Aortic Stenosis Phenotypes and Precision Transcatheter Aortic Valve Implantation
Patients with a clinical indication for aortic valve replacement can either undergo surgical aortic valve replacement (SAVR) or Transcatheter Aortic Valve Implantation (TAVI). There are many different factors that go into determining which type of replacement to undergo, including age, life expectan...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/10/7/265 |
| _version_ | 1797588889865551872 |
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| author | Muzamil Khawaja Hafeez Ul Hassan Virk Dhrubajyoti Bandyopadhyay Mario Rodriguez Johao Escobar Mahboob Alam Hani Jneid Chayakrit Krittanawong |
| author_facet | Muzamil Khawaja Hafeez Ul Hassan Virk Dhrubajyoti Bandyopadhyay Mario Rodriguez Johao Escobar Mahboob Alam Hani Jneid Chayakrit Krittanawong |
| author_sort | Muzamil Khawaja |
| collection | DOAJ |
| description | Patients with a clinical indication for aortic valve replacement can either undergo surgical aortic valve replacement (SAVR) or Transcatheter Aortic Valve Implantation (TAVI). There are many different factors that go into determining which type of replacement to undergo, including age, life expectancy, comorbidities, frailty, and patient preference. While both options offer significant benefits to patients in terms of clinical outcomes and quality of life, there is growing interest in expanding the indications for TAVI due to its minimally invasive approach. However, it is worth noting that there are several discrepancies in TAVI outcomes in regards to various endpoints, including death, stroke, and major cardiovascular events. It is unclear why these discrepancies exist, but potential explanations include the diversity of etiologies for aortic stenosis, complex patient comorbidities, and ongoing advancements in both medical therapies and devices. Of these possibilities, we propose that phenotypic variation of aortic stenosis has the most significant impact on post-TAVI clinical outcomes. Such variability in phenotypes is often due to a complex interplay between underlying comorbidities and environmental and inherent patient risk factors. However, there is growing evidence to suggest that patient genetics may also play a role in aortic stenosis pathology. As such, we propose that the selection and management of TAVI patients should emphasize a precision medicine approach. |
| first_indexed | 2024-03-11T00:58:27Z |
| format | Article |
| id | doaj.art-28a6dc0892dd40eea86ad6faef7c6e74 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-11T00:58:27Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-28a6dc0892dd40eea86ad6faef7c6e742023-11-18T19:49:48ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-06-0110726510.3390/jcdd10070265Aortic Stenosis Phenotypes and Precision Transcatheter Aortic Valve ImplantationMuzamil Khawaja0Hafeez Ul Hassan Virk1Dhrubajyoti Bandyopadhyay2Mario Rodriguez3Johao Escobar4Mahboob Alam5Hani Jneid6Chayakrit Krittanawong7Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30322, USAHarrington Heart & Vascular Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USADepartment of Cardiology, Westchester Medical Centre, New York Medical College, Valhalla, NY 10595, USADivision of Cardiology, Barnes-Jewish Hospital at Washington University in St. Louis School of Medicine, Saint Louis, MO 63110, USADivision of Cardiology, Harlem Cardiology, New York, NY 10035, USADivision of Cardiology, The Texas Heart Institute, Baylor College of Medicine, Houston, TX 77030, USADivision of Cardiology, University of Texas Medical Branch, Houston, TX 77030, USACardiology Division, NYU Langone Health and NYU School of Medicine, New York, NY 10016, USAPatients with a clinical indication for aortic valve replacement can either undergo surgical aortic valve replacement (SAVR) or Transcatheter Aortic Valve Implantation (TAVI). There are many different factors that go into determining which type of replacement to undergo, including age, life expectancy, comorbidities, frailty, and patient preference. While both options offer significant benefits to patients in terms of clinical outcomes and quality of life, there is growing interest in expanding the indications for TAVI due to its minimally invasive approach. However, it is worth noting that there are several discrepancies in TAVI outcomes in regards to various endpoints, including death, stroke, and major cardiovascular events. It is unclear why these discrepancies exist, but potential explanations include the diversity of etiologies for aortic stenosis, complex patient comorbidities, and ongoing advancements in both medical therapies and devices. Of these possibilities, we propose that phenotypic variation of aortic stenosis has the most significant impact on post-TAVI clinical outcomes. Such variability in phenotypes is often due to a complex interplay between underlying comorbidities and environmental and inherent patient risk factors. However, there is growing evidence to suggest that patient genetics may also play a role in aortic stenosis pathology. As such, we propose that the selection and management of TAVI patients should emphasize a precision medicine approach.https://www.mdpi.com/2308-3425/10/7/265aortic valve stenosisTAVRTAVI |
| spellingShingle | Muzamil Khawaja Hafeez Ul Hassan Virk Dhrubajyoti Bandyopadhyay Mario Rodriguez Johao Escobar Mahboob Alam Hani Jneid Chayakrit Krittanawong Aortic Stenosis Phenotypes and Precision Transcatheter Aortic Valve Implantation Journal of Cardiovascular Development and Disease aortic valve stenosis TAVR TAVI |
| title | Aortic Stenosis Phenotypes and Precision Transcatheter Aortic Valve Implantation |
| title_full | Aortic Stenosis Phenotypes and Precision Transcatheter Aortic Valve Implantation |
| title_fullStr | Aortic Stenosis Phenotypes and Precision Transcatheter Aortic Valve Implantation |
| title_full_unstemmed | Aortic Stenosis Phenotypes and Precision Transcatheter Aortic Valve Implantation |
| title_short | Aortic Stenosis Phenotypes and Precision Transcatheter Aortic Valve Implantation |
| title_sort | aortic stenosis phenotypes and precision transcatheter aortic valve implantation |
| topic | aortic valve stenosis TAVR TAVI |
| url | https://www.mdpi.com/2308-3425/10/7/265 |
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