Key result
A systematic review of 45 studies demonstrated an association between angiodysplasia and aortic stenosis, highlighting mitral and tricuspid regurgitation as potential etiologies for bleeding.
Why the study?
While the link between aortic stenosis and gastrointestinal bleeding is well documented, other valvular diseases are also implicated, warranting investigation into the spectrum of valvular abnormalities and treatment modalities.
What is the relationship between gastrointestinal bleeding and valvular heart disease, and does valvular intervention mitigate bleeding?
Systematic Review
What is the relationship between gastrointestinal bleeding and valvular heart disease, and does valvular intervention mitigate bleeding?
This systematic review confirms the association between gastrointestinal bleeding and aortic stenosis (Heyde syndrome) and highlights mitral and tricuspid regurgitation as potential etiologies that can be managed with valve intervention.
May warrant broader valvular evaluation in angiodysplasia bleeding; reinforces the aortic stenosis link while implicating mitral/tricuspid regurgitation.
Background: Gastrointestinal angiodysplasia is a significant vascular anomaly characterized by dilated, tortuous blood vessels in the gastrointestinal tract. The current literature extensively documents the association between angiodysplasia and aortic stenosis, known as Heyde syndrome, characterized by the triad of aortic stenosis, GIB, and acquired von Willebrand syndrome. However, other valvular diseases, including mitral and tricuspid regurgitation, have also been implicated. This comprehensive systematic review aims to investigate the spectrum of valvular abnormalities, exploring the intricate mechanisms by which they contribute to gastrointestinal bleeding. Furthermore, it will evaluate the available surgical and nonsurgical treatment modalities, assessing their efficacy in mitigating the incidence of such bleeding. Methods: A comprehensive search of the Pubmed/MEDLINE database was conducted to identify relevant studies to retrieve relevant articles from August 2014 to August 2024. A combination of Medical Subject Heading (MeSH) terms and text words related to cardiac valvular diseases and GIB were used. MeSH terms included “gastrointestinal bleeding”, “heart valve diseases”, “hematochezia”, “heart valve prosthesis”, “bioprosthesis”, “native valve diseases”, and “mechanical valve”. Results: Forty-five papers met the inclusion criteria. Twenty-seven studies covered GIB in aortic valve disease, ten on mitral valve disease, two on tricuspid valve disease, and six on multiple valves. Conclusions: This systematic review demonstrates the association between angiodysplasia and aortic stenosis and highlights mitral regurgitation and tricuspid regurgitation as potential etiologies. Definitive management with valvuloplasty or valve replacement is vital to preventing the onset or recurrence of GIB in patients with valvular disease.
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Gries et al. (2024) conducted a systematic review in Valvular heart disease and gastrointestinal bleeding. Valvular heart disease was evaluated on Gastrointestinal bleeding. A systematic review of 45 studies demonstrated an association between angiodysplasia and aortic stenosis, highlighting mitral and tricuspid regurgitation as potential etiologies for bleeding.
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