Physicochemical characterization of natural and bioprosthetic heart valve calcific deposits: implications for prevention.
Physicochemical characterization of natural and bioprosthetic heart valve calcific deposits: implications for prevention.
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天然和生物假体心脏瓣膜钙化沉积物的物理化学特征：对预防的影响。
DOI：
10.1016/0003-4975(95)00205-y
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Schoen,FJ
中科院分区：
文献类型：
--
作者：
Tomazic,BB;Edwards,WD;Schoen,FJ
这项研究的目的是提供各种病理条件下人类心脏瓣膜上形成的钙化沉积物 (CD) 的全面物理化学特征。我们检查并表征了与先天性二尖瓣主动脉瓣狭窄 (n = 10)、先前解剖结构正常的瓣膜上的退行性主动脉瓣狭窄 (n = 10) 以及风湿性主动脉 (n = 10) 和二尖瓣 (n = 10) 狭窄相关的 CD。天然和脱蛋白的 CD 进行了化学分析和结构表征，而脱蛋白的 CD 则进行了热力学溶解度测量。瓣膜性心脏病中的 CD 是微晶磷灰石产物，含有大量的钠镁、碳酸盐、氟化物和有机成分。将天然心脏瓣膜 CD 的特性与之前测量的在心脏瓣膜生物假体上或内部形成的 CD 的特性进行了比较。与生物瓣膜CD相比，天然瓣膜CD具有更高的钙磷比、更高的结晶度和更低的溶解度。这些差异表明天然心脏瓣膜 CD 似乎包含更成熟的生物矿物质。如果成熟 CD 的形成经历了涉及不稳定前体的短暂阶段，那么预防生物人工心脏瓣膜钙化恶化的主要策略将是开发局部应用的长期抑制剂，该抑制剂既 (1) 抑制更可溶性前体的成核和生长，又 (2) 抑制随后溶解性较差的 CD 的增加。
This investigation was performed to provide a comprehensive physicochemical characterization of calcific deposits (CDs) that form on human heart valves under various pathological conditions. We examined and characterized CDs associated with aortic stenosis on congenitally bicuspid valves (n = 10), degenerative aortic stenosis on valves with previously normal anatomy (n = 10), and rheumatic aortic (n = 10) and mitral (n = 10) stenosis. Native and deproteinated CDs underwent chemical analysis and structural characterization, whereas deproteinated CDs were measured for thermodynamic solubility. The CDs in valvular heart disease were microcrystalline apatitic products containing substantial amounts of sodium magnesium, carbonate, fluoride, and organic fraction. The properties of natural heart valve CDs were compared with those of previously measured CDs that form on or in heart valve bioprostheses. Compared with bioprosthetic valve CDs, natural valve CDs have a higher ratio of calcium to phosphorus, higher crystallinity, and lower solubility. These differences indicate that natural heart valve CDs appear to comprise a more mature biomineral. If the formation of mature CDs proceeds through transient stages involving unstable precursors then the main strategy for prevention of calcific deterioration of bioprosthetic heart valves would be the development of locally applied long-term inhibitors that both (1) suppress nucleation and growth of more soluble precursors and (2) inhibit subsequent augmentation of less soluble CDs.