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Sildenafil should be avoided in valve disease with residual pulmonary hypertension, study suggests

"Valvular disease is considered the next cardiac epidemic because of its strong association with age and the rapid aging of the population worldwide," said principal investigator Dr Javier Bermejo, a cardiologist at Hospital General Universitario Gregorio MaraƱon, Madrid, Spain. "The only established treatment is repair or replacement of the valve surgically or percutaneously," he continued. "But symptoms often remain or reappear in the long-term. Residual pulmonary hypertension is the most important risk factor for death and disability after successful correction of the valvular lesion." Pulmonary hypertension refers to increased blood pressure in the pulmonary artery. In patients with long-standing valvular disease, the high pressure in the left side of the heart is transmitted backwards to the lung vessels which react by thickening. This process may not revert after valve treatment, resulting in persistent pulmonary hypertension. Sildenafil (cen...

Preventing sudden death in hypertrophic cardiomyopathy

A large study conducted across North America, Europe, the Middle East and Asia has validated the ESC recommendations for predicting and preventing sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). The HCM-EVIDENCE study, presented at ESC Congress 20171, tested the ESC's recommendations in a diverse cohort of patients, said study investigator Constantinos O'Mahony, MRCP(UK). "Since 2014, the ESC has recommended using a special risk prediction tool called the HCM Risk-SCD to identify which patients are at highest risk for sudden death and would benefit most from having a prophylactic implantable cardioverter defibrillator," explained Dr O'Mahony, from St. Bartholomew's Centre for Inherited Cardiovascular Disease, St Bartholomew's Hospital, and the University College London Centre for Heart Muscle Disease, Institute of Cardiovascular Science, London. "But, whenever a risk model is created, there are concerns about ho...