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首页> 美国卫生研究院文献>Therapeutic Advances in Cardiovascular Disease >Serum copeptin might improve risk stratification and management of aortic valve stenosis: a review of pathophysiological insights and practical implications
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Serum copeptin might improve risk stratification and management of aortic valve stenosis: a review of pathophysiological insights and practical implications

机译：血清肽素可能会改善主动脉瓣狭窄的危险分层和管理：病理生理学见解和实际意义的综述

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摘要

Over recent decades, the prevalence of aortic valve stenosis (AVS) has been constantly increasing possibly owing to the aging of general population. Severe AVS as determined by an aortic valve area (AVA) of <1 cm2 has been regarded as a serious clinical condition potentially associated with a variety of adverse outcomes, including sudden cardiac death (SCD). However, patients with severe AVS (in the absence of overt high-risk features) are usually evaluated and managed exclusively based on symptomatology or imperfect prognostic tools including exercise testing and biomarkers, with a potential risk of mismanagement, suggesting the need for further objective risk stratifiers in this setting.Within this context, copeptin (C-terminal pro-vasopressin), a novel neurohormone widely considered as the surrogate marker of the arginine–vasopressin (AVP) system, may potentially serve as a reliable prognostic and therapeutic guide (e.g. timing of aortic valvular intervention) in patients with severe AVS largely based on its hemodynamic, fibrogenic as well as autonomic implications in these patients. Accordingly, the present paper aims to discuss clinical and pathophysiological implications of copeptin in the setting of AVS along with a summary of biomarkers and other prognostic tools used in this setting.
机译：在最近的几十年中，主动脉瓣狭窄（AVS）的患病率一直在不断增加，这可能是由于总人口的老龄化所致。由<1 areacm 2 的主动脉瓣面积（AVA）确定的严重AVS被认为是一种严重的临床疾病，可能与包括心脏性猝死（SCD）在内的各种不良后果相关。但是，严重AVS的患者（没有明显的高风险特征）通常仅根据症状或运动测试和生物标志物等不完善的预后工具进行评估和管理，存在管理不善的潜在风险，提示需要进一步的客观风险在这种情况下，分层蛋白是一种新的神经激素，被广泛认为是精氨酸-加压素（AVP）系统的替代标志物，可作为可靠的预后和治疗指南（例如，C肽前加压素）重度AVS患者的主动脉瓣膜介入治疗时机主要取决于其血液动力学，纤维化以及这些患者的自主神经功能。因此，本论文旨在探讨肽素在AVS设置中的临床和病理生理意义，以及在该设置中使用的生物标志物和其他预后工具的概述。

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