Insights into aortic sclerosis and its relationship with coronary artery disease.
Insights into aortic sclerosis and its relationship with coronary artery disease.
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DOI：
10.1161/jaha.114.001111
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发表时间：
2014-09-05
影响因子：
5.4
通讯作者：
Ardehali R
中科院分区：
文献类型：
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作者：
Milin AC;Vorobiof G;Aksoy O;Ardehali R
主动脉瓣硬化症(AVS)是一种主动脉瓣疾病，据估计，在美国65岁以上的人中有1/4会受到影响。1人口老龄化和非侵入性成像的广泛使用正在增加AVS的发生率。AVS的典型定义是主动脉瓣钙化，但无瓣叶偏移或明显的跨瓣压差损害。2它的特点是从钙沉积开始逐渐进展，最终可能转变为主动脉瓣狭窄(AS)，并伴有左心室流出道阻塞。严重的AS最终导致心室重构和血流动力学损害，如果不治疗，发病率和死亡率都很高。长期以来，AVS一直被认为是渐进性磨损引起的偶然的年龄相关的退行性病变，大量新出现的证据对这一假设提出了挑战。最近的观察表明，AVS和AS的发展可能涉及慢性炎症渗透、动脉粥样硬化性脂蛋白沉积和钙化，类似于冠状动脉疾病(CAD)。然而，AVS具有独特的特征，包括组织学上的钙优势、渐进性和位于高压部位，作为从心脏到体循环的门户。一些研究人员已经报道，在潜在的冠心病患者中，动静脉曲张或强直性脊柱炎经常共存。3多项研究表明，冠心病进展过程中的独立危险因素，如血脂异常、高血压和男性，也可能影响
Aortic valve (AV) sclerosis (AVS) is a form of AV disease affecting an estimated 1 in 4 people above the age of 65 in the United States. 1 An aging population and more widespread use of noninvasive imaging are increasing the incidence of AVS. AVS is typically defined as calcification of the aortic leaflets without impairment in leaflet excursion or a significant transvalvular pressure gradient. 2 It is characterized by a gradual progression beginning with calcium deposition that may ultimately transform to aortic stenosis (AS) with obstruction of outflow from the left ventricle. Severe AS eventually leads to ventricular remodeling and hemodynamic compromise with a high morbidity and mortality if not treated. Long considered an incidental age-related degenerative process as a result of progressive wear and tear, there is substantial emerging evidence related to AVS that challenges this assumption.Recent observations have shown that the development of AVS and AS may involve chronic inflammatory infiltrates, deposition of atherosclerotic lipoproteins, and calcification, akin to coronary artery disease (CAD). However, AVS has unique features, including a calcium predominance on histology, gradual progression, and location at a site of high pressure that serves as a gateway from the heart to the systemic circulation. Some investigators have reported the frequent coexistence of either AVS or AS in patients with underlying CAD. 3 Several studies have demonstrated that independent risk factors in the progression of CAD, such as dyslipidemia, hypertension, and male sex, may also affect