Background/Objectives: Advanced calcific aortic stenosis, with or without coronary artery disease [CAD], may lead to severe systolic dysfunction. The aim of the study was to reveal clinical and laboratory parameters that may differentiate patients with severe aortic stenosis with and without systolic dysfunction. Methods: A retrospective, single-center study included all consecutive patients diagnosed with severe aortic stenosis with overt heart failure. Patients with hematological and neoplastic diseases were excluded. Demographic, clinical and laboratory data were analysed. Neutrophil-to-lymphocyte [NLR], monocyte-to-lymphocyte [MLR], and platelet-to-lymphocyte [PLR] ratios were calculated. The study group was divided based on left ventricular ejection fraction [LVEF]. Results: The final study population comprised 301 patients [133 males [44%]; median [Q1–3] age of 80 [75–83] years]. Co-morbidities included CAD [48.8%], arterial hypertension [75.4%], diabetes mellitus [n = 124, 41.2%], atrial fibrillation [39.2%], chronic kidney disease [60.8%]. Fifty-seven patients presented with LVEF ≤ 40% (heart failure with reduced ejection fraction (HFrEF)) and 244 with LVEF > 40%. In the multivariable analysis, N-terminal pro-B-type natriuretic peptide [NTproBNP] [p < 0.001, OR 1.000, 95%CI 1.000–1.000], baseline MLR [p < 0.020, OR 7.393, 95%CI 1.363–40.091] and female sex [p < 0.001, OR 0.308, 95%CI 0.160–0.593] were revealed as significant predictors of HFrEF. Baseline MLR weakly correlated with EuroScore II [Spearman r = 0.141, p = 0.015] and NTproBNP [r = 0.142, p = 0.014]. Cut-off values were established as 0.36 for MLR and 3927 pg/mL for NTproBNP. After excluding 147 patients with CAD, there was still a statistically significant difference in MLR between the subgroups [p = 0.024]. Conclusions: Increased values of MLR and NTproBNP together with female sex are predictive parameters for LVEF ≤ 40% in patients with severe aortic stenosis.

Transcatheter aortic valve implantation (TAVI) has become an optimal alternative in selected groups of patients and evolved from procedures in non-option patients to lower-risk-profile patients. One of its main indications is previous cardiac surgery, since redo-intervention is burdened with a higher risk of complications. However, TAVI after mitral valve surgery may raise concerns due to potential interference with the mitral prosthesis or ring during or after the procedure. The present paper reviews the current knowledge, including possible complications and procedural aspects.

Background/Objectives: Coronary artery disease (CAD) and aortic stenosis (AS) frequently coexist and share similar pathophysiological pathways, including inflammation, lipid deposition, and extracellular matrix remodeling. Trace elements are involved in cellular and physiological processes, playing regulatory and signaling roles. Their concentrations may be altered in various pathological conditions. The aim of our study was to compare trace metal concentrations in patients with severe aortic stenosis with and without coexisting coronary artery disease. Methods: In 53 patients (25 male, 47.2%, median age of 78 (75–81) years) with severe aortic stenosis, CAD coexistence and progression were analyzed based on the most recent coronary angiography report and history of revascularization. Blood samples for trace element analysis were collected prior to the implantation of the prosthesis, from the peripheral artery and by the pigtail catheter at the aortic root. Results: Twenty-six patients presented any degree of CAD, and were further differentiated into more advanced disease stages. The analysis found that patients with CAD had lower median concentrations of aluminum and calcium in the peripheral blood, and manganese and selenium in the aorta. Furthermore, in most advanced CAD patients, the concentration of magnesium, calcium, nickel, and copper in peripheral blood, along with chromium and selenium in aortic blood, was found to be lower compared to non-CAD patients. Lower selenium in aortic blood samples was predictive of an advanced stage of CAD. Conclusions: Patients with severe aortic stenosis and coexisting CAD present significantly lower blood concentrations of trace elements compared to those with the isolated disease.

Introduction : Transapical aortic valve implantation (TA-AVI) has been widely introduced for treatment of patients with severe aortic stenosis in the last decade. Here we report our first clinical experience with 10 patients using the second-generation transapical Symetis Acurate TA aortic...

Introduction: Recently, a relationship between hyperparathyroidism and cardiovascular disorders has been highlighted. The current study aimed to find a possible relationship between parathyroid hormone (PTH) and valvular calcification performance. A secondary aim was to evaluate the potential association between PTH concentration and post-procedural outcomes after transcatheter aortic valve implantation (TAVI).Material and methods: Patients with severe symptomatic aortic stenosis were evaluated for the study eligibility. Demographics, clinical data, and blood samples were collected. Pre-procedurally, echocardiography and computed tomography (CT) were performed. Quantitative evaluation of calcific tissue was conducted over the three regions of interest: ascending aorta, aortic, and mitral valves using semiautomated software.Results: The final study group comprised 89 patients (50 females, median (Q1-3) age of 77 (72-82) years. Increased PTH concentration was associated with a higher peak aortic gradient (p=0.024), but not with mean aortic gradient nor mitral annular calcification occurrence. CT analysis revealed an association between increased PTH and mean calcific tissue attenuation in the mitral (p=0.004) and aortic valves (p<0.001) and ascending aorta (p<0.001), however lack of relationship with calcium volume in the regions of interest. Increased PTH did not differ between patients with and without paravalvular leak or new pacemaker implantation.Conclusions: Increased PTH concentration is associated with calcific tissue attenuation but not calcium volume, suggesting that PTH may influence the degree of calcium accumulation in degenerated regions. PTH could potentially serve as a biomarker of calcific loading in valvular heart disease. However, PTH concentration does not appear to be linked to the rate of complications following TAVI.