Aortic stenosis and diabetes mellitus: An ominous combination

Aortic stenosis and diabetes mellitus are both progressive diseases which, if left untreated, result in significant morbidity and mortality. There is evidence that the prevalence of diabetes is substantially increased in patients with aortic stenosis and those with diabetes have increased rates of progression from mild to severe aortic stenosis. There are good data supporting the hypothesis that aortic stenosis and diabetes mellitus are associated with diabetes mellitus being detrimental towards the quality of life and survival of patients. Thus, a thorough understanding of the pathogenesis of both of these disease processes and the relationship between them aids in designing appropriate preventive and therapeutic approaches. This review aims to give a comprehensive and up-to-date insight into the influence of diabetes mellitus on patients with degenerative aortic stenosis, as well as the prognosis and therapeutic approach to these patients.

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Diabetes Mellitus and Its Implications in Aortic Stenosis Patients

International Journal of Molecular Sciences ◽

10.3390/ijms22126212 ◽

2021 ◽

Vol 22 (12) ◽

pp. 6212

Author(s):

Laura Mourino-Alvarez ◽

Nerea Corbacho-Alonso ◽

Tamara Sastre-Oliva ◽

Cecilia Corros-Vicente ◽

Jorge Solis ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Aortic Valve ◽

Aortic Stenosis ◽

Aortic Valve Replacement ◽

Effective Treatment ◽

Patient Management ◽

Significant Morbidity ◽

Therapeutic Approaches ◽

The Relationship

Aortic stenosis (AS) and diabetes mellitus (DM) are both progressive diseases that if left untreated, result in significant morbidity and mortality. Several studies revealed that the prevalence of DM is substantially higher in patients with AS and, thus, the progression from mild to severe AS is greater in those patients with DM. DM and common comorbidities associated with both diseases, DM and AS, increase patient management complexity and make aortic valve replacement the only effective treatment. For that reason, a better understanding of the pathogenesis underlying both these diseases and the relationships between them is necessary to design more appropriate preventive and therapeutic approaches. In this review, we provided an overview of the main aspects of the relationship between AS and DM, including common comorbidities and risk factors. We also discuss the established treatments/therapies in patients with AS and DM.

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Aortic valve replacement surgery improves the quality of life of octogenarians with severe aortic stenosis

Revista Portuguesa de Cardiologia ◽

10.1016/j.repc.2019.12.004 ◽

2019 ◽

Vol 38 (10) ◽

pp. 743 ◽

Cited By ~ 1

Author(s):

Dina Bento ◽

Pedro Coelho ◽

João Lopes ◽

José Fragata

Keyword(s):

Quality Of Life ◽

Aortic Valve ◽

Aortic Stenosis ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Severe Aortic Stenosis ◽

Replacement Surgery ◽

Valve Replacement Surgery

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2477 Targeting pulsatile load to increase exercise capacity and quality of life after TAVR for severe aortic stenosis

Journal of Clinical and Translational Science ◽

10.1017/cts.2018.185 ◽

2018 ◽

Vol 2 (S1) ◽

pp. 48-48

Author(s):

Anupam Kumar ◽

Julio Chirinos

Keyword(s):

Quality Of Life ◽

Aortic Stenosis ◽

Exercise Capacity ◽

Severe Aortic Stenosis ◽

Myocardial Strain ◽

Study Drug ◽

Potassium Nitrate ◽

Exercise Intolerance ◽

Double Blind

OBJECTIVES/SPECIFIC AIMS: The objective of the study is to test the effect of oral inorganic nitrate on the primary outcomes of exercise capacity and quality of life in patients who have undergone TAVR for severe aortic stenosis. We will also test the effect of the study drug on various physiology endpoints, including systemic vasodilator response to exercise, LV diastolic function and myocardial strain, late systolic LV load and pulsatile arterial wave reflections. METHODS/STUDY POPULATION: This is a randomized double-blind crossover clinical trial, in which 24 subjects who underwent TAVR for severe AS 3 or more months before enrollment will receive the following 2 interventions, in randomized order: (1) Potassium nitrate (KNO3), at a dose of 12–18 mmol/day by mouth for ~4 weeks, or (2) Potassium chloride (KCl), at a dose of 12–18 mmol/day by mouth for ~4 weeks. A 1-week washout period will be introduced between the 2 interventions. RESULTS/ANTICIPATED RESULTS: We hypothesize that sustained oral administration of potassium nitrate will lead to improvement of exercise capacity and quality of life in this population.DISCUSSION/SIGNIFICANCE OF IMPACT: His study will have a significant impact on assessment and management of patients after TAVR. We will gain a better understanding of physiologic abnormalities leading to exercise intolerance after TAVR. In addition, there are currently no proven therapies that improve exercise capacity in this population.

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