Key result
Novel biomarkers may better identify LVH-to-HF transition to guide AVR timing in AS.
Why the study?
Current guidelines recommend aortic valve replacement in severe aortic stenosis based on symptoms or impaired ejection fraction, but symptoms are subjective and ejection fraction impairment is often irreversible.
Novel biomarkers may offer a more objective and earlier indication of left ventricular decompensation in aortic stenosis compared to current symptom and ejection fraction criteria, potentially optimizing the timing of aortic valve replacement.
May refine AS risk stratification; leaves open prospective validation before guiding AVR timing.
Calcified aortic stenosis is a condition that affects the valve and the myocardium. As the valve narrows, left ventricular hypertrophy occurs initially as an adaptive mechanism to maintain cardiac output. Ultimately, the ventricle decompensates and patients transition towards heart failure and adverse events. Current guidelines recommend aortic valve replacement in patients with severe aortic stenosis and evidence of decompensation based on either symptoms or an impaired ejection fraction <50%. However, symptoms can be subjective and correlate only modestly with the severity of aortic stenosis whilst impaired ejection fraction is an advanced manifestation and often irreversible. In this review, the authors will discuss the pathophysiology of left ventricular hypertrophy and the transition to heart failure. Subsequently, the authors will examine novel biomarkers that may better identify the transition from hypertrophy to heart failure and therefore guide the optimal timing for aortic valve replacement.
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Vassiliou et al. (2014) conducted a review in Aortic stenosis. Novel biomarkers was evaluated. Novel biomarkers may better identify the transition from left ventricular hypertrophy to heart failure in patients with aortic stenosis, helping to guide the optimal timing for aortic valve replacement.
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