A medical therapy for aortic valve sclerosis and aortic valve stenosis? Rationale of the ASSIST study (Asymptomatic aortic Sclerosis/Stenosis: Influence of STatins): a large, observational, prospective, multicenter study of the Italian Society of Cardiovascular Echography.
Progression of sclerosis and stenosis is substantially unpredictable in the individual patient: in some cases it is very slow, in others it is accelerated. In addition, different patterns of progression (linear and non-linear) are possible. It has been suggested that the aortic valve lesion can be considered a form within the spectrum of the same atherosclerotic disease. In this context it seemed reasonable to hypothesize that targeted medical therapy could retard the progression of the disease. In particular HMG-CoA reductase inhibitors (statins) and angiotensin-converting enzyme inhibitors have been tested. The first experimental and clinical studies are now available, even though they are not conclusive to date. Large, prospective, randomized trials are ideally needed, but they are quite difficult, if not even impossible, to realize in practice. The ASSIST study (Asymptomatic aortic Sclerosis/Stenosis: Influence of STatins) of the Italian Society of Cardiovascular Echography aims to create a large, prospective, observational investigation, involving many centers of echocardiography and thousands of patients, in order to provide from the real clinical world at least some of the answers to this unsolved question.
Antonini-Canterin
Francesco
F
Cardiologia-ARC A.O.S. Maria degli Angeli Pordenone, Italy. cardiologia@aopn.fvg.it
Corrado
Giovanni
G
Faggiano
Pompilio
P
Popescu
Bogdan Alexandru
BA
Carerj
Scipione
S
La Carrubba
Salvatore
S
Zuppiroli
Alfredo
A
Nicolosi
Gian Luigi
GL
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D050197:Atherosclerosis / Q000453:epidemiology; D018450:Disease Progression; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D012307:Risk Factors; D012598:Sclerosis; D014463:Ultrasonography
D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors