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Contrast-Associated Acute Kidney Injury and Serious Adverse Outcomes Following Angiography Association of CYP2C19 Loss-of-Function Alleles with Major Adverse Cardiovascular Events of Clopidogrel in Stable Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention: Meta-analysis Short-term and long-term clinical outcomes of rotational atherectomy in resistant chronic total occlusion Incidence, Predictors, and Outcomes of In-Hospital Percutaneous Coronary Intervention Following Coronary Artery Bypass Grafting 2020 AHA/ACC Key Data Elements and Definitions for Coronary Revascularization A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Coronary Revascularization) Causes, Timing, and Impact of Dual Antiplatelet Therapy Interruption for Surgery (from the Patterns of Non-adherence to Anti-platelet Regimens In Stented Patients Registry) Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease Mortality Differences Associated With Treatment Responses in CANTOS and FOURIER: Insights and Implications Improving the Design of Future PCI Trials for Stable Coronary Artery Disease: JACC State-of-the-Art Review Drug-Coated Balloon Versus Drug-Eluting Stent in Primary Percutaneous Coronary Intervention: A Feasibility Study
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Review ArticleVolume 13, Issue 2 Part 1, February 2020

JOURNAL：JACC Cardiovasc Imaging. Article Link

Management of Asymptomatic Severe Aortic Stenosis: Evolving Concepts in Timing of Valve Replacement

BR Lindman, MR Dweck, P Lancellotti et al. Keywords: aortic stenosis; biomarkers; cardiac magnetic resonance imaging; echocardiography

ABSTRACT

New insights into the pathophysiology and natural history of patients with aortic stenosis, coupled with advances in diagnostic imaging and the dramatic evolution of transcatheter aortic valve replacement, are fueling intense interest in the management of asymptomatic patients with severe aortic stenosis. An intervention that is less invasive than surgery could conceivably justify pre-emptive transcatheter aortic valve replacement in subsets of patients, rather than waiting for the emergence of early symptoms to trigger valve intervention. Clinical experience has shown that symptoms can be challenging to ascertain in many sedentary, deconditioned, and/or elderly patients. Evolving data based on imaging and biomarker evidence of adverse ventricular remodeling, hypertrophy, inflammation, or fibrosis may radically transform existing clinical decision paradigms. Clinical trials currently enrolling asymptomatic patients have the potential to change practice patterns and lower the threshold for intervention.
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