Targeting vasoactive peptides for managing calcific aortic valve disease

Tuomas Peltonen, Pauli Ohukainen, Heikki Juhani Ruskoaho, Jaana Rysä

Research output: Contribution to journalReview ArticleScientificpeer-review

Abstract

Calcific aortic valve disease (CAVD) represents a spectrum of disease spanning from milder degrees of calcification of valve leaflets, i.e., aortic sclerosis, to severe calcification i.e., aortic stenosis (AS) with hemodynamic instability. The prevalence of CAVD is increasing rapidly due to the aging of the population, being up to 2.8% among patients over 75 years of age. Even without significant aortic valve stenosis, aortic sclerosis is associated with a 50% increased risk of myocardial infarction and death from cardiovascular causes. To date, there is no pharmacological treatment available to reverse or hinder the progression of CAVD. So far, the cholesterol-lowering therapies (statins) and renin-angiotensin system (RAS) blocking drugs have been the major pharmacological agents investigated for treatment of CAVD. Especially angiotensin receptor blockers (ARB)s and angiotensin convertase enzyme inhibitors (ACEI)s, have been under active investigation in clinical trials, but have proven to be unsuccessful in slowing the progression of CAVD. Several studies have suggested that other vasoactive hormones, including endothelin and apelin systems are also associated with development of AS. In the present review, we discuss the role of vasoactive factors in the pathogenesis of CAVD as novel pharmacological targets for the treatment of aortic valve calcification.
Original languageEnglish
JournalAnnals of Medicine
Volume49
Issue number1
Pages (from-to)63-74
Number of pages12
ISSN0785-3890
DOIs
Publication statusPublished - Feb 2017
MoE publication typeA2 Review article in a scientific journal

Fields of Science

  • 3121 Internal medicine
  • aortic valve stenosis
  • apelin
  • bradykinin
  • endothelin
  • natriuretic peptides
  • renin-angiotensin system

Cite this

Peltonen, Tuomas ; Ohukainen, Pauli ; Ruskoaho, Heikki Juhani ; Rysä, Jaana. / Targeting vasoactive peptides for managing calcific aortic valve disease. In: Annals of Medicine. 2017 ; Vol. 49, No. 1. pp. 63-74.
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abstract = "Calcific aortic valve disease (CAVD) represents a spectrum of disease spanning from milder degrees of calcification of valve leaflets, i.e., aortic sclerosis, to severe calcification i.e., aortic stenosis (AS) with hemodynamic instability. The prevalence of CAVD is increasing rapidly due to the aging of the population, being up to 2.8{\%} among patients over 75 years of age. Even without significant aortic valve stenosis, aortic sclerosis is associated with a 50{\%} increased risk of myocardial infarction and death from cardiovascular causes. To date, there is no pharmacological treatment available to reverse or hinder the progression of CAVD. So far, the cholesterol-lowering therapies (statins) and renin-angiotensin system (RAS) blocking drugs have been the major pharmacological agents investigated for treatment of CAVD. Especially angiotensin receptor blockers (ARB)s and angiotensin convertase enzyme inhibitors (ACEI)s, have been under active investigation in clinical trials, but have proven to be unsuccessful in slowing the progression of CAVD. Several studies have suggested that other vasoactive hormones, including endothelin and apelin systems are also associated with development of AS. In the present review, we discuss the role of vasoactive factors in the pathogenesis of CAVD as novel pharmacological targets for the treatment of aortic valve calcification.",
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Targeting vasoactive peptides for managing calcific aortic valve disease. / Peltonen, Tuomas; Ohukainen, Pauli; Ruskoaho, Heikki Juhani; Rysä, Jaana.

In: Annals of Medicine, Vol. 49, No. 1, 02.2017, p. 63-74.

Research output: Contribution to journalReview ArticleScientificpeer-review

TY - JOUR

T1 - Targeting vasoactive peptides for managing calcific aortic valve disease

AU - Peltonen, Tuomas

AU - Ohukainen, Pauli

AU - Ruskoaho, Heikki Juhani

AU - Rysä, Jaana

PY - 2017/2

Y1 - 2017/2

N2 - Calcific aortic valve disease (CAVD) represents a spectrum of disease spanning from milder degrees of calcification of valve leaflets, i.e., aortic sclerosis, to severe calcification i.e., aortic stenosis (AS) with hemodynamic instability. The prevalence of CAVD is increasing rapidly due to the aging of the population, being up to 2.8% among patients over 75 years of age. Even without significant aortic valve stenosis, aortic sclerosis is associated with a 50% increased risk of myocardial infarction and death from cardiovascular causes. To date, there is no pharmacological treatment available to reverse or hinder the progression of CAVD. So far, the cholesterol-lowering therapies (statins) and renin-angiotensin system (RAS) blocking drugs have been the major pharmacological agents investigated for treatment of CAVD. Especially angiotensin receptor blockers (ARB)s and angiotensin convertase enzyme inhibitors (ACEI)s, have been under active investigation in clinical trials, but have proven to be unsuccessful in slowing the progression of CAVD. Several studies have suggested that other vasoactive hormones, including endothelin and apelin systems are also associated with development of AS. In the present review, we discuss the role of vasoactive factors in the pathogenesis of CAVD as novel pharmacological targets for the treatment of aortic valve calcification.

AB - Calcific aortic valve disease (CAVD) represents a spectrum of disease spanning from milder degrees of calcification of valve leaflets, i.e., aortic sclerosis, to severe calcification i.e., aortic stenosis (AS) with hemodynamic instability. The prevalence of CAVD is increasing rapidly due to the aging of the population, being up to 2.8% among patients over 75 years of age. Even without significant aortic valve stenosis, aortic sclerosis is associated with a 50% increased risk of myocardial infarction and death from cardiovascular causes. To date, there is no pharmacological treatment available to reverse or hinder the progression of CAVD. So far, the cholesterol-lowering therapies (statins) and renin-angiotensin system (RAS) blocking drugs have been the major pharmacological agents investigated for treatment of CAVD. Especially angiotensin receptor blockers (ARB)s and angiotensin convertase enzyme inhibitors (ACEI)s, have been under active investigation in clinical trials, but have proven to be unsuccessful in slowing the progression of CAVD. Several studies have suggested that other vasoactive hormones, including endothelin and apelin systems are also associated with development of AS. In the present review, we discuss the role of vasoactive factors in the pathogenesis of CAVD as novel pharmacological targets for the treatment of aortic valve calcification.

KW - 3121 Internal medicine

KW - aortic valve stenosis

KW - apelin

KW - bradykinin

KW - endothelin

KW - natriuretic peptides

KW - renin-angiotensin system

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DO - 10.1080/07853890.2016.1231933

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SP - 63

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JO - Annals of Medicine

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SN - 0785-3890

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