Nimesh Patel1, Dharam J Kumbhani2. 1. Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9047, USA. 2. Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9047, USA. dharam@post.harvard.edu.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to outline the relationship between serum biomarkers of cardiac stress and the pathophysiologic progression of aortic stenosis, to identify studies exploring the utility of biomarkers in the risk stratification and management of patients with aortic stenosis, and to highlight the biomarkers most practical to management of patients with aortic stenosis. RECENT FINDINGS: Several biomarkers have been identified that reflect various aspects of the pathogenesis of calcific aortic stenosis, subsequent hemodynamic obstruction leading to myocardial remodeling, oxidative stress and injury, and concomitant systemic inflammation. These markers are associated with adverse outcomes in aortic stenosis and offer incremental value in risk prediction over traditional clinical assessment for aortic stenosis. NTproBNP and troponin are the most rigorously studied serum biomarkers in aortic stenosis, and only NTproBNP is currently reflected in any major guideline on aortic stenosis management. Serum biomarkers show promise in guiding management of aortic stenosis, but still require significant prospective investigation before they can be incorporated in major guidelines.
PURPOSE OF REVIEW: The purpose of this review is to outline the relationship between serum biomarkers of cardiac stress and the pathophysiologic progression of aortic stenosis, to identify studies exploring the utility of biomarkers in the risk stratification and management of patients with aortic stenosis, and to highlight the biomarkers most practical to management of patients with aortic stenosis. RECENT FINDINGS: Several biomarkers have been identified that reflect various aspects of the pathogenesis of calcific aortic stenosis, subsequent hemodynamic obstruction leading to myocardial remodeling, oxidative stress and injury, and concomitant systemic inflammation. These markers are associated with adverse outcomes in aortic stenosis and offer incremental value in risk prediction over traditional clinical assessment for aortic stenosis. NTproBNP and troponin are the most rigorously studied serum biomarkers in aortic stenosis, and only NTproBNP is currently reflected in any major guideline on aortic stenosis management. Serum biomarkers show promise in guiding management of aortic stenosis, but still require significant prospective investigation before they can be incorporated in major guidelines.
Authors: Brian R Lindman; Jared G Breyley; Joel D Schilling; Anna M Vatterott; Alan Zajarias; Hersh S Maniar; Ralph J Damiano; Marc R Moon; Jennifer S Lawton; Brian F Gage; Marc A Sintek; Alejandro Aquino; Christopher L Holley; Neil M Patel; Cassandra Lawler; John M Lasala; Eric Novak Journal: Heart Date: 2015-06-02 Impact factor: 5.994
Authors: Gerd Baldenhofer; Kun Zhang; Sebastian Spethmann; Michael Laule; Björn Eilers; Franziska Leonhardt; Wasiem Sanad; Henryk Dreger; Michael Sander; Herko Grubitzsch; Gert Baumann; Karl Stangl; Verena Stangl; Fabian Knebel Journal: Int J Cardiol Date: 2014-10-20 Impact factor: 4.164
Authors: Francesco Antonini-Canterin; Bogdan A Popescu; Andreea C Popescu; Carmen C Beladan; Renata Korcova; Rita Piazza; Piero Cappelletti; Daniela Rubin; Matteo Cassin; Pompilio Faggiano; Gian Luigi Nicolosi Journal: Int J Cardiol Date: 2007-07-26 Impact factor: 4.164