invasive and Interventional Cardiology. […] After TAVR or SAVR, Cleveland Clinic valve specialists follow patients with yearly echocardiograms. […] Its important to maintain vigilant surveillance, because its likely that younger patients may outlive their current valve and require another valve replacement, Dr. Krishnaswamy says.

• #19 Appropriate Follow-Up Is Key to Aortic Valve Replacement

  https://consultqd.clevelandclinic.org/why-appropriate-follow-up-is-key-to-successful-aortic-valve-replacement

  Follow-up of mechanical valves is recommended based on symptoms. However, these valves also may develop complications over time. That is why it is so helpful to have a history of imaging. […] The role and extent of local follow-up is determined in large part by the availability of quality echocardiography studies. The quality of imaging is paramount, as some of the valve abnormalities are important if they are detected or missed, Dr. Rodriguez explains. […] Cleveland Clinics electronic medical record system prompts physicians to schedule patients for a return visit one year after their current visit and to undergo necessary testing if desired. This minimizes chances of patients being lost to follow-up. […] This is why its important for referring physicians to have conversations with their patients about the need for appropriate follow-up.

• #20 NHS England » Guide to implementing patient initiated follow-up and regular surveillance imaging for patients with mild to moderate heart valve disease

  https://www.england.nhs.uk/long-read/guide-to-implementing-pifu-imaging-mild-to-moderate-heart-valve-disease/

  Patients with mild to moderate disease or following valvular intervention are usually asymptomatic for many years and may only need dedicated imaging (usually echocardiography, with results reviewed by a HVD specialist) at pre-specified intervals and not necessarily a consultation with a HVD specialist. […] A heart valve PIFU service is likely to be a new concept of care in many centres, and like any new service, it should be evaluated on a regular basis to ensure that it is safe, effective, and equitable. […] New technologies that allow remote monitoring, assist rapid diagnosis and support electronic communication may also support a PIFU pathway. […] Remote monitoring technologies are used to monitor for early signs of cardiac decompensation in patients with heart failure; these may also be beneficial for patients with HVD.

• #21 NHS England » Guide to implementing patient initiated follow-up and regular surveillance imaging for patients with mild to moderate heart valve disease

  https://www.england.nhs.uk/long-read/guide-to-implementing-pifu-imaging-mild-to-moderate-heart-valve-disease/

  Cardiac ultrasound using artificial intelligence, though not yet in widespread use, has the potential to improve the efficiency of surveillance in HVD. […] Electronic patient portals through which patients can communicate directly and virtually with the clinical team may further empower the patient and facilitate the PIFU pathway.

• #22 Evaluation of TAVR Compared to Surveillance for Patients With Asymptomatic Severe Aortic Stenosis – EARLY TAVR

  https://www.acc.org/latest-in-cardiology/clinical-trials/2024/10/24/14/42/early-tavr

  The EARLY TAVR trial showed that TAVR for stage C aortic stenosis was beneficial compared with clinical surveillance. […] The goal of the trial was to evaluate transcatheter aortic valve replacement (TAVR) compared with clinical surveillance among patients with asymptomatic severe aortic stenosis (stage C aortic stenosis). […] Among patients with asymptomatic severe aortic stenosis (stage C aortic stenosis), early TAVR was beneficial. Early TAVR compared with clinical surveillance resulted in a lower incidence of the composite outcome of death, stroke, or unplanned hospitalization for cardiovascular cause. This trial will be used to inform future guideline recommendations regarding the management of stage C aortic stenosis.

• #23 Early transcatheter aortic valve replacement reduces cardiovascular events in asymptomatic aortic stenosis patients

  https://medicalxpress.com/news/2025-05-early-transcatheter-aortic-valve-cardiovascular.html

  New analysis from the EARLY TAVR trial showed patients between the age of 65 and 70 years old derived the most benefits of a strategy of early intervention with transcatheter aortic valve replacement (TAVR) compared to other age groups, especially in regards to stroke risk, and in regards to the composite of death, stroke, and heart failure hospitalization. […] As many as 300,000 Americans are diagnosed with AS each year, a serious condition that occurs when the aortic valve in the heart is narrowed or blocked. Two strategies to manage asymptomatic severe AS are typically performed; clinical surveillance (CS), with routine monitoring and aortic valve replacement only when symptoms developed, or aortic valve replacement. […] For patients with asymptomatic, severe AS, the EARLY TAVR trial demonstrated that a strategy of early TAVR was superior to CS for the primary endpoint of death, stroke, or unplanned cardiovascular hospitalization.

