| 摘要: |
| 随着人口的老龄化和风湿热发病率的降低,钙化性主动脉瓣疾病(calcific aortic valve disease, CAVD)的发病率在我国呈逐年上升的趋势,已成为老年人最常见的心脏瓣膜病。CAVD以往被视为是一种与瓣膜退行性变、钙盐沉积相关的被动过程,但最新研究发现CAVD的发生实际是一个涉及内皮损伤、脂质浸润、慢性炎症、基质重塑、细胞分化、进展性钙化及新生血管形成等复杂变化的主动过程,一些基因的变异在其发生发展中也扮演重要角色。CAVD的临床诊治措施目前也取得了一系列进展,包括一些延缓或阻断CAVD进展干预靶点的发现以及经导管主动脉瓣置换术(transcatheter aortic valve implantation, TAVI)的临床应用,都为防治CAVD提供了新思路。本文主要就CAVD发病机制的最新研究进展进行综述,并展望了CAVD未来的诊治方向。 |
| 关键词: 钙化性主动脉瓣疾病 主动脉瓣狭窄 血管内皮损伤 炎症 基质重塑 骨生成 |
| DOI：10.3724/SP.J.1008.2015.00309 |
| 投稿时间：2014-11-20修订日期：2015-03-10 |
| 基金项目:上海市申康医院发展中心新兴前沿技术项目 (SHDC12014107), 上海市"优秀学科带头人"计划(12XD1400300). |
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| Calcific aortic valve disease: a review of the pathogenesis and therapeutical trends |
| XI Wang,LI Wei,YIN Liang,SHEN Hua,WANG Zhi-nong* |
(Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author) |
| Abstract: |
| The incidence of calcific aortic valve disease (CAVD) has increased dramatically as a result of the decline in rheumatic fever and the increase of the aging population, and by now CAVD has become the most common cardiac valve disease in the elderly in China. CAVD used to be thought as an irreversible passive process relating to valve degeneration and calcium accumulation. However, latest research has shown that CAVD is a complex active process, which involving vascular endothelial injury, lipid infiltration, chronic inflammation, matrix remodeling, cell differentiation, progressive bone formation, and neovascularization. Besides, genetic mutation also play a significant role in the process. Novel therapeutic target and technology such as transcatheter aortic valve implantation have been developed, which casts new lights on CAVD prevention and treatment. This review focused on the current understanding of the pathogenesis and future diagnosis/therapies of CAVD. |
| Key words: calcific aortic valve disease aortic valve stenosis vascular endothelial injury inflammation matrix remodeling osteogenesis |
