Robert A. Levine
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View article: Collagen Fiber Maturity and Architecture in MVP-Associated Fibrosis Quantified by Digital Pathology
Collagen Fiber Maturity and Architecture in MVP-Associated Fibrosis Quantified by Digital Pathology Open
Recent evidence demonstrates that mitral valve prolapse (MVP) increases mechanical stress on the subvalvular apparatus and is linked to regional myocardial fibrosis and life-threatening ventricular arrhythmias. However, current surgical gu…
View article: Short- and Long-Term Effects of Pulsed Ultrasound Cavitation Therapy of Calcified Valvular Interstitial Cells in Culture
Short- and Long-Term Effects of Pulsed Ultrasound Cavitation Therapy of Calcified Valvular Interstitial Cells in Culture Open
These studies suggest that ultrasound therapy, currently limited to very severe aortic stenosis, could be of interest at an earlier stage of the disease.
View article: Mitral Valve Remodeling in Response to Atrial and Ventricular Changes: Mechanisms and Clinical Implications for Functional Mitral Regurgitation
Mitral Valve Remodeling in Response to Atrial and Ventricular Changes: Mechanisms and Clinical Implications for Functional Mitral Regurgitation Open
Mitral regurgitation (MR) is a frequent and heterogeneous disease associated with significant morbidity and mortality. Normal mitral valve closure requires a complex interplay between left ventricular shape and dynamics, papillary muscles,…
View article: Severe Mitral Regurgitation in Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis
Severe Mitral Regurgitation in Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis Open
BACKGROUND: Patients with paradoxical low-flow, low-gradient severe aortic stenosis exhibit low transvalvular flow rate (Q), while maintaining preserved left ventricular ejection fraction. Severe mitral regurgitation (MR) also causes a low…
View article: Rheumatic heart valve disease: navigating the challenges of an overlooked autoimmune disorder
Rheumatic heart valve disease: navigating the challenges of an overlooked autoimmune disorder Open
Despite being a leading cause of morbidity and mortality among young people, affecting predominantly women, rheumatic heart disease (RHD) remains neglected and understudied. This autoimmune condition arises from a complex continuum that be…
View article: Prevalence of Rheumatic Heart Disease in First-degree Relatives of Index-cases: A Systematic Review and Meta-Analysis
Prevalence of Rheumatic Heart Disease in First-degree Relatives of Index-cases: A Systematic Review and Meta-Analysis Open
Background: Rheumatic heart disease (RHD) is the leading cause of cardiac death in children, with over 300,000 annual fatalities. Immunological, genetic, and environmental factors contribute to an increased risk of RHD. It remains unclear …
View article: Clinical Outcomes After Valve Intervention in Rheumatic Mitral Valve Disease
Clinical Outcomes After Valve Intervention in Rheumatic Mitral Valve Disease Open
This study identified older age and higher NYHA functional class as significant predictors of composite outcomes in patients with rheumatic MV disease requiring intervention. Left ventricular systolic dysfunction was independently associat…
View article: Characterization of LTBP2 mutation causing mitral valve prolapse
Characterization of LTBP2 mutation causing mitral valve prolapse Open
Aims Mitral valve prolapse (MVP) is a common valvular disorder associated with significant morbidity and mortality, with a strong genetic basis. This study aimed to identify a mutation in a family with MVP and to characterize the valve phe…
View article: Isolated prolapse of the posterior mitral valve leaflet: phenotypic refinement, heritability and genetic etiology
Isolated prolapse of the posterior mitral valve leaflet: phenotypic refinement, heritability and genetic etiology Open
BACKGROUND Isolated posterior leaflet mitral valve prolapse (PostMVP), a common form of MVP, often referred as fibroelastic deficiency, is considered a degenerative disease. PostMVP patients are usually asymptomatic and often undiagnosed u…
View article: Severe Mitral Regurgitation in Paradoxical Low-Flow Low-Gradient Severe Aortic Stenosis
Severe Mitral Regurgitation in Paradoxical Low-Flow Low-Gradient Severe Aortic Stenosis Open
Background Patients with paradoxical low-flow, low-gradient severe aortic stenosis (LFLGAS) exhibit low transvalvular flow rate (Q), while maintaining preserved left ventricular ejection fraction (LVEF). Concomitant severe mitral regurgita…
View article: Characterization of LTBP2 mutation causing Mitral Valve Prolapse
Characterization of LTBP2 mutation causing Mitral Valve Prolapse Open
Background Mitral Valve Prolapse (MVP) is a prevalent valvular disorder linked to considerable morbidity and mortality, affecting approximately 2.4% of the general population. A prior genome association study linked LTBP2 to this trait. We…
