Review
Published: 2017-09-15

Calcific aortic stenosis: a peculiar feature of diastolic heart failure in the elderly

Department of Translational Medical Sciences, University “Federico II”, Naples, Italy
Department of Translational Medical Sciences, University “Federico II”, Naples, Italy
Department of Translational Medical Sciences, University “Federico II”, Naples, Italy
Department of Translational Medical Sciences, University “Federico II”, Naples, Italy
Department of Translational Medical Sciences, University “Federico II”, Naples, Italy
Department of Translational Medical Sciences, University “Federico II”, Naples, Italy
Aortic stenosis Elderly Diastolic dysfunction Myocordial fibrosis Left ventricular hypertrophy

Abstract

Calcific aortic stenosis represents the most frequent valvular heart disease and one of the major cause of morbidity
and mortality in the elderly. Aortic stenosis results from active biological events, characterized by lipid
infiltration, inflammation, neoangiogenesis, endothelial dysfunction and bone deposition. The reduced mobility
of aortic valve leaflets produces a fixed obstruction at the outflow, with a consequent remodelling of the left
ventricle. The degree of left ventricle hypertrophy and fibrosis results in different degree of diastolic dysfunction
and heart failure. Thus, the response of the left ventricle to the pressure overload guides the clinical status
and the prognosis of patients with aortic stenosis. After aortic valve replacement hypertrophy and fibrosis
partially regress, however the maladaptive LV remodelling strongly impacts the prognosis even after surgery.
This review outlines the importance in the evaluation of the left ventricle in patients with severe aortic stenosis,
exploring the pathophysiology of the transition from adaptive to maladaptive remodelling.

Affiliations

V. Parisi

Department of Translational Medical Sciences, University “Federico II”, Naples, Italy

G. Rengo

Department of Translational Medical Sciences, University “Federico II”, Naples, Italy

L. Petraglia

Department of Translational Medical Sciences, University “Federico II”, Naples, Italy

R. Formisano

Department of Translational Medical Sciences, University “Federico II”, Naples, Italy

D. Leosco

Department of Translational Medical Sciences, University “Federico II”, Naples, Italy

N. Ferrara

Department of Translational Medical Sciences, University “Federico II”, Naples, Italy

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2017

How to Cite

[1]
Parisi, V., Rengo, G., Petraglia, L., Formisano, R., Leosco, D. and Ferrara, N. 2017. Calcific aortic stenosis: a peculiar feature of diastolic heart failure in the elderly. JOURNAL OF GERONTOLOGY AND GERIATRICS. 65, 03 Special (Sep. 2017), 192-197.
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