Heart failure and excess mortality after aortic valve replacement in aortic stenosis.
Expert Rev Cardiovasc Ther
; 21(3): 193-210, 2023 Mar.
Article
en En
| MEDLINE
| ID: mdl-36877090
ABSTRACT
INTRODUCTION:
In aortic stenosis (AS), the heart transitions from adaptive compensation to an AS cardiomyopathy and eventually leads to decompensation with heart failure. Better understanding of the underpinning pathophysiological mechanisms is required in order to inform strategies to prevent decompensation. AREAS COVERED In this review, we therefore aim to appraise the current pathophysiological understanding of adaptive and maladaptive processes in AS, appraise potential avenues of adjunctive therapy before or after AVR and highlight areas of further research in the management of heart failure post AVR. EXPERT OPINION Tailored strategies for the timing of intervention accounting for individual patient's response to the afterload insult are underway, and promise to guide better management in the future. Further clinical trials of adjunctive pharmacological and device therapy to either cardioprotect prior to intervention or promote reverse remodeling and recovery after intervention are needed to mitigate the risk of heart failure and excess mortality.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Estenosis de la Válvula Aórtica
/
Implantación de Prótesis de Válvulas Cardíacas
/
Insuficiencia Cardíaca
Límite:
Humans
Idioma:
En
Revista:
Expert Rev Cardiovasc Ther
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
TERAPEUTICA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Reino Unido