Interv Akut Kardiol 2011; 10(5-6): 240-244

Pharmacotherapy and the aortic stenosis progression

Roman Čerbák
Centrum kardiovaskulární a transplantační chirurgie Brno

Aortic stenosis is the most frequent and the most operated heart valve disease. The current capabilities and limitations of the pharmacological

treatment are provided. Hypolipidemic treatment of the disease by means of statins did not fulfill the expectations, the big

randomized studies did not include the earliest stages of the disease. The success in treatment by bisphosphonates was found only in

retrospective studies. The association of bisphosphonates with atrial fibrillation remains uncertain. The treatment of aortic stenosis

by means of inhibitors converting the angiotenzin (ACEi) does not prove definite results and new perspective studies are expected.

Inflammatory changes were detected both in early and in late stages of the disease. The dysfunctional anti-inflammatory mechanism of

the aortic stenosis was found. Currently there is no pharmacotherapy for the disease which would prevent its progression. The surgical

aortic valve replacement (AVR) or transfemoral (transapical) implantation of bioprothesis (TAVI) are the only successfull, validated and

recomended treatment procedures.

Keywords: statins in aortic stenosis, bisphosphonates in aortic stenosis, bisphosphonates and atrial fibrillation, ACEI in aortic stenosis, inflammatory changes in aortic stenosis, ICAM and VCAM and aortic stenosis, dysfunctional mechanisms of anti-inflammation

Published: November 1, 2011  Show citation

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Čerbák R. Pharmacotherapy and the aortic stenosis progression. Interv Akut Kardiol. 2011;10(5-6):240-244.
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References

