Ito Saki, Oh Jae K
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Korean Circ J. 2022 Oct;52(10):721-736. doi: 10.4070/kcj.2022.0234.
Aortic stenosis (AS) is one of the most common valvular heart diseases and the number of patients with AS is expected to increase globally as the older population is growing fast. Since the majority of patients are elderly, AS is no longer a simple valvular heart disease of left ventricular outflow obstruction but is accompanied by other cardiac and comorbid conditions. Because of the significant variations of the disease, identifying patients at high risk and even earlier detection of patients with AS before developing symptomatic severe AS is becoming increasingly important. With the proven of efficacy and safety of transcatheter aortic valve replacement (TAVR) in the severe AS population, there is a growing interest in applying TAVR in those with less than severe AS. A medical therapy to reduce or prevent the progression in AS is actively investigated by several randomized control trials. In this review, we will summarize the most recent findings in AS and discuss potential future management strategies of patients with AS.
主动脉瓣狭窄(AS)是最常见的心脏瓣膜疾病之一,随着老年人口快速增长,全球AS患者数量预计将会增加。由于大多数患者为老年人,AS不再仅仅是一种单纯的左心室流出道梗阻性心脏瓣膜病,而是伴有其他心脏及合并症。鉴于该疾病存在显著差异,识别高危患者以及在出现症状性重度AS之前更早地检测出AS患者变得越来越重要。随着经导管主动脉瓣置换术(TAVR)在重度AS人群中的疗效和安全性得到证实,人们越来越有兴趣将TAVR应用于非重度AS患者。多项随机对照试验正在积极研究一种可减少或预防AS进展的药物治疗方法。在本综述中,我们将总结AS的最新研究结果,并讨论AS患者未来潜在的管理策略。