Current Evidence and Future Perspectives on Pharmacological Treatment of Calcific Aortic Valve Stenosis

Int J Mol Sci. 2020 Nov 4;21(21):8263. doi: 10.3390/ijms21218263.

Abstract

Calcific aortic valve stenosis (CAVS), the most common heart valve disease, is characterized by the slow progressive fibro-calcific remodeling of the valve leaflets, leading to progressive obstruction to the blood flow. CAVS is an increasing health care burden and the development of an effective medical treatment is a major medical need. To date, no effective pharmacological therapies have proven to halt or delay its progression to the severe symptomatic stage and aortic valve replacement represents the only available option to improve clinical outcomes and to increase survival. In the present report, the current knowledge and latest advances in the medical management of patients with CAVS are summarized, placing emphasis on lipid-lowering agents, vasoactive drugs, and anti-calcific treatments. In addition, novel potential therapeutic targets recently identified and currently under investigation are reported.

Keywords: aortic valve; calcific aortic valve disease; calcification; stenosis; valvular interstitial cells.

Publication types

  • Review

MeSH terms

  • Aortic Valve / pathology*
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / drug therapy*
  • Aortic Valve Stenosis / etiology
  • Aortic Valve Stenosis / surgery
  • Calcinosis / complications
  • Calcinosis / drug therapy*
  • Calcinosis / surgery
  • Calcium-Regulating Hormones and Agents / therapeutic use
  • Disease Progression
  • Drug Discovery / methods
  • Drug Discovery / trends*
  • Heart Valve Prosthesis
  • Humans
  • Hypolipidemic Agents / therapeutic use
  • Lipid Metabolism / drug effects
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Calcium-Regulating Hormones and Agents
  • Hypolipidemic Agents
  • Vasoconstrictor Agents

Supplementary concepts

  • Aortic Valve, Calcification of