Overview
This study is intended to investigate the effect of angiotensin receptor blockers (ARBs) on mild-to-moderate aortic stenosis.
Description
Studies support the concept that activation of the renin-angiotensin system may be involved in the progression of valve stenosis and myocardial fibrosis in aortic stenosis. Furthermore recent studies have shown that renin-angiotensin system medication may slow down aortic stenosis progression rate and left ventricle remodeling.
Thus the present study is a randomized control trial to test the efficacy of the angiotensin receptor blocker (ARB) to slow down aortic stenosis progression and left ventricular remodeling/dysfunction in patients with mild-to-moderate aortic stenosis.
Eligibility
Inclusion Criteria:
- Mild to moderate aortic stenosis (peak aortic jet velocity ≥2.5 and <4m/s)
- Normal left ventricular ejection fraction (i.e. ≥50%)
- Systolic blood pressure >110 mmHg
- Diastolic blood pressure >70 mmHg
Exclusion Criteria:
- More than mild aortic or mitral regurgitation, or mitral stenosis
- Current use or documented indication for renin-angiotensin system medication or Aliskiren
- Known allergy or intolerance to angiotensin II receptor blockers (ARBs)
- Alzheimer, dementia or known non-compliant patient
- Renal dysfunction (glomerular filtration rate <30ml/min/1.73m2)
- Chronic hyperkalemia
- Diagnosed hepatic failure, cirrhosis, hepatitis or history of hepatic impairment
- Newly diagnosed (<2 months) or poorly controlled diabetes
- Pre-existing obstructive coronary artery disease with CCS III-IV angina or recent myocardial infarction (<3 months)
- Pregnant or lactating women
- Patients unable to read, understand or sign research consent