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Related Concept Videos

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
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Blood Pressure01:24

Blood Pressure

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The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
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Measurement of Pulse Propagation Velocity, Distensibility and Strain in an Abdominal Aortic Aneurysm Mouse Model
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Using Augmented Mean Arterial Pressure to Identify High Mortality Risk Patients With Moderate Aortic Stenosis.

Chieh-Ju Chao1, Pradyumma Agasthi1, Marlene Girardo2

  • 1Department of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, AZ; Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, MN.

Mayo Clinic Proceedings
|October 4, 2023
PubMed
Summary

A novel echocardiographic marker, augmented mean arterial pressure (AugMAP), effectively identifies high-risk patients with moderate aortic stenosis. Lower AugMAP levels independently predict worse survival, regardless of left ventricular ejection fraction.

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Area of Science:

  • Cardiology
  • Echocardiography
  • Medical Diagnostics

Background:

  • Moderate aortic stenosis (AS) poses a significant risk for adverse outcomes.
  • Current risk stratification methods may not fully capture the prognosis in moderate AS.
  • Novel echocardiographic markers are needed to improve patient risk assessment.

Purpose of the Study:

  • To evaluate the utility of augmented mean arterial pressure (AugMAP) as an echocardiographic marker for identifying high-risk patients with moderate AS.
  • To determine if AugMAP is independently associated with all-cause mortality in this patient population.

Main Methods:

  • A retrospective study of 4563 adult patients with moderate AS was conducted.
  • Augmented mean arterial pressure (AugMAP) was calculated using a specific formula.
  • Kaplan-Meier and Cox regression analyses were employed to assess the association between AugMAP and mortality.

Main Results:

  • Patients with lower AugMAP levels (<80 mm Hg) exhibited significantly worse survival outcomes (P<.001).
  • AugMAP was independently associated with all-cause mortality (HR, 0.962 per 5-mm Hg increase; P<.001).
  • The predictive value of AugMAP was consistent across patients with preserved or reduced left ventricular ejection fraction (LVEF).

Conclusions:

  • Augmented mean arterial pressure (AugMAP) is a simple and effective echocardiographic marker for identifying high-risk patients with moderate AS.
  • AugMAP provides prognostic information independent of LVEF.
  • This marker could aid in selecting patients for potential future aortic valve interventions.