  1. Mookadam F, Jalal U, Wilansky S. Aortic valve disease: preventable or inevitable? Future Cardiol 2010; 6(6): 777-783. Go to original source... Go to PubMed...
  2. Sell S, Scully RE. Aging ganges in the aortic and mitral valves. Histologic and histochemical studies with observations on the pathogenesis of calcific aortic stenosis and calcification of the mitral anullus. Am J Pathol. 1965; 46: 345-365.
  3. Faggiano P, Aurigemma GP, Rusconi C, Gaasch WH. Progression of valvular aortic stenosis in adults: literature review and clinical implications. Am Heart J. 1996; 132: 408-417. Go to original source... Go to PubMed...
  4. Stewart BF, Siscovick D, Lind BK, et al. Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study. J Am Coll Cardiol. 1997; 29(3): 630-634. Go to original source... Go to PubMed...
  5. O´Brien KD, Kuusisto J, Reichenbach DD, et al. Osteopontin is expressed in human aortic valvular lesions. Circulation 1995; 92(8): 2163-2168. Go to original source... Go to PubMed...
  6. Pedersen TR, Berg K, Cook TJ, et al. Safety and tolerability of cholesterol lowering with simvastatin during 5 years in the Scandinavian Simvastatin Survival Study. Arch Intern Med. 1996; 156(18): 2085-2092. Go to original source...
  7. Nathaniel S, Saligram S, Innasimuthu Al. Aortic stenosis: An update. J Cardiol. 2010; 2(6): 135-139. Go to original source... Go to PubMed...
  8. Poggio P, Grau JB, Field BC, et al. J Cell Physiol 2010 Osteopontin controls endothelial cell migration in vitro and in excised human valvular tissue from patients with Calcific Aortic Stenosis and controls J Cell Physiol 2010, Epub ahead.
  9. Parolari A, Loardi C, Mussoni L, et al. Nonrheumatic calcific aortic stenosis: an overview from basic science to pharmagological prevention Eur J Cardiothorac Surg. 2009; 35(3): 493-504. Go to original source... Go to PubMed...
  10. Novaro GM, Tiong IY, Pearce GL. Effect of hydroxymethylglutaryl coenzyme a reductase inhibitors on the progression of calcific aortic stenosis. Circulation 2001; 104(18): 2205-2209. Go to original source... Go to PubMed...
  11. Bellamy MF, Pellikka PA, Klarich KW. Association of cholesterol levels, hydroxymethylglutaryl coenzyme-A reductase inhibitor treatment, and progression of aortic stenosis in the community. J Am Cardiol 2002; 40(10): 1723-1730. Go to original source... Go to PubMed...
  12. Moura LM, Ramos SF, Zamorano JL. Rosuvastatin affecting aortic valve endothelium to slow the progression of aortic stenosis. J Am Cardiol 2007; 49: 554-561. Go to original source... Go to PubMed...
  13. Pearlman AS. Medical treatment of aortic stenosis: promising, or wishful thinking? J Am Coll Cardiol. 2002; 40(10): 1731-1734. Go to original source... Go to PubMed...
  14. Cowell SJ, Newby DE, Prescott RJ, Bloomfield P, Reid J, Northridge DB, Boon NA. Scottish Aortic Stenosis and Lipid Lowering Trial, Impact on Regression (SALTIRE) Investigators: A randomized trial of intensive lipid-lowering therapy in calcific aortic stenosis. N Engl J Med 2005; 362(23): 2389-2397. Go to original source... Go to PubMed...
  15. Chan KL, Teo K, Dumesnil JG, Ni A, Tam J. ASTRONOMER Investigators: Effect of Lipid lowering with rosuvastatin on progression of aortic stenosis: results of the aortic stenosis progression observation: measuring effects of rosuvastatin (ASTRONOMER) trial. Circulation. 2010; 121(2): 306-314. Go to original source... Go to PubMed...
  16. Gerdts E, Rossebo AB, Pedersen TR, et al. Impact of baseline severity of aortic valve stenosis on effect of intensive lipid lowering therapy (from the SEAS study). Am J Cardiol. 2010; 106(11): 1634-1639. Go to original source... Go to PubMed...
  17. Miller JD, Weiss RM, Serrano KM. Lowering plasma cholesterol levels halts progression of aortic valve disease in mice. Circulation. 2009; 119(20): 2693-2701. Go to original source... Go to PubMed...
  18. Helske S, Otto CM. Lipid lowering in aortic stenosis: still some light at the end of the tunnel? Circulation. 2009; 119(20): 2653-2655. Go to original source... Go to PubMed...
  19. Van der Linde D, Yap SC, van Dijk AP, et al. Effects of Rosuvastatin on Progression of Stenosis in Adult Patients With Congenital Aortic Stenosis (PROCAS Trial). Am J Cardiol. 2011. [Epub ahead of print]. Go to original source... Go to PubMed...
  20. Yetkin E, Waltenberger J. Molecular and cellular mechanisms of aortic stenosis. Int J Cardiol. 2009; 135(1): 4-13. Go to original source... Go to PubMed...
  21. Kaden JJ, Kiliç R, Sarikoç A, et al. Tumor necrosis factor alpha promotes an osteoblast-like phenotype in human aortic valve myofibroblasts: a potential regulatory mechanism of valvular calcification. Int J Mol Med. 2005; 16(5): 869-872. Go to original source...
