p.2 抽出テキスト

Document Reviewers: Alec Vahanian, (ESC Review Co-ordinator) (France), Carlos-A. Mestres, (EACTS Review Co-ordinator) (South Africa), Leila Abid (Tunisia), Suleman Aktaa (United Kingdom), Enoch F. Akowuah (United Kingdom), Elena Arbelo (Spain), Folkert W. Asselbergs (Netherlands), Emanuele Barbato (Italy), Giuseppe Boriani (Italy), Margarita Brida (Croatia), Sergio Buccheri (Sweden), Robert A. Byrne (Republic of Ireland), Ovidiu Chioncel (Romania), Lenard Conradi (Germany), Michele De Bonis (Italy), Victoria Delgado (Spain), Anna Franzone (Italy), Kristina Hermann Haugaa (Norway), Bettina Heidecker (Germany), Borja Ibanez (Spain), Bernard Iung (France), Stefan James (Sweden), Lars Køber (Denmark), Konstantinos C. Koskinas (Switzerland), Ulf Landmesser (Germany), Gregory Y.H. Lip (United Kingdom), John William McEvoy (Ireland), Gil Meltzer (Israel), David Messika-Zeitoun (Canada), Borislava Mihaylova (United Kingdom), Richard Mindham (United Kingdom), Inge Moelgaard (Denmark), Jens Cosedis Nielsen (Denmark), Gareth Owens (United Kingdom), Agnes A. Pasquet (Belgium), Thomas Pilgrim (Switzerland), Eva Prescott (Denmark), Eduard Quintana (Spain), Volker Rudolph (Germany), Rafael Sadaba (Spain), Anna Sannino (Germany), Felix C. Tanner (Switzerland), Marina Urena (France), Ilonca Vaartjes (Netherlands), Christiaan Vrints (Belgium), Alexander Wahba (Norway), Thomas Walther (Germany), Adam Witkowski (Poland), and Katja Zeppenfeld (Netherlands)

All experts involved in the development of these guidelines have submitted declarations of interest, which are reported in a supplementary document to the guidelines. See the European Heart Journal online or https://www.escardio.org/Guidelines for supplementary documents as well as evidence tables.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Keywords Guidelines • European Society of Cardiology (ESC) • European Association for Cardio-Thoracic Surgery (EACTS) • Valvular heart disease • Aortic stenosis • Aortic regurgitation • Mitral stenosis • Mitral regurgitation • Tricuspid regurgitation • Tricuspid stenosis • Multivalvular disease • TAVI • SAVR • Heart surgery • Transcatheter edge-toedge repair • Transcatheter valve replacement

Table of contents

1. Preamble .............................................................................................................. 4640 2. Introduction ....................................................................................................... 4642 2.1. What is new ............................................................................................. 4643 3. The Heart Team and Heart Valve Centre ............................................ 4649 3.1. The Heart Valve Network ................................................................. 4649 3.1.1. Composition of the Heart Team ............................................. 4650 3.1.2. Procedural volume and clinical outcomes ........................... 4651 4. Imaging of patients with valvular heart disease ................................... 4652 4.1. Initial valve assessment ......................................................................... 4652 4.2. Associated diseases and conditions ................................................ 4653 4.3. Evaluation of valvular heart disease dynamics and variability 4653 4.4. Assessment of extravalvular cardiac consequences from valvular heart disease ..................................................................................... 4653 4.5. Evaluation of eligibility, planning, and guiding of interventions 4653 5. Clinical evaluation of patients with valvular heart disease ............. 4653 5.1. Clinical examination .............................................................................. 4653 5.2. Assessment of comorbidities and risk stratification ................ 4653 5.3. Biomarkers ................................................................................................ 4654 5.4. Exercise testing ....................................................................................... 4655 5.5. Invasive investigations ........................................................................... 4655 5.5.1. Coronary angiography .................................................................. 4655 5.5.2. Cardiac catheterization ................................................................ 4655 5.6. Patient-centred care and shared decision-making ................... 4655 6. Management of conditions associated with valvular heart disease 4655 6.1. Diagnosis and management of coronary artery disease ........ 4655 6.2. Atrial fibrillation ...................................................................................... 4657 6.3. Cancer and radiation therapy ........................................................... 4657 6.4. Prophylaxis of rheumatic fever ........................................................ 4658 6.5. Cardiogenic shock and acute heart failure .................................. 4658 6.6. Palliative care ............................................................................................ 4658 7. Aortic regurgitation ........................................................................................ 4658 7.1. Prevalence and aetiology ..................................................................... 4658 7.2. Evaluation ................................................................................................... 4658 7.3. Medical therapy ....................................................................................... 4660 7.4. Indications for intervention ................................................................ 4660 7.5. Follow-up ................................................................................................... 4660 7.6. Special patient populations ................................................................ 4662 8. Aortic stenosis .................................................................................................. 4662 8.1. Prevalence and aetiology ..................................................................... 4662 8.2. Evaluation ................................................................................................... 4662 8.2.1. Echocardiography and cardiac computed tomography . 4662 8.2.2. Additional diagnostic and prognostic parameters ............ 4663 8.2.3. Procedural planning ....................................................................... 4663 8.3. Medical therapy ....................................................................................... 4663 8.4. Indication for intervention .................................................................. 4665 8.4.1. Symptomatic severe aortic stenosis ....................................... 4665 8.4.2. Asymptomatic severe aortic stenosis .................................... 4665 8.4.3. Moderate aortic stenosis ............................................................. 4665 8.5. Treatment options ................................................................................. 4667 8.5.1. The mode of intervention in candidates for a bioprosthesis ................................................................................................. 4667

8.5.1.1. Age and life expectancy ....................................................... 4668 8.5.1.2. Anatomical features .............................................................. 4668 8.5.1.3. Lifetime management ........................................................... 4668 Downloaded from academic.oup.com/eurheartj/article/46/44/4635/8234488 by guest on 07 October 2026