지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2015.1
- 수록면
- 59 - 69 (11page)
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초록· 키워드
오류제보하기
Aortic stenosis (AS) occurs in almost 10% of adults over age 80 years with a mortality about 50% at 2 years unless outflowobstruction is relieved by aortic valve replacement (AVR). Development of AS is associated with anatomic, clinical and geneticrisk factors including a bicuspid valve in 50%; clinical factors that include older age, hypertension, smoking, diabetes andelevated serum lipoprotein(a) [Lp(a)] levels; and genetic factors such as a polymorphism in the Lp(a) locus. Early stages of AS arecharacterized by focal areas of leaflet thickening and calcification. The rate of hemodynamic progression is variable but eventualsevere AS is inevitable once even mild valve obstruction is present. There is no specific medical therapy to prevent leaflet calcification.
Basic principles of medical therapy for asymptomatic AS are patient education, periodic echocardiographic and clinicalmonitoring, standard cardiac risk factor evaluation and modification and treatment of hypertension or other comorbid conditions.
When severe AS is present, a careful evaluation for symptoms is needed, often with an exercise test to document symptom statusand cardiac reserve. In symptomatic patients with severe AS, AVR improves survival and relieves symptoms. In asymptomaticpatients with severe AS, AVR also is appropriate if ejection fraction is < 50%, disease progression is rapid or AS is very severe(aortic velocity > 5 m/s). The choice of surgical or transcatheter AVR depends on the estimated surgical risk plus other factorssuch as frailty, other organ system disease and procedural specific impediments.
목차
등록된 정보가 없습니다.
참고문헌 (49)
참고문헌 신청
Capoulade R / 2014 / Prognostic value of plasma B-type natriuretic peptide levels after exercise in patients with severe asymptomatic aortic stenosis / Heart 100:1606~1612
Lindman BR / 2014 / BNP during exercise : a novel use for a familiar biomarker in aortic stenosis / Heart 100:1567~1568
Teo KK / 2011 / Lipid lowering on progression of mild to moderate aortic stenosis : meta-analysis of the randomized placebo-controlled clinical trials on 2344 patients / Can J Cardiol 27:800~808
Rossebø AB / 2008 / Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis / N Engl J Med 359:1343~1356
Rieck ÅE / 2012 / Hypertension in aortic stenosis : implications for left ventricular structure and cardiovascular events / Hypertension 60:90~97
Lindman BR / 2014 / BNP during exercise : a novel use for a familiar biomarker in aortic stenosis / Heart 100:1567~1568
Teo KK / 2011 / Lipid lowering on progression of mild to moderate aortic stenosis : meta-analysis of the randomized placebo-controlled clinical trials on 2344 patients / Can J Cardiol 27:800~808
Rossebø AB / 2008 / Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis / N Engl J Med 359:1343~1356
Rieck ÅE / 2012 / Hypertension in aortic stenosis : implications for left ventricular structure and cardiovascular events / Hypertension 60:90~97
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