View article: Left atrial function in patients with rheumatic mitral stenosis: addressing prognostic insights beyond atrial fibrillation prediction
Left atrial function in patients with rheumatic mitral stenosis: addressing prognostic insights beyond atrial fibrillation prediction Open
Aims Rheumatic mitral stenosis (MS) frequently leads to impaired left atrial (LA) function because of pressure overload, highlighting the underlying atrial pathology. Two-dimensional speckle tracking echocardiography (2D-STE) offers early …
View article: Challenges and Opportunities in Valvular Heart Disease: From Molecular Mechanisms to the Community
Challenges and Opportunities in Valvular Heart Disease: From Molecular Mechanisms to the Community Open
Valvular heart disease (VHD) takes a central stage in contemporary cardiology due to population aging and immense progress in percutaneous approaches to its treatment.VHD continues to be a major cause of death and suffering in both develop…
View article: Left Ventricular Fibrosis and CMR Tissue Characterization of Papillary Muscles in Mitral Valve Prolapse Patients
Left Ventricular Fibrosis and CMR Tissue Characterization of Papillary Muscles in Mitral Valve Prolapse Patients Open
Purpose . Mitral valve prolapse (MVP) is associated with left ventricle (LV) fibrosis, including the papillary muscles (PM), which is in turn linked to malignant arrhythmias. This study aims to evaluate comprehensive tissue characterizatio…
View article: Utilization of Engineering Advances for Detailed Biomechanical Characterization of the Mitral–Ventricular Relationship to Optimize Repair Strategies: A Comprehensive Review
Utilization of Engineering Advances for Detailed Biomechanical Characterization of the Mitral–Ventricular Relationship to Optimize Repair Strategies: A Comprehensive Review Open
The geometrical details and biomechanical relationships of the mitral valve–left ventricular apparatus are very complex and have posed as an area of research interest for decades. These characteristics play a major role in identifying and …
View article: Atrial Dysfunction in Significant Atrial Functional Mitral Regurgitation: Phenotypes and Prognostic Implications
Atrial Dysfunction in Significant Atrial Functional Mitral Regurgitation: Phenotypes and Prognostic Implications Open
Background: Atrial functional mitral regurgitation (AFMR) is associated with increased morbidity and mortality. Left atrial (LA) size and function in AFMR are poorly characterized. We aimed to assess LA function by reservoir strain (LASr) …
View article: Abnormal Mechanics Relate to Myocardial Fibrosis and Ventricular Arrhythmias in Patients With Mitral Valve Prolapse
Abnormal Mechanics Relate to Myocardial Fibrosis and Ventricular Arrhythmias in Patients With Mitral Valve Prolapse Open
Background: The relation between ventricular arrhythmia and fibrosis in mitral valve prolapse (MVP) is reported, but underlying valve-induced mechanisms remain unknown. We evaluated the association between abnormal MVP-related mechanics an…
View article: Left atrial function and not volume predicts mid-to-late atrial fibrillation after mitral valve repair
Left atrial function and not volume predicts mid-to-late atrial fibrillation after mitral valve repair Open
OBJECTIVES Patients undergoing surgical mitral valve repair (MVr) for degenerative mitral regurgitation are at risk of even late postoperative atrial fibrillation (AF). Left atrial (LA) function has been shown superior to LA volume in eval…
View article: Histopathological insights into mitral valve prolapse-induced fibrosis
Histopathological insights into mitral valve prolapse-induced fibrosis Open
Mitral valve prolapse (MVP) is a cardiac valve disease that not only affects the mitral valve (MV), provoking mitral regurgitation, but also leads to maladaptive structural changes in the heart. Such structural changes include the formatio…
View article: Percutaneous Transluminal Caval-Flow Regulation PTCR®: A New Alternative Therapy to Reshape the Future Treatment of Heart Failure
Percutaneous Transluminal Caval-Flow Regulation PTCR®: A New Alternative Therapy to Reshape the Future Treatment of Heart Failure Open
Percutaneous Transluminal Caval-flow Regulation (PTCR) is an emerging alternative therapy to treat patients with acute heart failure (AHF). AHF represents the first cause of hospitalization in elderly persons and is the main determinant of…
View article: Research Opportunities in the Treatment of Mitral Valve Prolapse
Research Opportunities in the Treatment of Mitral Valve Prolapse Open
In light of the adverse prognosis related to severe mitral regurgitation, heart failure, or sudden cardiac death in a subset of patients with mitral valve prolapse (MVP), identifying those at higher risk is key. For the first time in decad…