Effect of Bisphosphonates on the Progression of Degenerative Aortic Stenosis

@article{Innasimuthu2011EffectOB,
  title={Effect of Bisphosphonates on the Progression of Degenerative Aortic Stenosis},
  author={Antony Leslie Innasimuthu and William E. Katz},
  journal={Echocardiography},
  year={2011},
  volume={28}
}
  • Antony Leslie Innasimuthu, W. Katz
  • Published 1 January 2011
  • Medicine, Biology
  • Echocardiography
Bisphosphonates appear to regulate mineralization in both bone and vasculature. Degenerative aortic stenosis (AS) is thought to be due to vascular calcification. We studied the effect of bisphosphonates on the progression of degenerative AS. A retrospective study was performed on patients >70 years, who had transthoracic echocardiograms (TTE) >1 year apart and an initial aortic valve area (AVA) of 0.6–2.0 cm2. Patients were excluded if they had an ejection fraction <40%, other significant… 
Do bisphosphonates slow the progression of aortic stenosis?
Osteoporosis and Aortic Stenosis: ‘Killing Two Birds with One Stone'?
TLDR
In this issue of Cardiology, Rajamannan shows a beneficial effect of statins in two distinct processes, namely aortic valve calcification and osteoporotic bone resorption, in an experimental hypercholesterolemic mouse model.
Inhibition of Aortic Valve Calcification by Local Delivery of Zoledronic Acid—an Experimental Study
TLDR
Inhibition of AV calcification by local delivery of zoledronate is feasible and effective and Ascending aorta (AA) calcification progressed in both zoledronsate and placebo groups.
Bisphosphonates for cardiovascular risk reduction: A systematic review and meta-analysis.
Medical Therapy for Calcific Aortic Stenosis: The Use of Bisphosphonates
TLDR
The use of bisphosphonates in calcific aortic stenosis is associated with slower progression in mild disease in patients with preserved renal function and NCBPs may provide a unique and novel means to slow vascular and valvular calcification in addition to their statin-like effects.
Alendronate slows down aortic stenosis progression in osteoporotic patients: An observational prospective study
TLDR
Treatment with alendronate in patients with AS and concurrent osteoporosis slows down the progression of stenosis and improves their prognosis, which could open a new pathway for the treatment of AS.
Slowing the Progression of Aortic Stenosis: The Emerging Role of Bisphosphonates
TLDR
The evidence suggesting a role forNCBPs in the management of aortic valve calcification (AVC) and the resultant valve obstruction is reviewed and interest is consequently growing in the use of NCBPs for calcific cardiovascular disease.
Role of Bisphosphonates in Vascular Calcification and Bone Metabolism: A Clinical Summary
TLDR
A review of the literature available regarding the use of bisphosphonates in animal and human models to highlight the pathophysiologic phenomena implicated in vascular and valvular calcification and discuss novel treatment approaches for vascular calcification.
Mineral metabolism disturbances are associated with the presence and severity of calcific aortic valve disease
TLDR
An association between mineral metabolism disturbance and the presence and severity of CAVD in patients with normal or mildly impaired renal function is suggested, and abnormal bone turnover may be a potential mechanism.
THE QUEST FOR A MEDICAL TREATMENT OF AORTIC STENOSIS: PUTATIVE THERAPEUTIC TARGETS
TLDR
Further mechanistic studies and prospective trials are needed to better understand the pathophysiology of AS and to lead to new therapeutic strategies for the prevention, or at least the delay, of either surgical or transcatheter valve implantations.
...
...

References

SHOWING 1-10 OF 41 REFERENCES
Calcific aortic stenosis: an update
TLDR
This Review will discuss the current understanding of the pathophysiology, risk factors, cellular mechanisms, diagnosis and finally, future medical therapies for calcific aortic stenosis.
Characterization of the Early Lesion of ‘Degenerative’ Valvular Aortic Stenosis: Histological and Immunohistochemical Studies
TLDR
The early lesion of “degenerative” aortic stenosis is an active inflammatory process with some similarities (lipid deposition, macrophage and T-cell infiltration, and basement membrane disruption) and some dissimilarities (presence of prominent mineralization and small numbers of smooth muscle cells) to atherosclerosis.
Bisphosphonates Alendronate and Ibandronate Inhibit Artery Calcification at Doses Comparable to Those That Inhibit Bone Resorption
TLDR
It is concluded that bisphosphonates inhibit the calcification of arteries and heart valves at doses comparable to the doses that inhibit bone resorption.
Bisphosphonates: mechanism of action and role in clinical practice.
TLDR
Current understanding of the mechanisms by which bisphosphonates exert their effects on osteoclasts are reviewed, the role of bisph phosphonates in clinical practice is discussed, and some areas of concern associated with bis phosphonate use are highlighted.
A randomized trial of intensive lipid-lowering therapy in calcific aortic stenosis.
TLDR
Long-term, large-scale, randomized, controlled trials are needed to establish the role of statin therapy in patients with calcific aortic stenosis, and this study cannot exclude a small reduction in the rate of disease progression or a significant reduction in major clinical end points.
Prospective study of asymptomatic valvular aortic stenosis. Clinical, echocardiographic, and exercise predictors of outcome.
TLDR
In adults with asymptomatic AS, the rate of hemodynamic progression and clinical outcome are predicted by jet velocity, the rates of change inJet velocity, and functional status.
Spectrum of Calcific Aortic Valve Disease: Pathogenesis, Disease Progression, and Treatment Strategies
TLDR
There is compelling histopathologic and clinical data suggesting that calcific valve disease is an active disease process akin to atherosclerosis with lipoprotein deposition, chronic inflammation, and active leaflet calcification.
Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis.
TLDR
Simvastatin and ezetimibe did not reduce the composite outcome of combined aortic-valve events and ischemic events in patients with aorti stenosis, and such therapy reduced the incidence of isChemic cardiovascular events but not events related to aorting stenosis.
...
...