Place des marqueurs biologiques dans l'exploration du rétrécissement aortique calcifié

Calcified aortic valve disease (CAVD) is a highly prevalent cardiovascular disorder, characterized by a progressive thickening and calcification of the aortic valve with devastating consequences on myocardial function. So far, there are no medical therapies to prevent the progression of CAVD and aortic valve replacement, either surgically or percutaneously, remains the only treatment available in patients with severe symptomatic CAVD. Diagnosis and management of CAVD is generally established using an echocardiographic examination. The development and the use of established or novel biomarkers could represent a complementary approach. During the progression of CAVD, several molecules are released into the circulation whose measurement could reflect either the aortic valve lesions or the myocardium consequences of CAVD. These biomarkers, by giving informations on the severity, the progression and the prognostic of CAVD, would enhance the clinical decision making. They have the advantage over echocardiography examination to provide insight into etiological and causal factors for the disease. Since they can help to stratify the cardiovascular risk, the use of biomarkers would improve the decision to the optimal timing for aortic valve replacement in asymptomatic patients. The objective of this review is to summarize the main biomarkers that have been studied in CAVD and to identify those which have the greatest clinical utility.