Abstract
I am pleased to introduce the third issue in the life of the Journal of the Heart Valve Society, which is actually the second issue of Volume 2 published in 2025. This issue highlights major innovations in mitral, tricuspid, and multiple valve diseases.
Although aortic valve disease is responsible for the largest proportion of hospitalizations and valve procedures in high-income countries, mitral valve disease is the most prevalent worldwide, in particular because of the burden of rheumatic heart disease in low-income countries. Furthermore, tricuspid valve disease, which has been neglected from both a research and clinical standpoint for a long time, is now the focus of intense research and innovations. Finally, although multiple and mixed valvular disease is highly prevalent in the general population, 1 there is a striking lack of data and thus guidelines recommendations, essentially because patients with this condition have been excluded from the trials and registries that generally focus on single valve lesions. In this third issue of the Journal, we explore the remarkable progress in research and care of mitral, tricuspid, and multiple valve diseases. This very rich issue features 3 original research articles, 7 state-of-the-art reviews, 1 viewpoint, and 1 case report.
In an original research article, Daria Evensen, and colleagues from the University of Oslo compare different osteogenic media to induce aortic valve calcification in vitro in cell cultures. This methodologic research study provides important new insights for the basic researchers investigating calcific aortic valve disease.
In another original research article, Michael Hagler, Jordan Miller, and colleagues from the Mayo Clinic in Rochester used a cutting-edge approach, combining high-throughput sequencing of RNA and microRNA from human mitral valve tissue to understand the mechanism of myxomatous mitral valve disease. In particular, this very important study uncovered a strong association between this disease and disruptions in the circadian rhythm, which is an entirely novel finding.
An elegant and provocative research study by Bram Roosens, Bernard Cosyns, Gilbert Habib, and colleagues from University of Brussels in Belgium and Marseille in France examined the safety of antithrombotic therapy in the context of infective endocarditis, which remains a controversial topic. The results of this study actually challenge the traditional caution against using antithrombotic therapy in patients with endocarditis.
In this issue, we are also featuring a fascinating review article by Simon Houle, Jonathan Beaudoin, and colleagues from Laval University in Québec and Harvard Medical School in Boston, which focuses on mitral valve remodeling in functional mitral regurgitation. The key takeaway of this review is that, in this complex and multifaceted valve disease, the mitral valve is not just a passive player in heart failure, as previously believed; but it actively remodels in response to changes in the left ventricle and atrium.
A comprehensive review article by Andrea Faggiano, Gregg Pressman, and colleagues from several institutions in Italy, South Korea, and the USA presents an overview of the clinical and hemodynamic implications of mitral annular calcification, which is a frequent and not yet well understood condition. This condition is more than just a structural anomaly; it is a significant marker for various cardiovascular risks and it has a direct impact on patient's hemodynamic and clinical outcomes.
In the first inaugural issue of the JHVS, we published an important initiative of the Heart Valve Society (HVS) regarding a Multicenter Aortic Valve Registry and Database. 2 In the present issue, the spotlight is now on the Mitral and Tricuspid Valve Database of the HVS. Kevin Veen and colleagues from Erasmus University Medical Center in the Netherlands, Columbia University Irving Medical Center, Michigan Technological University in Houston, Piedmont Heart Institute in Atlanta, Leiden University Medical Center, University of Brescia in Italy and several other institutions, indeed present a comprehensive overview of the HVS Mitral and Tricuspid Valve Database. This initiative is a collaborative effort involving cardiologists, surgeons, and scientists from multiple institutions across the globe, all working to elevate the standard of care for heart valve patients. The editors of the JHVS strongly encourage investigators throughout the world to join this initiative.
This issue presents a compelling review article by Zahra Keshavarz-Motamed from McMaster University in Hamilton, Canada, on transforming cardiac care for aortic valve disease patients undergoing transcatheter aortic valve replacement (TAVR) using personalized simulations and Artificial Intelligence. This review article provides a glimpse to the future and promising perspectives on the application of Artificial Intelligence to optimize the outcomes of TAVR.
With a state-of-the-art review by Rafael Jiménez-Arjona, Marta Sitges, and colleagues from Hospital Clinic in Barcelona, Spain, we dive into the emerging roles of cardiac magnetic resonance and cardiac computed tomography in the evaluation of patients with tricuspid regurgitation eligible for percutaneous valve interventions. Tricuspid regurgitation has evolved from being seen as a benign and neglected condition to one with significant clinical implications. This shift is largely due to the development of transcatheter intervention techniques, which require comprehensive imaging for optimal outcomes.
A state-of-the-art review article by Miho Fukui and Joao Cavalcante from the Minneapolis Heart Institute stresses the importance of not only focusing on the grading of the severity of the valve lesion, per se, but also incorporating cardiac damage staging into routine practice to better assess the broader cardiac health issues associated with heart valve disease. This review article nicely complements the viewpoint article published by Erwan Salaun and Josep Rodés-Cabau from Laval University on cardiac damage staging in the first inaugural issue of the Journal. 3
Our issue also features a very comprehensive and timely state-of-the-art review by Elsa Richard de Vesvrotte, Théo Pezel, and colleagues from University Hospital Lariboisière in Paris, France, on multiple and mixed valve disease (MMVD). This review underscores the need for a more holistic approach to diagnosing and managing MMVD. The future in this field lies in combined imaging, advanced techniques, and collaborative research and care. The authors also present two ongoing large-scale studies (EACVI-MMVD and MULTIVALVE) designed to address the major knowledge gaps in the field of MMVD.
In this issue, we are publishing an interesting viewpoint by Anze Djordjevic and colleagues from the University Hospital Dubrava, in Zagreb, Croatia, who actually challenge current guidelines for the management of aortic regurgitation, advocating for earlier intervention. And finally, Calvin Diep and colleagues from Centre Hospitalier de L’Université de Montréal, Canada, present a fascinating case report of a type A aortic dissection 1 week after a TAVR procedure due to a migrated self-expanding valve. This is a serious complication, emphasizing the need for careful post-operative management.
I am convinced that you will enjoy and learn a lot by reading this third issue that we are publishing today. We also recently published the supplemental issue featuring the abstracts that have been presented at the 2025 Heart Valve Society meeting in Cairo in April. Looking ahead, our forthcoming issues will focus on: (i) One World Many Heart Valve Voices, and (ii) Rheumatic Heart Valve Disease. So, our next issues will address underrepresented, underserved, and/or undertreated populations with heart valve disease. We welcome any submission of original research, review, or viewpoint articles on these important and timely topics.