Aortic stenosis : grading, prognosis, and pathophysiological features
(2025)
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- Abstract
- Aortic stenosis (AS) is a narrowing of the aortic valve that obstructs left ventricular outflow, reducing cardiac output and causing significant morbidity and mortality. Its main cause is degenerative, characterized by progressive thickening and calcification of the valve leaflets. To date, no pharmacological treatment can halt the progression of the disease; aortic valve replacement (AVR) remains the only effective therapy. Diagnosis relies on the evaluation of several echocardiographic parameters. However, these are frequently discordant, and their clinical significance remains debated. Beyond anatomical severity, symptoms onset and cardiac dysfunction are essential in deciding on intervention, although they appear late in the course of the disease. The optimal timing of AVR is therefore critical, requiring a balance between surgical risks and long-term prognosis, particularly in asymptomatic patients. New prognostic markers, such as the occurrence of atrial fibrillation, enrich decision-making, along with cardiac imaging tools. PET scanning appears promising in detecting calcific metabolic activity and predicting disease progression. This work explores the prognosis of AS, its pathophysiological mechanisms, and the potential of advanced imaging techniques to refine clinical management.
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De Azevedo Coutinho Pereira, D. (2025). Aortic stenosis : grading, prognosis, and pathophysiological features. https://hdl.handle.net/2078.5/245423