Calcific aortic stenosis: lessons learned from experimental and clinical studies.
Calcific aortic stenosis: lessons learned from experimental and clinical studies.
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DOI：
10.1161/atvbaha.107.156752
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发表时间：
2009-02
期刊：
影响因子：
--
通讯作者：
Rajamannan NM
中科院分区：
文献类型：
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作者：
Rajamannan NM
在美国，钙化性主动脉瓣狭窄是外科瓣膜置换术最常见的指征。多年来，这种疾病被描述为一种被动的退行性过程，在此过程中，血清钙附着在瓣膜表面并与小叶结合形成结节。因此，这种疾病的手术治疗一直是缓解这些患者流出梗阻的方法。最近的研究表明动脉粥样硬化与其主动脉瓣疾病的危险因素之间存在关联。2008年，越来越多的流行病学和实验研究提供证据，证明这种疾病过程不是被动现象。有一个活跃的细胞过程，在瓣膜小叶内发展，并导致一个受调节的骨形成的发展。如果动脉粥样硬化假说在主动脉狭窄的发生中起重要作用，那么用于减缓动脉粥样硬化进展的治疗可能对主动脉瓣疾病患者有效。本文将通过对实验研究的总结，对钙化性主动脉瓣狭窄的发病机制和潜在的药物治疗进行综述。
Calcific aortic stenosis is the most common indication for surgical valve replacement in the United States. For years this disease has been described as a passive degenerative process during which serum calcium attaches to the valve surface and binds to the leaflet to form nodules. Therefore, surgical treatment of this disease has been the approach towards relieving outflow obstruction in these patients. Recent studies demonstrate an association between atherosclerosis and its risk factors for aortic valve disease. In 2008, there are increasing number of epidemiology and experimental studies to provide evidence that this disease process is not a passive phenomena. There is an active cellular process that develops within the valve leaflet and causes a regulated bone formation to develop. If the atherosclerotic hypothesis is important in the initiation of aortic stenosis than treatments used in slowing the progression of atherosclerosis may be effective in patients with aortic valve disease. This review will review the pathogenesis and the potential for medical therapy in the management of patients with calcific aortic stenosis by examining the lessons provided from the experimental research.