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Exercise Hemodynamics and Risk Assessment in Asymptomatic Aortic Stenosis.
MedLine Citation:
PMID:  22832785     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Over a half century ago in Circulation, Dr. Paul Wood aptly described aortic stenosis (AS) as "a simple mechanical fault which, if severe enough, imposes a heavy burden on the left ventricle and sooner or later overcomes it"(1). Our subsequent understanding of the pathophysiology of AS, with more sophisticated tools than those at Dr. Wood's disposal, has confirmed his concept. Severe chronic pressure overload and outflow obstruction beget left ventricular (LV) hypertrophy and its attendant myocardial fibrosis and impaired coronary vasodilator reserve, leading to LV systolic and diastolic dysfunction, progressing ultimately to the anticipated symptoms of dyspnea, angina, and presyncope or syncope, which are harbingers of death within a few years. Once symptoms develop, the treatment strategy is clear, as aortic valve replacement (AVR) improves symptoms, improves LV function, and improves survival. The indications for AVR in asymptomatic patients, however, remain less clear and the subject of ongoing debate(2-4). (SELECT FULL TEXT TO CONTINUE).
Authors:
Robert O Bonow
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-25
Journal Detail:
Title:  Circulation     Volume:  -     ISSN:  1524-4539     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Northwestern University Feinberg School of Medicine, Chicago, IL.
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