Division of Cardiology, Mount Sinai Heart Institute, Columbia University, Miami Beach, FL 33140, USA.
J Cardiovasc Pharmacol Ther. 2012 Jun;17(2):133-8. doi: 10.1177/1074248411416504. Epub 2011 Aug 9.
Severe aortic stenosis due to calcification of the aortic valve is the most common indication for aortic valve replacement in the United States and Europe. The standard therapy for symptomatic patients with severe aortic stenosis is replacement of the valve. Some of the risk factors and pathophysiologic mechanisms in atherosclerosis play an important role in the development of calcific aortic stenosis. In the last few years, there have been an increased number of publications regarding the use of medications in order to delay the progression of aortic stenosis. These medications include statins, angiotensin-converting enzyme inhibitors, and biphosphanates. This article describes and summarizes some of the medical approaches that have emerged to alter the progression of aortic stenosis. Currently, only statins have been evaluated in randomized, placebo-control trials. Furthermore, statins have not proven to alter the progression of aortic stenosis. Ongoing randomized controlled trials with the use of angiotensin-converting enzyme inhibitors, statins, and biphosphonates will determine the use of these medications to delay the progression of aortic stenosis.
在美国和欧洲，因主动脉瓣钙化导致的严重主动脉瓣狭窄是主动脉瓣置换术最常见的适应证。对于有症状的严重主动脉瓣狭窄患者，标准治疗方法是置换瓣膜。动脉粥样硬化的一些危险因素和病理生理机制在钙化性主动脉瓣狭窄的发展中起着重要作用。在过去几年中，有关药物治疗以延缓主动脉瓣狭窄进展的出版物数量有所增加。这些药物包括他汀类药物、血管紧张素转换酶抑制剂和双膦酸盐。本文描述并总结了一些出现的改变主动脉瓣狭窄进展的医学方法。目前，只有他汀类药物在随机、安慰剂对照试验中进行了评估。此外，他汀类药物并未证明可改变主动脉瓣狭窄的进展。正在进行的使用血管紧张素转换酶抑制剂、他汀类药物和双膦酸盐的随机对照试验将确定这些药物在延缓主动脉瓣狭窄进展中的应用。
