Calcific Aortic Stenosis: Lessons Learned From Experimental and Clinical Studies

• Published in: Arteriosclerosis, thrombosis, and vascular biology Vol. 29; no. 2; pp. 162 - 168
• Main Author: Rajamannan, Nalini M
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Heart Association, Inc 01-02-2009; Lippincott Williams & Wilkins
• Subjects: Animals; Aortic Valve Stenosis - etiology; Aortic Valve Stenosis - genetics; Aortic Valve Stenosis - pathology; Aortic Valve Stenosis - therapy; Atherosclerosis (general aspects, experimental research); Atherosclerosis - complications; Atherosclerosis - pathology; Atherosclerosis - therapy; Biological and medical sciences; Blood and lymphatic vessels; Calcinosis - etiology; Calcinosis - genetics; Calcinosis - pathology; Calcinosis - therapy; Cardiology. Vascular system; Disease Models, Animal; Diseases of the aorta; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Genetic Predisposition to Disease; Heart Valve Prosthesis Implantation; Humans; Hypolipidemic Agents - therapeutic use; Medical sciences; Osteoblasts - pathology; Phenotype; Risk Factors; Severity of Illness Index; Vascular disease; Aortic stenosis; lipids; experimental models; Cardiac valvular disease; Atherosclerosis; pathophysiology atherosclerosis; Cardiovascular disease; valvular heart disease; Experimental study
• ISSN: 1079-5642; 1524-4636
• DOI: 10.1161/ATVBAHA.107.156752

Calcific aortic stenosis is the most common indication for surgical valve replacement in the United States. For years this disease has been described as a passive degenerative process during which serum calcium attaches to the valve surface and binds to the leaflet to form nodules. Therefore, surgical treatment of this disease has been the approach toward relieving outflow obstruction in these patients. Recent studies demonstrate an association between atherosclerosis and its risk factors for aortic valve disease. In 2008, there are increasing number of epidemiology and experimental studies to provide evidence that this disease process is not a passive phenomena. There is an active cellular process that develops within the valve leaflet and causes a regulated bone formation to develop. If the atherosclerotic hypothesis is important in the initiation of aortic stenosis, then treatments used in slowing the progression of atherosclerosis may be effective in patients with aortic valve disease. This review will discuss the pathogenesis and the potential for medical therapy in the management of patients with calcific aortic stenosis by examining the lessons provided from the experimental research.