Aortic Stenosis Progression: How To Stop It?

Patients at risk of aortic stenosis hear a lot about how to prevent the disease, such as controlling blood pressure, lowering cholesterol, a healthy diet, regular exercise, and not smoking. Patients already living with aortic stenosis usually find that the only treatment for the disease is valve replacement. There’s not much information, though, about how to slow or stop the progression of aortic stenosis. So, when we received a patient question from Sharon on this topic, we wanted to provide her and our whole community with an answer.

Sharon wrote to us and asked, “Is there any new research on how to delay or stop the progression of aortic stenosis? Can you tell me anything about Valvosoft or HMR766 (also known as Ataciguat)?” We spoke with Dr. Eric Roselli at the American Association for Thoracic Surgeons’ annual meeting to get some answers. Dr. Roselli is the Chief of Adult Cardiac Surgery at the Cleveland Clinic in Cleveland, Ohio.  He’s performed thousands of heart valve surgeries and specializes in complex aortic valve procedures.

Video available online at:

https://www.youtube.com/watch?v=mtyiFTipcM0

Facts About How to Stop the Progression of Aortic Valve Stenosis

Here are the key insights shared by Dr. Roselli:

• Research investigating statin therapy and coronary artery disease. Dr. Roselli explained that the Valvosoft and Ataciguat that Sharon mentioned are investigational and are still being studied and tested. He said, “What we have looked at are more straightforward questions about the similarities between the risk factors for aortic stenosis and those for coronary artery disease. For a long time, we recognized the importance of managing your overall cardiovascular health and taking a statin to control cholesterol.” Dr. Roselli described a study in which patients with aortic valve stenosis were randomized into two groups. One group was given aggressive statin therapy while the other was not. “Interestingly, patients in both groups progressed to needing a valve replacement at the same pace. But patients who had aggressive statin therapy were less likely to need bypass surgery at the time of a valve replacement. So, we know that statin therapy is good for coronary artery disease, and even though the risk factors for coronary artery disease and aortic stenosis mirror each other, the treatment process is probably not the same.”

• Research and investigational studies that could help delay the progression of aortic stenosis. Dr. Roselli said, “There’s been a shift in direction where we ask, ‘What else can we do?’ Antaciguat, the medicine Sharon mentioned, is in clinical trials. It targets a different mechanism of calcified plaque formation on valves with the hope that it might slow it down. They have good theoretical science behind it, and maybe some animal studies, but that’s all I can tell you right now because there is no data available.”

• Valvosoft and aortic stenosis. “The problem with aortic stenosis is that when we identify someone with a bad aortic valve, a lot of times the process is too far gone because once you have calcium, it’s already late-stage disease. Now, Valvosoft is a mechanical tool that goes in and breaks down some of that hard calcium. It’s believed to make valve leaflets more mobile, which can make the valve last a bit longer. Valvosoft is still in clinical trials. I don’t know of any places in the US doing it, but I think they’re doing it in Europe. It could buy some time and may become a tool that helps physicians break down some of the disease process, making someone more amenable to a transcatheter valve.”

• Having a healthy heart is the priority. Dr. Roselli said, “Keep doing your research, Sharon; that’s awesome. Also, when you get to the point where you need your valve to be replaced, remember it’s not just about the valve; it’s about the heart. The heart comes first. You need good valves to have a heart that’s healthy and working well for a lifetime.”

Thanks Dr. Roselli and the Cleveland Clinic!

On behalf of all the patients in our community, thank you, Dr. Eric Roselli, for everything you and your team are doing at the Cleveland Clinic in Cleveland, Ohio!

Related links:

• See Dr. Eric Roselli’s Interactive Surgeon Profile

• Ask Dr. Eric Roselli: What About Aortic Valve Repair?

Keep on tickin,
Adam

P.S. For the deaf and hard-of-hearing members of our patient community, we have provided a written transcript of our interview with Dr. Roselli below.