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Published on: October 20, 2023
Aortic Stenosis Prevention: Is a New Cardiovascular Disease Paradigm Coming of Age?
Antonios Halapas1, Dennis V Cokkinos2
1Department of Interventional Cardiologist and THV Program, Athens Medical Center, 11526 Athens, Greece.
Insights
Calcific aortic stenosis (CAS) is a common cardiovascular issue in older adults. This review details CAS pathophysiology and explores preventive strategies beyond surgery.
Area of Science:
- Cardiovascular Medicine
- Geriatrics
- Pathophysiology
Background:
- Calcific aortic stenosis (CAS) affects over 30% of individuals over 60.
- It is the third most common cardiovascular disorder in the elderly.
- CAS involves complex fibro-calcific remodeling of aortic valve leaflets.
Purpose of the Study:
- To present a comprehensive review of CAS pathophysiology.
- To explore potential preventive strategies for CAS.
- To discuss alternatives to surgical and interventional treatments for CAS.
Main Methods:
- Literature review of current research on CAS.
- Analysis of pathophysiological mechanisms.
- Identification and evaluation of preventive strategies.
Main Results:
- CAS is an active, multifactorial process.
- Key factors include hemodynamics, genetics, inflammation, and osteoblastic transformation.
- Several preventive strategies are under investigation.
Conclusions:
- Understanding CAS mechanisms is crucial for developing new treatments.
- Preventive approaches may offer alternatives to current interventions.
- Further research is needed to validate preventive strategies.
Abstract:
Calcific aortic stenosis (CAS) is currently recognized as the third most frequent cardiovascular disorder in persons aged above 60 years, after atherosclerotic disease and hypertension, and together with its precursor aortic sclerosis it has been found in more than 30% of elderly individuals. CAS is an active multifactorial process characterized by a progressive fibro-calcific remodeling and thickening of the AV leaflets caused by hemodynamic flow factors, genetic factors, lipoprotein deposition, oxidation, chronic inflammation, immunomodulators, and finally osteoblastic transformation of cardiac. Herein a comprehensive state-of-the-art paper is presented regarding the underlying pathophysiological mechanisms of CAS and the potential preventive strategies as an alternative to surgical and interventional treatment.
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