Mihatov Nino, Pibarot Philippe
Division of Cardiology, New York-Presbyterian Brooklyn Methodist Hospital & Weill Cornell Medical College, New York, New York, United States.
Department of Cardiology, Québec Heart & Lung Institute - Laval University, Québec Canada. Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Université Laval, Québec City, Québec, Canada.
Struct Heart. 2024 Jun 26;8(6):100336. doi: 10.1016/j.shj.2024.100336. eCollection 2024 Nov.
The clinical implications of severe aortic stenosis have been well established. Understanding of moderate aortic stenosis, however, continues to evolve. Athough moderate aortic stenosis may be less clinically impactful in patients with normal ventricular function, it may carry prognostic significance in those patients with a ventricle exhibiting signs of cardiac damage. Moderate aortic stenosis in the presence of cardiac damage or dysfunction may be prognostically comparable to that of severe aortic stenosis. Extravalvular risk parameters can inform aortic stenosis risk stratification. Three ongoing trials seek to evaluate transcatheter aortic valve assessment in patients with moderate aortic stenosis and signs of cardiac damage or left ventricular dysfunction.
重度主动脉瓣狭窄的临床意义已得到充分证实。然而，对于中度主动脉瓣狭窄的认识仍在不断发展。虽然中度主动脉瓣狭窄对心室功能正常的患者临床影响可能较小，但对于那些心室出现心脏损伤迹象的患者，它可能具有预后意义。存在心脏损伤或功能障碍时的中度主动脉瓣狭窄在预后方面可能与重度主动脉瓣狭窄相当。瓣膜外风险参数可为主动脉瓣狭窄风险分层提供依据。三项正在进行的试验旨在评估中度主动脉瓣狭窄且有心脏损伤迹象或左心室功能障碍患者的经导管主动脉瓣评估情况。
