scholarly journals The Progression of Aortic Sclerosis to Aortic Stenosis

Aortic Valve ◽  
10.5772/21562 ◽  
2011 ◽  
Author(s):  
Uzma Jalal Serageldin Raslan ◽  
Farouk Mookadam
Keyword(s):  
Aortic Stenosis ◽  
Aortic Sclerosis

scholarly journals Prevalence and risk factors of aortic stenosis and aortic sclerosis: a 21-year follow-up of middle-aged men

2019 ◽  
Vol 54 (2) ◽  
pp. 115-123
Author(s):  
Silvana Kontogeorgos ◽  
Erik Thunström ◽  
Carmen Basic ◽  
Per-Olof Hansson ◽  
You Zhong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Stenosis ◽  
Middle Aged ◽  
Aortic Sclerosis

45 EVALUATION OF RISK FACTORS FOR PROGRESSION OF AORTIC SCLEROSIS TO AORTIC STENOSIS:

2005 ◽  
Vol 53 (1) ◽  
pp. S261.5-S261
Author(s):  
U. Patel ◽  
A. Gupta ◽  
S. Jain ◽  
S. Niranjan ◽  
A. Khanna
Keyword(s):  
Risk Factors ◽  
Aortic Stenosis ◽  
Aortic Sclerosis

scholarly journals Aortic stenosis: From diagnosis to optimal treatment

2008 ◽  
Vol 136 (3-4) ◽  
pp. 176-180 ◽  
Author(s):  
Dragan Tavciovski ◽  
Zaklina Davicevic
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Preoperative Evaluation ◽  
Bone Matrix ◽  
Inflammatory Cells ◽  
Optimal Time ◽  
Heart Catheterization ◽  
Exercise Tests ◽  
Aortic Sclerosis

Aortic stenosis is the most frequent valvular heart disease. Aortic sclerosis is the first characteristic lesion of the cusps, which is considered today as the process similar to atherosclerosis. Progression of the disease is an active process leading to forming of bone matrix and heavily calcified stiff cusps by inflammatory cells and osteopontin. It is a chronic, progressive disease which can remain asymptomatic for a long time even in the presence of severe aortic stenosis. Proper physical examination remains an essential diagnostic tool in aortic stenosis. Recognition of characteristic systolic murmur draws attention and guides further diagnosis in the right direction. Doppler echocardiography is an ideal tool to confirm diagnosis. It is well known that exercise tests help in stratification risk of asymptomatic aortic stenosis. Serial measurements of brain natriuretic peptide during a follow-up period may help to identify the optimal time for surgery. Heart catheterization is mostly restricted to preoperative evaluation of coronary arteries rather than to evaluation of the valve lesion itself. Currently, there is no ideal medical treatment for slowing down the disease progression. The first results about the effect of ACE inhibitors and statins in aortic sclerosis and stenosis are encouraging, but there is still not enough evidence. Onset symptoms based on current ACC/AHA/ESC recommendations are I class indication for aortic valve replacement. Aortic valve can be replaced with a biological or prosthetic valve. There is a possibility of percutaneous aortic valve implantation and transapical operation for patients that are contraindicated for standard cardiac surgery.

scholarly journals Medical treatments in aortic stenosis: Role of statins and angiotensin-converting enzyme inhibitors

2010 ◽  
Vol 63 (1-2) ◽  
pp. 82-85 ◽  
Author(s):  
Zaklina Davicevic ◽  
Dragan Tavciovski ◽  
Radomir Matunovic
Keyword(s):  
Aortic Stenosis ◽  
Disease Progression ◽  
Enzyme Inhibitors ◽  
Severe Aortic Stenosis ◽  
Bone Matrix ◽  
Valve Surgery ◽  
Western World ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Aortic Sclerosis

Calcific arotic stenosis and atherosclerosis. Aortic stenosis is the most frequent valvular heart disease in-western world and its incidence continues to rise. Aortic sclerosis is the first characteristic lesion of the cusps, which is today considered a process similar to atherosclerosis. The progression of the disease is an active process leading to forming of bone matrix and heavily calcified stiff cusps by inflammatory cells and osteopontin. Aortic stenosis is a chronic, progressive disease which can remain asymptomatic for a long time even in the presence of severe aortic stenosis. Medical treatment for aortic stenosis. The need for alternative to aortic valve surgery is highlighted by increasing longevity of the population and new therapeutic strategies to limit disease progression are needed to delay or potentially avoid, the need for valve surgery. Currently, there are no established disease modifying treatments in regard to the progression of aortic stenosis. The first results about influence of angiotenzin-converting enzyme inhibitors and statins on aortic sclerosis and stenosis progression are promising. Statins are likely to reduce cardiovascular events rather than disease progression, but may be potentially a valuable preventive treatment in these patients. The prejudice against the use of angiotenzin-converting enzyme inhibitors by patients with aortic stenosis is changing. The cautious use of angiotenzin-converting enzyme inhibition by patients with concomitant hypertension, coronary artery disease, and heart failure seems appropriate. Definite evidence from large clinical trials is awaited.

scholarly journals Valve area and the risk of overestimating aortic stenosis

Heart ◽  
2019 ◽  
pp. heartjnl-2018-314482 ◽  
Author(s):  
Ana González-Mansilla ◽  
Pablo Martinez-Legazpi ◽  
Andrea Prieto ◽  
Elena Gomá ◽  
Pilar Haurigot ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Stenosis ◽  
Normal Values ◽  
Small Body ◽  
Velocity Ratio ◽  
Large Population ◽  
Aortic Valve Area ◽  
Morphological Findings ◽  
Aortic Sclerosis ◽  
Valve Area

ObjectiveTo obtain reference values of aortic valve area (AVA) in a large population and to infer the risk of overestimating aortic stenosis (AS) when focusing on flow-corrected indices of severity.MethodsWe prospectively measured indices of AS in all consecutive echocardiograms performed in a large referral cardiac imaging laboratory for 1 year. We specifically analysed the distribution of AVA, indexed AVA and velocity ratio (Vratio) in patients with and without AS, the latter defined as the coexistence of valvular outflow obstruction (Vmax ≥2.5 m/s) and morphological findings of valve degeneration.Results16 156 echocardiograms were analysed, 14 669 of which did not show valvular obstruction (peak jet velocity <2.5 m/s). In the latter group, AVA was 2.6±0.7 cm2 in 8190 studies with normal valves and 2.3±0.7 cm2 in 6479 studies with aortic sclerosis (AScl). There was a relatively wide overlap between values of AVA, indexed AVA and velocity ratio between studies of patients with AScl and AS. Values of AVA ≤1.0 cm2 were found in 0.5% of studies with normal valves and 1.8% of studies with AScl. These proportions were 3.1% and 9.3% for AVA ≤1.5 cm2, respectively. Vratio ≤0.25 were found in 0.1% of patients without obstruction. Risk factors for a small AVA in patients without obstruction were AScl, female sex, small body surface area, low ejection fraction and mitral regurgitation.ConclusionsNormal values of continuity-equation derived AVA are smaller than previously considered. AVA values below cutoffs of moderate or severe AS can be found in patients without the disease. Flow-corrected indices may overestimate AS in patients with low gradients, particularly in the presence of well-identified risk factors.

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