Left Ventricular Systolic Dysfunction in Aortic Stenosis: Pathophysiology, Diagnosis, Management, and Future Directions

Spilias, Nikolaos; Martyn, Trejeeve; Denby, Kara; Harb, Serge C.; Popović, Zoran B.; Kapadia, Samir

doi:10.1016/j.shj.2022.100089

Cited by 8 publications

(2 citation statements)

References 73 publications

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“…The amplitude of cell death of the post-infarct myocardium caused by I/R injury has been shown to be associated with the severity of cardiac dysfunction as well as mortality [ 22 ]. Therefore, interventions to reduce cardiac cell death have been investigated in pre-clinical and clinical studies [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Galanin Coordinates Macrophage-Associated Fibro-Inflammatory Response and Mitochondrial Integrity in Myocardial Infarction Reperfusion Injury

Savchenko,

Kramar,

Todua

et al. 2024

IJMS

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Myocardial infarction activates an intense fibro-inflammatory reaction that is essential for cardiac remodeling and heart failure (HF). Bioactive peptide galanin plays a critical role in regulating cardiovascular homeostasis; however, its specific functional relevance in post-infarction fibro-inflammatory reprogramming remains obscure. Here, we show that galanin coordinates the fibro-inflammatory trajectory and mitochondrial integrity in post-infarction reperfusion injury. Aberrant deposition of collagen was associated with a marked increase in CD68-positive macrophage infiltration in cardiac tissue in mice subjected to myocardial ischemia/reperfusion (I/R) for 14 days compared to sham controls. Furthermore, we found that the myocardial expression level of a specific marker of M2 macrophages, CD206, was significantly down-regulated in I/R-challenged mice. In contrast, galanin treatment started during the reperfusion phase blunted the fibro-inflammatory responses and promoted the expression of CD206 in I/R-remodeled hearts. In addition, we found that the anti-apoptotic and anti-hypertrophic effects of galanin were associated with the preservation of mitochondrial integrity and promotion of mitochondrial biogenesis. These findings depict galanin as a key arbitrator of fibro-inflammatory responses to cardiac I/R injury and offer a promising therapeutic trajectory for the treatment of post-infarct cardiovascular complications.

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Section: Discussionmentioning

confidence: 99%

Galanin Coordinates Macrophage-Associated Fibro-Inflammatory Response and Mitochondrial Integrity in Myocardial Infarction Reperfusion Injury

Savchenko,

Kramar,

Todua

et al. 2024

IJMS

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“…Klein et al draw attention to the timely detection of more advanced stages of DD in AS to identify the asymptomatic patients who would benefit from AVR, knowing that DD may be multi-factorial due to comorbidities, which impact diastolic LV function, such as hypertension and amyloidosis, particularly in elderly patients [20]. If the disease progresses, irreversible myocardial damage and interstitial fibrosis occur, leading to LV systolic dysfunction and a further decline in LVEF [21]. Stassen et al recently demonstrated the importance of DD of LV in AS patients with preserved LVEF [22].…”

Section: Left Ventricular Response To Aortic Stenosismentioning

confidence: 99%

Novel Biomarkers and Advanced Cardiac Imaging in Aortic Stenosis: Old and New

Drăgan,

Mateescu

2023

Biomolecules

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Currently, the symptomatic status and left ventricular ejection fraction (LVEF) play a crucial role in aortic stenosis (AS) assessment. However, the symptoms are often subjective, and LVEF is not a sensitive marker of left ventricle (LV) decompensation. Over the past years, the cardiac structure and function research on AS has increased due to advanced imaging modalities and potential therapies. New imaging parameters emerged as predictors of disease progression in AS. LV global longitudinal strain has proved useful for risk stratification in asymptomatic severe AS patients with preserved LVEF. The assessment of myocardial fibrosis by cardiac magnetic resonance is the most studied application and offers prognostic information on AS. Moreover, the usage of biomarkers in AS as objective measures of LV decompensation has recently gained more interest. The present review focuses on the transition from compensatory LV hypertrophy (H) to LV dysfunction and the biomarkers associated with myocardial wall stress, fibrosis, and myocyte death. Moreover, we discuss the potential impact of non-invasive imaging parameters for optimizing the timing of aortic valve replacement and provide insight into novel biomarkers for possible prognostic use in AS. However, data from randomized clinical trials are necessary to define their utility in daily practice.

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Impact of Baseline Left Ventricular Ejection Fraction on Midterm Outcomes in Women Undergoing Transcatheter Aortic Valve Implantation: Insight from the WIN-TAVI Registry

Di Muro,

Vogel,

Sartori

et al. 2025

The American Journal of Cardiology

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Left Ventricular Systolic Dysfunction in Aortic Stenosis: Pathophysiology, Diagnosis, Management, and Future Directions

Cited by 8 publications

References 73 publications

Galanin Coordinates Macrophage-Associated Fibro-Inflammatory Response and Mitochondrial Integrity in Myocardial Infarction Reperfusion Injury

Galanin Coordinates Macrophage-Associated Fibro-Inflammatory Response and Mitochondrial Integrity in Myocardial Infarction Reperfusion Injury

Novel Biomarkers and Advanced Cardiac Imaging in Aortic Stenosis: Old and New

Impact of Baseline Left Ventricular Ejection Fraction on Midterm Outcomes in Women Undergoing Transcatheter Aortic Valve Implantation: Insight from the WIN-TAVI Registry

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