Abstract

Aortic stenosis (AS) is one of the most common valvular diseases in clinical practice. The prevalence of calcified AS with moderate or severe stenosis exceeds 2% after 75 years. The optimal timing of intervention for asymptomatic severe AS is uncertain and controversial. Identification of high-risk patients is based on echocardiographic parameters (left ventricular dysfunction, AS severity and progression), hemodynamic response to exercise, pulmonary hypertension, and elevated brain natriuretic peptides. However, early surgical aortic valve replacement (AVR), when compared to the watchful waiting approach, was associated with survival advantage. Moreover, new insights into pathophysiology of AS and advances in imaging modalities were helpful in the management of asymptomatic AS. In this report, we detail the potential role of echocardiography to guide timing of surgery and we discussed the use of early risk features based on recent imaging modalities.

摘要

主动脉瓣狭窄（AS）是临床上最常见的瓣膜疾病之一。75 年后，伴有中度或重度狭窄的钙化 AS 的患病率超过 2%。无症状严重 AS 的最佳干预时机尚不确定且存在争议。高危患者的识别基于超声心动图参数（左心室功能障碍、AS 严重程度和进展）、对运动的血流动力学反应、肺动脉高压和脑利钠肽升高。然而，与观察等待方法相比，早期外科主动脉瓣置换术 (AVR) 与生存优势相关。此外，对 AS 病理生理学的新见解和成像方式的进步有助于无症状 AS 的管理。在这份报告中，