• #24 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20250502/Early-TAVR-shows-greatest-stroke-reduction-in-patients-aged-65-to-70.aspx

  New analysis from the EARLY TAVR trial showed patients between the age of 65 and 70 years old derived the most benefits of a strategy of early intervention with transcatheter aortic valve replacement (TAVR) compared to other age groups, especially in regards to stroke risk, and in regards to the composite of death, stroke, and heart failure hospitalization. […] As many as 300,000 Americans are diagnosed with AS each year, a serious condition that occurs when the aortic valve in the heart is narrowed or blocked. […] For patients with asymptomatic, severe AS, the EARLY TAVR trial demonstrated that a strategy of early TAVR was superior to CS for the primary endpoint of death, stroke, or unplanned cardiovascular hospitalization. […] Older age was associated with higher rates of death, stroke, or HF hospitalizations up to five years post-procedure for both patient groups. Early TAVR demonstrated benefits over CS across all age groups.

• #25 Early transcatheter aortic valve replacement reduces cardiovascular events in asymptomatic aortic stenosis patients

  https://medicalxpress.com/news/2025-05-early-transcatheter-aortic-valve-cardiovascular.html

  Older age was associated with higher rates of death, stroke, or HF hospitalizations up to five years post-procedure for both patient groups. Early TAVR demonstrated benefits over CS across all age groups. […] That said, patients aged 65–69 who underwent early TAVR derived the most benefits, with significant reduction in stroke risk (0% early TAVR vs. 13% CS) and had six times lower rate of death, stroke, or HF hospitalization compared to those who underwent CS (4.7% vs. 25.6%, respectively) up to five years post-procedure. […] „Taking all together, and given the benefits and the lack of risks in patients 65 years or greater, early TAVR should be preferred to clinical surveillance in all age groups,” said Philippe Genereux, MD, Director of the Structural Heart Program at the Gagnon Cardiovascular Institute at Morristown Medical Center, in Morristown, New Jersey, Principal Investigator of the EARLY TAVR trial, and lead author of the study.

• #26 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20250502/Early-TAVR-shows-greatest-stroke-reduction-in-patients-aged-65-to-70.aspx

  Patients aged 65-69 who underwent early TAVR derived the most benefits, with significant reduction in stroke risk (0% early TAVR vs. 13% CS) and had six times lower rate of death, stroke, or HF hospitalization compared to those who underwent CS (4.7% vs. 25.6%, respectively) up to five years post-procedure. […] Patients aged over 80 years old also derived the most benefits in regards of stroke risk, with early TAVR strategy associated with a 4-fold reduction in stroke up to 5 years follow-up compared to clinical surveillance. […] We are discovering that aortic stenosis itself might be an important risk factor of stroke if left untreated. Taking all together, and given the benefits and the lack of risks in patients 65 years or greater, early TAVR should be preferred to clinical surveillance in all age groups.

• #27 Younger Patients with Asymptomatic Aortic Stenosis who Undergo TAVR Experience Fewer Serious Cardiovascular Events | DAIC

  https://www.dicardiology.com/content/younger-patients-asymptomatic-aortic-stenosis-who-undergo-tavr-experience-fewer-serious

  According to a presentation at the SCAI 2025 Scientific Sessions, analysis from EARLY TAVR trial shows early TAVR correlates to lower risk of death, stroke, or heart failure hospitalization compared to clinical surveillance across patients aged 65-80. […] For patients with asymptomatic, severe AS, the EARLY TAVR trial demonstrated that a strategy of early TAVR was superior to CS for the primary endpoint of death, stroke, or unplanned cardiovascular hospitalization. […] Early TAVR demonstrated benefits over CS across all age groups. […] That said, patients aged 65-69 who underwent early TAVR derived the most benefits, with significant reduction in stroke risk (0% early TAVR vs. 13% CS) and had six times lower rate of death, stroke, or HF hospitalization compared to those who underwent CS (4.7% vs. 25.6%, respectively) up to five years post-procedure.

