Aortic valvular heart disease: Is there a place for angiotensin-converting-enzyme inhibitors?

Expert Rev Cardiovasc Ther. 2013 Jan;11(1):107-14. doi: 10.1586/erc.12.143.

Abstract

Aortic valve disease (AVD) is the most common form of valvular heart disease in the western world. The only proven therapy for severe AVD is open aortic valve replacement, with trans-catheter aortic valve implantation emerging as a promising modality to treat severe aortic stenosis in a selected group of patients. AVD has a long asymptomatic phase with symptoms occurring late in the disease and once symptoms develop, prognosis is poor. There is a growing appreciation that aortic valvular heart disease incorporates a disease process that extends beyond the valve itself leading to an aortic valvular 'heart' disease. The renin-angiotensin system is known to modulate adverse left ventricular remodeling and myocardial fibrosis, which could be caused by increased load caused by the AVD. In this review, the authors explore evidence that suggest that drugs that target the renin-angiotensin system may have a potential therapeutic role in AVD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Animals
  • Aortic Valve / metabolism
  • Aortic Valve / physiopathology
  • Aortic Valve Stenosis / etiology
  • Aortic Valve Stenosis / prevention & control
  • Bicuspid Aortic Valve Disease
  • Cardiotonic Agents / adverse effects
  • Cardiotonic Agents / therapeutic use*
  • Evidence-Based Medicine
  • Heart Defects, Congenital / drug therapy*
  • Heart Defects, Congenital / metabolism
  • Heart Defects, Congenital / physiopathology
  • Heart Valve Diseases / drug therapy*
  • Heart Valve Diseases / metabolism
  • Heart Valve Diseases / physiopathology
  • Humans
  • Renin-Angiotensin System / drug effects
  • Ventricular Remodeling / drug effects

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Cardiotonic Agents