La estenosis aórtica es la lesión valvular más frecuente. Puede ser degenerativa o reumática. El diagnóstico se realiza mediante ecocardiograma que mide la velocidad máxima y el gradiente transvalvular. La estenosis aórtica sintomática requiere cirugía, mientras que la asintomática se controla periódicamente. Existen evidencias de que las estatinas podrían retrasar la progresión de la enfermedad al afectar factores como la función endotelial y la inflam
8. Carabello, B. A. et al. N Engl J Med 1997;337:32-41 Principles of the Use of Doppler Ultrasonography and the Continuity Equation in Estimating Aortic-Valve Area Figure 1. Principles of the Use of Doppler Ultrasonography and the Continuity Equation in Estimating Aortic -Valve Area. For blood flow (A1 x V1) to remain constant when it reaches a stenosis (A2), velocity must increase to V2. Doppler examination of the stenosis detects the increase in velocity, which can be used to calculate the aortic -valve gradient or to solve the continuity equation for A2. A denotes area, and V velocity.
19. Figure 2. Kaplan–Meier Analysis of Event-free Survival among 33 Patients 50 Years of Age or Younger, as Compared with 93 Patients over 50 Years of Age. The vertical bars indicate standard errors. NEJM,Agosto 2000
20. Figure 3. Kaplan–Meier Analysis of Event-free Survival among 25 Patients with No or Mild Aortic-Valve Calcification, as Compared with 101 Patients with Moderate or Severe Calcification. The vertical bars indicate standard errors. NEJM, Agosto2000
33. Estatinas y no IECA retrasan la progresión hemodinámica de la Estenosis Aórtica Rosenhek, Circulation, 2004;110:1291-1295
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Notas del editor
Figure 2. Kaplan–Meier Analysis of Event-free Survival among 33 Patients 50 Years of Age or Younger, as Compared with 93 Patients over 50 Years of Age. The vertical bars indicate standard errors. Figure 2. Kaplan–Meier Analysis of Event-free Survival among 33 Patients 50 Years of Age or Younger, as Compared with 93 Patients over 50 Years of Age. The vertical bars indicate standard errors. Figure 2. Kaplan–Meier Analysis of Event-free Survival among 33 Patients 50 Years of Age or Younger, as Compared with 93 Patients over 50 Years of Age. The vertical bars indicate standard errors. Figure 2. Kaplan–Meier Analysis of Event-free Survival among 33 Patients 50 Years of Age or Younger, as Compared with 93 Patients over 50 Years of Age. The vertical bars indicate standard errors.
Evidencia circunstancial sugiere que la terapia agresiva con estatinas puede tener un impacto positivo en la calcificación valvular. Novaro et cols en un estudio retrospectivo demostraron una menor progresión de la lesión al demostrar menor vmax y gradiente. Shavelle demostró una disminución de un 62% en la tasa de acumulación de calcio.