Slowing the progression of aortic stenosis.

Aortic stenosis (AS) is the most frequent valvular heart disease in the Western world. The only definitive treatment for this disorder is surgical replacement of the aortic valve. Recent histopathologic studies have provided important insights into the pathogenesis of calcific AS. These results suggest that this disease develops as the result of an active disease process at the cellular and molecular levels that shares many similarities with vascular atherosclerosis, ranging from endothelial dysfunction to, ultimately, calcification. In this review, we discuss the cellular and molecular mechanisms, natural history, diagnosis, and therapeutic options, including the potential for medical therapies, for the treatment of AS.