Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

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.

Original publication

DOI

10.1586/14779072.2014.923307

Type

Journal article

Journal

Expert rev cardiovasc ther

Publication Date

07/2014

Volume

12

Pages

901 - 912

Keywords

aortic stenosis, cardiac MRI, echocardiography, left ventricular decompensation, left ventricular hypertrophy, myocardial T1 mapping, myocardial fibrosis, myocyte death, tissue Doppler imaging, Aortic Valve Stenosis, Biomarkers, Heart Failure, Humans, Hypertrophy, Left Ventricular, Severity of Illness Index