Protective Effect of Aortic Stenosis on the Coronary Arteries. Hypothetic Considerations to an Old Enigma | Zendy

Paulo Roberto Barbosa Évora | Zendy; Lívia Arcêncio | Zendy; Alfredo José Rodrigues | Zendy; André Schmidt | Zendy

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Protective Effect of Aortic Stenosis on the Coronary Arteries. Hypothetic Considerations to an Old Enigma

Author(s) -

Paulo Roberto Barbosa Évora,

Lívia Arcêncio,

Alfredo José Rodrigues,

André Schmidt

Publication year - 2016

Publication title -

arquivos brasileiros de cardiologia

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.4

H-Index - 53

eISSN - 1678-4170

pISSN - 0066-782X

DOI - 10.5935/abc.20160039

Subject(s) - medicine , cardiology , coronary artery disease , coronary arteries , stenosis , endothelium , pressure overload , incidence (geometry) , artery , muscle hypertrophy , cardiac hypertrophy , physics , optics

A literature overview of angiographic studies has shown that the prevalence of significant coronary disease in patients with aortic stenosis (AS) varies from 20 to 60%. Early necropsy studies suggested that patients with AS had a lower than expected incidence of coronary artery disease (CAD), originating the concept of a protective effect of AS on the coronary arteries. The myth of AS protection against CAD would be better explained as endothelium-myocardial interaction (crosstalk) protection triggered by left ventricular overload. Therefore, the cGMP/NO pathway induced by the AS overload pressure would explain the low incidence of CAD, which is compatible with the amazing natural long-term evolution of this cardiac valve disease.

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