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Diagnosis and management of aortic valve stenosis in patients with heart failure

Vasileios Kamperidis1,2, Victoria Delgado1, Nicolas M van Mieghem3

  • 1Department of Cardiology, Heart and Lung Centrum, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.

European Journal of Heart Failure
|January 5, 2016
PubMed

Insights

Heart failure complicates aortic stenosis, the most common heart valve disease in aging Western populations. This review covers diagnosis, imaging, and treatment for patients with severe aortic stenosis and heart failure.

Area of Science:

  • Cardiology
  • Valvular Heart Disease
  • Heart Failure

Background:

  • Aortic stenosis (AS) is the most common degenerative valvular heart disease in Western countries.
  • Its prevalence increases with population aging.
  • Heart failure (HF) affects up to 25% of severe AS patients, presenting diagnostic and management challenges.

Purpose of the Study:

  • To review the prevalence of HF in severe AS patients.
  • To discuss diagnostic challenges and advances in multimodality imaging for identifying suitable candidates for aortic valve replacement.
  • To summarize current evidence on managing AS patients with HF.

Main Methods:

  • Literature review focusing on prevalence, diagnosis, imaging, and management.
  • Analysis of multimodality imaging techniques for patient selection.
  • Synthesis of current clinical evidence and guidelines.

Main Results:

  • Severe AS is a significant cause of HF, particularly in the elderly.
  • Multimodality imaging offers improved diagnostic accuracy and patient stratification.
  • Optimal management strategies are evolving, balancing risks and benefits of interventions.

Conclusions:

  • HF in severe AS requires careful diagnostic evaluation and tailored management.
  • Advanced imaging plays a crucial role in guiding treatment decisions for aortic valve replacement.
  • Further research is needed to refine management protocols for this complex patient group.

Keywords:
Aortic stenosisHeart failureMulti-detector computed tomographyStress echocardiographyTranscatheter aortic valve replacement

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