• #28 Long COVID May Cause Long-Term Changes in the Heart and Lungs and May Lead to Cardiac and Pulmonary Diseases | Mount Sinai – New York

  https://www.mountsinai.org/about/newsroom/2025/long-covid-may-cause-long-term-changes-in-the-heart-and-lungs-and-may-lead-to-cardiac-and-pulmonary-diseases

  Patients suffering from long COVID may exhibit persistent inflammation in the heart and lungs for up to a year following SARS-CoV-2 infection—even when standard medical tests return normal results—potentially placing them at elevated risk for future cardiac and pulmonary conditions. […] These abnormalities could serve as early warning signs of diseases such as heart failure, valvular heart disease, and pulmonary hypertension. […] This study brings us closer to understanding how SARS-CoV-2 affects the heart and lungs over time. […] We believe long COVID results in an inflammatory response that may predispose patients to premature coronary artery disease, pulmonary hypertension, and valvular damage such as stenosis or regurgitation. […] This paper provides more data to highlight that SARS-CoV-2 is a virus that profoundly affects vascular health and that every new infection can do damage.

• #29 Long COVID May Cause Long-Term Changes in the Heart and Lungs and May Lead to Cardiac and Pulmonary Diseases | Mount Sinai – New York

  https://www.mountsinai.org/about/newsroom/2025/long-covid-may-cause-long-term-changes-in-the-heart-and-lungs-and-may-lead-to-cardiac-and-pulmonary-diseases

  If patients experience lingering symptoms such as shortness of breath, they should consult a physician for further evaluation. […] Our results should also raise awareness among clinicians to consider a patient’s COVID history and evaluate persistent symptoms more thoroughly. […] These findings should change how we approach care and surveillance—not only recognizing SARS-CoV-2 as a potential long-term cardiovascular risk factor, but also integrating molecular imaging into post-COVID evaluation protocols. […] We now have objective evidence that can guide earlier detection and potentially prevent future cardiopulmonary events.

• #30 NHS England » Guide to implementing patient initiated follow-up and regular surveillance imaging for patients with mild to moderate heart valve disease

  https://www.england.nhs.uk/long-read/guide-to-implementing-pifu-imaging-mild-to-moderate-heart-valve-disease/

  The number of patients with HVD is predicted to double by 2046, and given the chronic nature of HVD, ageing population, improved access to diagnostics/screening and increasing percutaneous valve implantations, valve surveillance services risk being significantly impacted. […] Heart valve services need to be structured according to patient need so all patients can be seen by the right experts at the right time. Over 70% of patients followed up in one NHS heart valve clinic had non-severe HVD or prosthetic valves (Leeds Teaching Hospitals audit data, 2021); this indicates that reducing the number of consultations for stable patients with mild to moderate HVD or following valve intervention will allow heart valve clinic resources to be directed to those with severe HVD who are at risk of heart failure and death (NICE guidance 2021).

• #31 Epidemiology of valvular heart disease in Portugal: The time has come for the heart valve unit | Revista Portuguesa de Cardiologia (English edition)

  https://www.revportcardiol.org/en-epidemiology-valvular-heart-disease-in-articulo-S2174204918303866

  Significant valvular heart disease (VHD) is a growing public health problem, due to increasing life expectancy and the lack of effective prevention strategies for valve disease of degenerative etiology. […] The characteristics of patients with severe VHD have changed considerably in the last 15 years: they are now older, with more comorbidities, and are more likely to have multivalvular disease. […] The mean age of the study population was around 75 years, which is older than in the 2001 Euro Heart Survey on Valvular Heart Disease but similar to the more recent (2017) Valvular Heart Disease II (VHDII) Survey of the European Society of Cardiology’s EURObservational Research Programme. […] Multiple comorbidities were found in 53% of patients, the most common of which were coronary artery disease (28.2%), chronic kidney disease (20.9%) and chronic anemia (26.5%).