  22. Skolnick AH, Osranek M, Formica P, Kronzon I. Osteoporosis treatment and progression of aortic stenosis. Am J Cardiol. 2009; 104(1): 122-124. Go to original source... Go to PubMed...
  23. Sterbakova G, Vyskocil V, Linhartova K, et al. Bisphosphonates in calcific aortic stenosis: association with slower progression in mild disease-a pilot retrospective study. Cardiology. 2010; 117(3): 184-189. Go to original source... Go to PubMed...
  24. Innasimuthu AL, Katz WE. Effect of bisphosphonates on the progression of degenerative aortic stenosis. Echocardiography. 2011; 28(1): 1-7. Go to original source... Go to PubMed...
  25. 25. Black DM, Delmas PD, Eastell R, et al. Once-Yearly Zoledronic Acid for Treatment of Postmenopausal Osteoporosis N Engl J Med 2007; 356: 1809-1822.
  26. Heckbert SR, Li G, Cummings SR, et al. Use of alendronate and risk of incident atrial fibrillation in women. Arch Intern Med 2008; 168(8): 826-831. Go to original source... Go to PubMed...
  27. Sorensen HT, Christensen S, Mehnert F. Use of bisphosphonates among women and risk of atrial fibrillation and flutter: population based case-control study. BMJ 2008; 336(7648): 813-816. Go to original source... Go to PubMed...
  28. Huang WF, Tsai YW, Wen YW, et al. Osteoporosis treatment and atrial fibrillation: alendronate versus raloxifene. Menopause 2010; 17(1): 57-63. Go to original source... Go to PubMed...
  29. Howard PA, Barnes BJ, Vacek JL, et al. Impact of bisphosphonates on the risk of atrial fibrillation. Am J Cardiovasc Drug 2010; 10(6): 359-367. Go to original source... Go to PubMed...
  30. Kemeny-Suss N, Kasneci A, Rivas D, et al. Alendronate effects kalcium dynamics in cardiomyocytes in vitro. Vacular Pharmacol 2009; 51(5-6): 350-358. Go to original source... Go to PubMed...
  31. Linhartová K, Veselka J, Sterbáková G, et al. Parathyroid hormone and vitamin D levels are independently associated with calcific aortic stenosis. Circ J. 2008; 72(2): 245-250. Go to original source... Go to PubMed...
  32. Owens DS, Katz R, Takasu J. Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA). Am J Cardiol. 2010; 105(5): 701-708. Go to original source... Go to PubMed...
  33. Elmariah S, Rajamannan NM. Medical therapy for calcific aortic stenosis: the use of bisphosphonates. Cardiology. 2010; 117(3): 229-230. Go to original source... Go to PubMed...
  34. Rosenhek R, Rader F, Loho N. Statins but not angiotensin-converting enzyme inhibitors delay progression of aortic stenosis. Circulation 2004; 110(10): 1291-1295. Go to original source... Go to PubMed...
  35. O'Brien KD, Probstfield JL, Caulfield MT. Angiotensin-converting enzyme inhibitors and change in aortic valve calcium Arch Intern Med. 2005; 165(8): 858-862. Go to original source... Go to PubMed...
  36. Davicević Z, Tavciovski D, Matunović R. Medical treatments in aortic stenosis: role of statins and angiotensin-converting enzyme inhibitors. Med Pregl. 2010; 63(1-2): 82-85. Go to original source... Go to PubMed...
  37. Nathaniel S, Saligram S, Innasimuthu AL. Aortic Stenosis: An update. J Cardiol 2010; 2(6): 135-139. Go to original source... Go to PubMed...
  38. Shahi CN, Ghaisas NK, Goggins M. Elevated levels of circulating soluble adhesion molecules in patients with nonrheumatic aortic stenosis. Am J Cardiol 1997; 79(7): 980-982. Go to original source... Go to PubMed...
  39. Linhartova K, Sterbakova G, Racek J. Linking soluble vascular adhesion molecule-1 level to calcific aortic stenosis in patients with coronary artery disease. Exp Clin Cardiol. 2009; 14(3): 80-83.
  40. Tahir M, Foley B, Pate G. Impact of vitamin E and C supplementation on serum adhesion molecules in chronic degenerative aortic stenosis: a randomized controlled trial. Am Heart J. 2005; 150(2): 302-306. Go to original source... Go to PubMed...
  41. Lee JH, Meng X, Weyant MJ. Stenotic aortic valves have dysfunctional mechanisms of anti-inflammation: implications for aortic stenosis. J Thorac Cardiovasc Surg. 2011; 141(2): 481-486. Go to original source... Go to PubMed...
  42. Anderson KV, Jürgens G, Nüsslein-Volhardt C. Establishment of dorsal-ventral polarity in the Drosophila embryo: genetic studies on the role of the Toll gene product. Cell 1985; 42(3): 779-780. Go to original source... Go to PubMed...
  43. Meng X, Ao L, Song Y, et al. Expression of functional Tolllike receptors 2 and 4 in human aortic valve interstitial cells: potential roles in aortic valve inflammation and stenosis. Am J Physiol Cell Physiol 2008; 294: 29-35. Go to original source... Go to PubMed...
  44. Čerbák R: Das ist ja toll! Cor Vasa 2011; 53(4-5): 293.
  45. López J, Fernández-Pisonero I, Due?as AI. Viral and bacterial patterns induce TLR-mediated sustained inflammation and calcification in aortic valve interstitial cells. Int J Cardiol 2011; Epub ahead of print. Go to original source...




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