利尿钠肽在主动脉瓣狭窄中的作用

主动脉瓣狭窄是临床最常见的瓣膜疾病之一,可导致心力衰竭和死亡风险增加,其发病率在未来20年内可能会随着人口老龄化而翻倍。目前有症状的严重主动脉瓣狭窄患者的首选治疗方法是手术或经导管主动脉瓣置换术,然而无症状严重主动脉瓣狭窄患者的最佳手术时机仍存在争议,警惕的等待策略既安全又可行,但猝死的风险每年几乎达到5%。研究发现,血浆利尿钠肽水平与主动脉瓣狭窄的严重程度、症状的发展以及预后相关,有助于监测疾病进展,并确定哪些患者将从早期治疗干预中获益最大,从而降低长期不良事件的风险。文章概述了利尿钠肽在主动脉瓣狭窄的诊断、临床管理、风险分层和潜在治疗意义中的作用。

The role of natriuretic peptide in aortic stenosis

Aortic valve stenosis is one of the most common valve diseases in clinic, which can lead to increased risk of heart failure and death, and its incidence may double in the next 20 years as the population ages. At present, the preferred treatment for patients with symptomatic severe aortic stenosis is surgery or transcatheter aortic valve replacement. However, the optimal timing of surgery for patients with asymptomatic severe aortic stenosis is still controversial. The vigilant waiting strategy is safe and secure. It is feasible, but the risk of sudden death is almost 5% per year. Studies have found that plasma natriuretic peptide levels are related to the severity of aortic valve stenosis, the development of symptoms, and prognosis, which can help monitor disease progression and determine which patients will benefit most from early treatment intervention, thereby reducing long-term adverse events risks. This article outlines the role of natriuretic peptides in the diagnosis, clinical management, risk stratification, and potential therapeutic significance of aortic stenosis.