Mechanism of Decompensation Evaluation - Aortic Stenosis
Mechanism of Decompensation Evaluation - Aortic Stenosis
Aortic stenosis is the most common heart valve disease requiring intervention in high income
 countries. It is characterised by progressive valvular thickening, and restriction as well is
 hypertrophy and fibrosis of the left ventricle in response to pressure overload. The
 pathological processes in the left ventricle that ultimately result in heart failure and
 death are incompletely understood. Further elucidation of these processes and how they
 correlate with novel blood biomarkers may help us design new treatments and optimise the
 timing of surgical intervention.

 In brief, recruited patients with severe aortic stenosis and scheduled to undergo valve
 replacement surgery will be invited for some simple tests (blood sampling, ECG,
 echocardiogram). A septal myocardial biopsy will be taken at the time of surgery and the
 disease valve retained. These will be examined histologically and pathological changes
 compared with results obtained from ECG, echocardiogram and blood tests.
-  Inclusion Criteria (aortic stenosis group):

 -  Age over 18

 -  Severe aortic stenosis with planned aortic valve replacement

 Inclusion Criteria (control group):

 -  Age over 18

 -  Planned non-aortic valve cardiac or elective ascending aorta surgery

 Exclusion Criteria (aortic stenosis group):

 -  Coexistent severe aortic or mitral regurgitation

 -  Coexistent mitral stenosis greater than mild in severity

 -  Acute valvular heart disease (e.g. acute mitral regurgitation or endocarditis)

 -  Acute pulmonary oedema or cardiogenic shock

 -  Coexistent hypertrophic cardiomyopathy

 -  Unable to give informed consent

 Exclusion Criteria (control group):

 -  Significant aortic valve disease (mild aortic stenosis / regurgitation or greater)

 -  Acute valvular heart disease (e.g. acute mitral regurgitation or endocarditis)

 -  Acute pulmonary oedema or cardiogenic shock

 -  Coexistent hypertrophic cardiomyopathy

 -  Unable to give informed consent