Medical Treatment of Aortic Stenosis.

Guillaume Marquis-Gravel, Björn Redfors, Martin B Leon, Philippe Généreux

Journal: Circulation 2017;134(22):1766-1784

PMID: 27895025

Abstract

Untreated, severe, symptomatic aortic stenosis is associated with a dismal prognosis. The only treatment shown to improve survival is aortic valve replacement; however, before symptoms occur, aortic stenosis is preceded by a silent, latent phase characterized by a slow progression at the molecular, cellular, and tissue levels. In theory, specific medical therapy should halt aortic stenosis progression, reduce its hemodynamic repercussions on left ventricular function and remodeling, and improve clinical outcomes. In the present report, we performed a systematic review of studies focusing on the medical treatment of patients with aortic stenosis. Lipid-lowering therapy, antihypertensive drugs, and anticalcific therapy have been the main drug classes studied in this setting and are reviewed in depth. A critical appraisal of the preclinical and clinical evidence is provided, and future research avenues are presented.

© 2016 American Heart Association, Inc.

Address: From Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, QC, Canada (G.M.-G., P.G.); Cardiovascular Research Foundation, New York, NY (B.R., M.B.L., P.G.); Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); Columbia University Medical Center, New York, NY (M.B.L., P.G.); and Morristown Medical Center, Morristown, NJ (P.G.).; From Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, QC, Canada (G.M.-G., P.G.); Cardiovascular Research Foundation, New York, NY (B.R., M.B.L., P.G.); Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); Columbia University Medical Center, New York, NY (M.B.L., P.G.); and Morristown Medical Center, Morristown, NJ (P.G.). [email protected].
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