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Santangelo G, Tumminello G, Barbieri L, Mallardi GPF, Faggiano A, Moscardelli S, Rossi A, Cozza F, Carugo S, Faggiano P. Unraveling the Enigma of Moderate Aortic Stenosis: Challenges and Future Prospects. J Clin Med 2024; 13:3478. [PMID: 38930005 PMCID: PMC11204855 DOI: 10.3390/jcm13123478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/26/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
According to current guidelines, only clinical surveillance is recommended for patients with moderate aortic valve stenosis (AS), while aortic valve replacement may be considered in patients undergoing surgery for other indications. Recent studies have shown that moderate AS is associated with a high risk of adverse cardiovascular events, including death, especially in patients with left ventricular dysfunction. In this context, multimodality imaging can help to improve the accuracy of moderate AS diagnosis and to assess left ventricular remodeling response. This review discusses the natural history of this valve disease and the role of multimodality imaging in the diagnostic process, summarizes current evidence on the medical and non-medical management, and highlights ongoing trials on valve replacement.
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Affiliation(s)
- Gloria Santangelo
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.S.); (G.T.); (L.B.); (G.P.F.M.); (A.F.); (S.C.)
| | - Gabriele Tumminello
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.S.); (G.T.); (L.B.); (G.P.F.M.); (A.F.); (S.C.)
| | - Lucia Barbieri
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.S.); (G.T.); (L.B.); (G.P.F.M.); (A.F.); (S.C.)
| | - Giulio Pio Federico Mallardi
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.S.); (G.T.); (L.B.); (G.P.F.M.); (A.F.); (S.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Andrea Faggiano
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.S.); (G.T.); (L.B.); (G.P.F.M.); (A.F.); (S.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Silvia Moscardelli
- Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, 20122 Milan, Italy;
| | | | - Fabiana Cozza
- Cardiothoracic Department Unit, Fondazione Poliambulanza, 25124 Brescia, Italy;
| | - Stefano Carugo
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.S.); (G.T.); (L.B.); (G.P.F.M.); (A.F.); (S.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Pompilio Faggiano
- Cardiothoracic Department Unit, Fondazione Poliambulanza, 25124 Brescia, Italy;
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Cormican DS, Czerny M, Ramakrishna H. The Dilemma of Moderate Aortic Stenosis in Patients With Heart Failure and Reduced Ejection Fraction: Are We Waiting Too Long to Intervene, or Should We Wait for More Evidence? J Cardiothorac Vasc Anesth 2021; 36:15-17. [PMID: 34518100 DOI: 10.1053/j.jvca.2021.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Daniel S Cormican
- Division of Cardiothoracic Anesthesiology, Division of Surgical Critical Care, Anesthesiology Institute, Allegheny Health Network, Pittsburgh, PA
| | - Martin Czerny
- University Heart Center Freiburg - Bad Krozingen, Freiburg, Germany
| | - Harish Ramakrishna
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
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