• #32 Epidemiology of valvular heart disease in Portugal: The time has come for the heart valve unit | Revista Portuguesa de Cardiologia (English edition)

  https://www.revportcardiol.org/en-epidemiology-valvular-heart-disease-in-articulo-S2174204918303866

  The high all-cause (9.8%) and cardiovascular (8.7%) in-hospital mortality in Esteves et al. illustrates the challenges of managing VHD in these patients and the need for the involvement of multidisciplinary teams that include not only clinical cardiologists, interventional cardiologists and thoracic surgeons but also anesthetists, geriatricians, physiatrists and nutritionists, among others. […] The picture of the VHD patient hospitalized in the cardiology department is changing rapidly, but hospital structures are not keeping up with these changes.

• #33 Epidemiology of Valvular Heart Disease — Radcliffe Department of Medicine

  https://www.rdm.ox.ac.uk/oxvalve/information-for-health-professionals/epidemiology-of-valvular-heart-disease

  Valvular heart Disease (VHD) is the source of significant morbidity and mortality with increasing prevalence but is poorly researched in comparison with other areas of cardiac disease. […] Although echocardiographic studies provide some indication of disease prevalence, accurate epidemiological data are lacking and there are no European or UK studies to date. […] The largest epidemiological study of VHD examined pooled data from three population-based studies in the U.S., as well as community-based data from a separate cohort. […] In total, this amounted to over 28,000 adults, and documented VHD of at least moderate severity. […] The prevalence of VHD increased with age in both the population- and community-based cohorts, rising from 0.7% in those aged 18-44 years to 13% in those over 75 in the population-based studies, and from 0.3% to 12% in the corresponding age groups in the community-based cohort.

• #34 Epidemiology of Valvular Heart Disease — Radcliffe Department of Medicine

  https://www.rdm.ox.ac.uk/oxvalve/information-for-health-professionals/epidemiology-of-valvular-heart-disease

  Importantly, the authors demonstrated that the presence of VHD had a statistically significant impact on survival in both cohorts, underlining the fact that VHD is a significant health care issue. […] It is hoped that the OxVALVE Study will allow an insight into the epidemiology of VHD in the United Kingdom.

• #35 The Global Burden of Valvular Heart Disease: From Clinical Epidemiology to Management

  https://www.mdpi.com/2077-0383/12/6/2178

  Valvular heart disease is a leading cause of cardiovascular morbidity and mortality and a major contributor of symptoms and functional disability. Knowledge of valvular heart disease epidemiology and a deep comprehension of the geographical and temporal trends are crucial for clinical advances and the formulation of effective health policy for primary and secondary prevention. […] The comprehension of the geographical and temporal trends and changes in VHD epidemiology are crucial for advances in clinical practice and the development of effective health policy for primary and secondary prevention. […] The specific causes of VHD can be misclassified, especially in areas where rheumatic heart disease (RHD) is endemic and the classification of VHD is easily prone to error. […] The most marginalized and poorest populations regionally, nationally, and at a subnational level are not showing signs of improvement, and people continue to die early from RHD.

• #36 The Global Burden of Valvular Heart Disease: From Clinical Epidemiology to Management

  https://www.mdpi.com/2077-0383/12/6/2178

  The incidence of calcific aortic valve disease (CAVD) has increased sevenfold during the last 30 years, with age-standardized rates four times as high in high-income compared with middle-income countries. […] The increase in the predisposing factors of infective endocarditis. […] The resultant VHD disease burden is only projected to increase in the coming decades, with a consequent worsening of related morbidity and mortality. […] The improvement in valve surgery and the advent of transcatheter procedures. […] The central role of the VHD specialist has been emphasized by both American and European guidelines. […] The multidisciplinary approach is recommended for all types of VDH and has been formally endorsed by several Scientific Societies. […] VHD is a leading cause of cardiovascular morbidity and mortality, with substantial regional differences. Population aging, the availability of imaging techniques, accessibility to diagnosis and treatment, migration flows, the improvement in valve surgery, and the advent of transcatheter procedures are the principal factors responsible for changes in the epidemiology of VHD.

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