title: Protective Effect of Aortic Stenosis on the Coronary Arteries. Hypothetic Considerations to an Old Enigma.
abstract: A literature overview of angiographic studies has shown that the prevalence of significant coronary disease in patients with aortic stenosis (AS) varies from 20 to 60%. Early necropsy studies suggested that patients with AS had a lower than expected incidence of coronary artery disease (CAD), originating the concept of a protective effect of AS on the coronary arteries. The myth of AS protection against CAD would be better explained as endothelium-myocardial interaction (crosstalk) protection triggered by left ventricular overload. Therefore, the cGMP/NO pathway induced by the AS overload pressure would explain the low incidence of CAD, which is compatible with the amazing natural long-term evolution of this cardiac valve disease.
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Paulo Roberto Barbosa
authors.initials: PR
authors.lastname: Evora
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Livia
authors.initials: L
authors.lastname: Arcêncio
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Alfredo José
authors.initials: AJ
authors.lastname: Rodrigues
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Schmidt
mesh_terms: D001024:Aortic Valve Stenosis / Q000473:pathology / Q000503:physiopathology*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000473:pathology / Q000503:physiopathology*; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology*; D006350:Heart Valve Prosthesis; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D012720:Severity of Illness Index