Can Statins Prevent Progression of Degenerated Aortic Valve Stenosis?

Authors: Wolfgang Dichtl; Jan Nilsson; Gudrun Feuchtner; Otmar Pachinger; Franz Weidinger; Silvana Muller

Source: Vascular Disease Prevention, Volume 1, Number 3, November 2004 , pp. 207-210(4)

Publisher: Bentham Science Publishers

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Abstract:

Degenerative, nonrheumatic aortic valve stenosis is the most common acquired valve disease. Regardless whether the stenosis develops on a congenitally normal or abnormal (bicuspid) aortic valve, the progressive fibrosis, calcification, fusion and degeneration of the aortic cusps can be regarded as an atherosclerotic disease. Accordingly, it is strongly correlated to the prevalence of coronary artery disease. Stenotic valves show histologic characteristics similar to atherosclerotic lesions and induce a systemic subclinical inflammatory response. Severe symptomatic aortic stenosis is an indication for surgical valve replacement. There is, however, no established medical treatment to delay the progression of aortic valve stenosis in asymptomatic patients. Recent retrospective studies suppose that statin treatment inhibits the accumulation of aortic valve calcification, as assessed by electron beam computed tomography (EBCT), or delay progression of elevated hemodynamic parameters such as systolic pressure gradients or peak aortic jet velocity, as measured by Doppler echocardiography. Mechanisms responsible for the potential benefit of statins for patients with aortic valve stenosis may be mediated by pleiotropic effects besides lipid lowering. These may include anti-inflammation, anti-angiogenesis, inhibition of matrix degrading enzymes, as well as modulation of local lipid oxidation and / or immune responses. Ongoing randomized prospective clinical trials will provide much stronger evidence for or against the recommendation of aggressive treatment with statins to slow the process of aortic valve stenosis.

Keywords: degenerative aortic valve stenosis; echocardiograms; ventricular function; therapy; atherosclerosis; aortic valve orifice area; electrombeam computed tomography

Document Type: Review article

DOI: http://dx.doi.org/10.2174/1567270043404980

Affiliations: 1: Clinical Division of Cardiology, Innsbruck Medical University, Innsbruck, Anichstrabe 35, A-6020 Innsbruck, Austria.

Publication date: 2004-11-01

More about this publication?

Vascular Disease Prevention publishes reviews as well as original papers to update all those concerned with this topic at the clinical or scientific level. In addition to clinically relevant topics, we consider reviews and original papers dealing with the more scientific aspects of vascular disease prevention. This includes the evaluation of emerging vascular risk factors, research dealing with the pathogenesis of atherosclerosis and the investigation of new treatment options both at the clinical and scientific level (e.g. epidemiology, patient-based studies, experimental models, in vitro experiments or molecular research). Therefore, another function of Vascular Disease Prevention is to bridge the gap between clinical practice and ongoing laboratory-based research.

In particular, we welcome critical reviews and comments on recent trials. This is a topic that requires regular updates because of the large number of trials published every year.

Debates are encouraged in the correspondence section of this journal.
The editorial structure of Vascular Disease Prevention is set up with the aim of dealing with the submitted material as rapidly as possible. Specialist editors will provide a more expert and rapid assessment unlike a more centralized editorial structure.

Can Statins Prevent Progression of Degenerated Aortic Valve Stenosis?

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