European Heart Journal (2023) 44, 3178–3180 EDITORIAL
https://doi.org/10.1093/eurheartj/ehad277
Heyde syndrome: treat aortic valve disease to
stop gastrointestinal bleeding?
Lara Waldschmidt1,2 and Moritz Seiffert 1,2
*
1
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany; and 2DZHK
(German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Germany
Online publish-ahead-of-print 5 July 2023
This editorial refers to ‘Effectiveness of aortic valve replacement in Heyde syndrome: a meta-analysis’, by L.C.M.J. Golstein et al., https://doi.
org/10.1093/eurheartj/ehad340.
Graphical Abstract
aVWS
HMWM
Aortic stenosis TAVI/SAVR
High shear GIB
stress
Angiodysplasia
Heyde syndrome is the association of aortic stenosis and gastrointestinal bleeding (GIB) from angiodysplasia, accompanied by acquired von Willebrand
syndrome (aVWS) leading to decreased levels of high molecular weight multimers (HMWMs). The development of angiodysplasia in the gastrointestinal
tract remains unclear. Mucosal ischaemia, high shear stress resulting from turbulence caused by the stenotic valve, and the presence of aVWS may be
involved. Aortic valve replacement through surgical replacement (SAVR) or transcatheter aortic valve implantation (TAVI) leads to decreased shear
stress and may resolve GIB through recovery of aVWS and potentially dissolving angiodysplasias.
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