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引用次数: 0
摘要
中度主动脉瓣狭窄越来越被认为是一种预后不良的疾病。中度主动脉瓣狭窄的诊断可辅以实验室检查和先进的成像技术,重点检测心脏损伤的迹象,如心肌酶(N-末端前 B 型钠尿肽、肌钙蛋白)增加、左室重塑(肥厚、左室射血分数降低)或心肌纤维化。治疗应包括指南指导的心力衰竭最佳药物治疗。有心脏损伤迹象的患者可能会从早期干预中获益,这也是几项正在进行的随机对照试验的重点。到目前为止,还没有循证疗法可以阻止主动脉瓣钙化的进展。
Moderate Aortic Stenosis—Advanced Imaging, Risk Assessment, and Treatment Strategies
Moderate aortic stenosis is increasingly recognized as a disease entity with poor prognosis. Diagnosis of moderate aortic stenosis may be complemented by laboratory tests and advanced imaging techniques focused at detecting signs of cardiac damage such as increase of cardiac enzymes (N-terminal pro-B-type Natriuretic Peptide, troponin), left ventricular remodeling (hypertrophy, reduced left ventricular ejection fraction), or myocardial fibrosis. Therapy should include guideline-directed optimal medical therapy for heart failure. Patients with signs of cardiac damage may benefit from early intervention, which is the focus of several ongoing randomized controlled trials. As yet, no evidence-based therapy exists to halt the progression of aortic valve calcification.