Peltier M, Enriquez-Sarano M, Slama M, Tribouilloy Ch
Service de cardiologie B, CHRU d'Amiens, hôpital Sud, Amiens.
Arch Mal Coeur Vaiss. 2004 Apr;97(4):327-32.
Calcified "degenerative" aortic stenosis is currently the most common valvulopathy in industrialised countries. In the course of the last decade, experimental studies have allowed a better understanding of the physiopathology of this vavlulopathy. The latest development is the evidence for the initiation and progression of this disease, similar to those described for atherosclerosis. Lipid disturbances, in particular hypercholesterolaemia, constitute an important factor in the initiation of valvular lesions, but also in aortic orifice calcification. Certain preliminary clinical studies are in favour of the significance of statins for slowing the progression of aortic stenosis. This potential beneficial effect requires confirmation by randomised prospective studies and raises hopes for medical therapy in order to avoid the evolution of ordinary aortic sclerosis into tight calcified aortic stenosis.
钙化性“退行性”主动脉瓣狭窄目前是工业化国家最常见的瓣膜病。在过去十年中,实验研究使人们对这种瓣膜病的病理生理学有了更好的理解。最新进展是有证据表明这种疾病的发生和发展过程与动脉粥样硬化相似。脂质紊乱,尤其是高胆固醇血症,不仅是瓣膜病变发生的重要因素,也是主动脉瓣口钙化的重要因素。某些初步临床研究支持他汀类药物对减缓主动脉瓣狭窄进展具有重要意义。这种潜在的有益作用需要通过随机前瞻性研究来证实,这也为药物治疗带来了希望,有望避免普通主动脉硬化发展为严重的钙化性主动脉瓣狭窄。