The year in cardiology 2016: valvular heart disease.

Abstract

A large number of studies addressing various aspects of the diagnosis and treatment of valvular heart disease (VHD) have been published since the ESC Annual congress in 2015. As expected in this era of rapidly evolving therapeutic modalities and technologies, many scientific contributions are related to the expanded role of percutaneous interventions. New data are now available, consolidating the validity of the transcatheter approach in a variety of subsets of patients and therefore offering new strategies and perspectives in management. The most relevant articles have been selected for this review. It is well known that ageing of the population is associated with a higher prevalence of VHD. A large-scale echocardiographic screening involving 2500 individuals aged > 65 years was conducted to detect undiagnosed VHD ( Figure 1 ).1 Clinically significant (moderate or severe) undiagnosed VHD was identified in 6.4%. In addition, 4.9% of the cohort had pre-existing VHD (a total prevalence of 11.3%). Projecting these findings using population data, the prevalence of clinically significant VHD is estimated to double before 2050. The unique data of this study confirm the scale of the emerging epidemic of VHD, with widespread implications for clinicians and healthcare resources. In this scenario of predominantly elderly people affected by significant VHD, percutaneous modalities of treatment are expected to play a major role. Figure 1 UK population projections of diagnosed and undiagnosed significant valvular heart disease. The OxValve Population Cohort Study. Diagnosed estimates are based on the number excluded from participation in the present study due to a prior diagnosis of valvular heart disease. Undiagnosed estimates are based on the number with newly diagnosed significant valvular heart disease in OxVALVE-PCS. Reproduced with permission from D’Arcy JL et al .1 The mechanisms responsible for aortic valve calcification and development of aortic stenosis (AS) have been explored, and an association between valvular …