PMID- 24314166
OWN - NLM
STAT- MEDLINE
DCOM- 20140710
LR  - 20131209
IS  - 0578-1426 (Print)
IS  - 0578-1426 (Linking)
VI  - 52
IP  - 9
DP  - 2013 Sep
TI  - [The clinical features of gastrointestinal bleeding complicating aortic 
      stenosis].
PG  - 753-6
AB  - OBJECTIVE: To deepen the understanding about Heyde's syndrome by investigating 
      the clinical characteristics and prognosis of the patients with aortic valve 
      stenosis complicating with gastrointestinal bleeding. METHODS: Patients with 
      aortic valve stenosis and gastrointestinal bleeding coincidently admitted to our 
      hospital from 2001 to 2011 were retrieved and analyzed. RESULTS: In all the 443 
      157 in-patients, 474 patients were diagnosed with aortic valve stenosis (0.11%, 
      474/443 157) and 14 patients (9 males and 5 females, aged 53-87 years old) with 
      gastrointestinal bleeding coincidently(2.95%, 14/474). Among the 14 patients, 3 
      were moderate aortic valve stenosis, 11 severe aortic valve stenosis. The aortic 
      valve peak flow velocity was 324-709 (480.54 +/- 188.25) cm/s and the mean aortic 
      valve pressure gradient was 21.04-91.56 (56.93 +/- 29.90) mm Hg(1 mm Hg = 0.133 
      kPa).Heavy gastrointestinal bleeding was manifested in all the 14 patients with 1 
      of haematemesis and 13 of hematochezia.Hemoglobin (Hb) and red blood cell (RBC) 
      count were significantly lower than the normal range [(69 +/- 28) g/L and (2.71 +/- 
      2.04)x10(12)/L, P < 0.05]. Their mean corpuscular volume(MCV), mean corpuscular 
      hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), platelet(PLT) 
      count, prothrombin time (PT) and international normalized ratio (INR) were in 
      normal range [(90.21 +/- 2.94) fl, (29.39 +/- 1.99) pg, (327.57 +/- 14.82) g/L, (185.13 
      +/- 22.55)x10(9)/L, (11.4 +/- 1.04) s and 1.22 +/- 0.44, respectively]. Among all the 
      14 patients, 13 were over 65 years old and they all accepted gastrointestinal 
      imaging (13/14).Vascular malformation of intestine was found in 6 patients with 4 
      lesions located in descending colon and 2 located in sigmoid colon.Hemorrhage 
      foci were found in 2 patients with one of colon cancer, and another of duodenal 
      ulcer, while no definite hemorrhage foci were found in the other 11 patients. A 
      total of 6 patients with severe aortic valve stenosis underwent aortic valve 
      replacement (AVR) successfully (6/11) and no recurrent gastrointestinal bleeding 
      was ever found. Conservative treatment was performed in the other 5 patients with 
      severe aortic valve stenosis (5/11) and resulted in sudden death in 2 patients 
      (2/5). CONCLUSIONS: Prompt echocardiography and gastrointestinal endoscopy should 
      be performed in the elderly patients with obscure gastrointestinal bleeding to 
      facilitate the early diagnosis and treatment of Heyde's syndrome. AVR is a 
      fundamental procedure to improve the prognosis of Heyde's syndrome.
FAU - Liu, Fang
AU  - Liu F
AD  - Department of Geriatric, the First Hospital of Peking University, Beijing 100034, 
      China.
FAU - Jiang, Cheng-gong
AU  - Jiang CG
FAU - Feng, Xue-ru
AU  - Feng XR
FAU - Liu, Mei-lin
AU  - Liu ML
LA  - chi
PT  - English Abstract
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Zhonghua Nei Ke Za Zhi
JT  - Zhonghua nei ke za zhi
JID - 16210490R
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/*complications
MH  - Female
MH  - Gastrointestinal Hemorrhage/*complications
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
EDAT- 2013/12/10 06:00
MHDA- 2014/07/11 06:00
CRDT- 2013/12/10 06:00
PHST- 2013/12/10 06:00 [entrez]
PHST- 2013/12/10 06:00 [pubmed]
PHST- 2014/07/11 06:00 [medline]
PST - ppublish
SO  - Zhonghua Nei Ke Za Zhi. 2013 Sep;52(9):753-6.