Markers of left ventricular decompensation in aortic stenosis

Calvin WL Chin, Vassilios Vassiliou, William SA Jenkins, Sanjay K Prasad, David E Newby, Marc R Dweck

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

Abstract

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 languageEnglish
Pages (from-to)901-912
Number of pages12
JournalExpert Review of Cardiovascular Therapy
Volume12
Issue number7
Early online date28 May 2014
DOIs
Publication statusPublished - 1 Jul 2014

Keywords

  • aortic stenosis
  • cardiac MRI
  • echocardiography
  • left ventricular decompensation
  • left ventricular hypertrophy
  • myocardial fibrosis
  • myocardial T1 mapping
  • myocyte death
  • tissue Doppler imaging

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