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Published on: October 20, 2023
Unraveling the Link Between Aortic Stenosis and Atherosclerosis: What Have We Learned?
Corina Cinezan1,2, Camelia Bianca Rus1,2,3, Ioana Tiberia Ilias1,2
1Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.
Insights
Aortic stenosis (AS) shares mechanisms with atherosclerosis, but treatments differ. Early detection and intervention for AS are crucial, drawing from cardiovascular disease insights.
Area of Science:
- Cardiology
- Vascular Biology
- Translational Medicine
Background:
- Aortic stenosis (AS) was traditionally viewed as a degenerative condition, primarily affecting older men.
- Emerging evidence links AS to atherosclerosis, sharing risk factors and pathological pathways.
- This suggests potential for early prevention of aortic stenosis.
Purpose of the Study:
- To review the literature on shared mechanisms between AS and atherosclerosis.
- To explore common risk factors, pathogenic pathways, and therapeutic strategies.
- To evaluate the efficacy of atherosclerosis treatments in managing AS.
Main Methods:
- Narrative review of existing literature.
- Synthesis of clinical trials and translational studies.
- Focus on inflammatory, lipid-mediated, and calcific pathways.
Main Results:
- AS and atherosclerosis share inflammatory, lipid, and calcific mechanisms.
- Atherosclerosis treatments like statins have inconsistent benefits for AS.
- New therapies aim to delay aortic valve replacement and reduce morbidity.
Conclusions:
- Despite shared pathogenesis, AS and atherosclerosis exhibit different clinical courses and treatment responses.
- Understanding the overlap's limitations and potential can guide future AS strategies.
- Early AS detection and targeted interventions are key, informed by cardiovascular disease management.
Abstract:
Background: Aortic stenosis (AS) has long been considered a degenerative disease and is typically diagnosed in older men at an advanced stage. However, accumulating evidence has highlighted the similarities between AS and atherosclerosis, particularly regarding shared risk factors and overlapping pathophysiological mechanisms. This connection has led to a paradigm shift, suggesting that AS may be preventable in its early stages. Methods: This narrative review synthesizes the existing literature exploring the parallels between AS and atherosclerosis, focusing on common risk factors, pathogenic pathways, and evolving therapeutic strategies. Clinical trials and translational studies were examined to assess the effectiveness of atherosclerosis-based treatments for AS. Results: Multiple studies have confirmed the shared inflammatory, lipid-mediated, and calcific mechanisms of AS and atherosclerosis. Despite these similarities, therapeutic strategies effective in atherosclerosis, such as statin therapy, have not consistently shown benefits in AS. New medical approaches aim to delay aortic valve replacement and reduce the associated morbidity. The partially overlapping pathogenesis continues to guide future research. Conclusions: While AS and atherosclerosis share several pathogenic features, their clinical courses and treatment responses diverge. Understanding the limits and potential of their overlap may inform future preventive and therapeutic strategies. Earlier detection and targeted intervention in AS remain key goals, drawing on insights from cardiovascular disease management.
Related Concept Videos
Atherosclerosis I: Introduction
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
Mitral Stenosis I: Introduction
Coronary Artery Disease II: Pathophysiology
Aortic Regurgitation I: Introduction
Coronary Artery Disease I: Introduction

