Peltier M, Tribouilloy C
INSERM, ERI 12, CHU, Amiens.
Arch Mal Coeur Vaiss. 2006 Sep;99(9):818-22.
Degenerative calcific aortic stenosis is the most common valvular disease in the industrialised world. During the last decade, experimental studies have improved our understanding of the physiopathology of this disease. The latest data concerns the demonstration of the mode of installation and progression which resembles that of athrosclerosis. Lipid abnormalities, especially hypercholesterolaemia, are important in the initiation of the valvular lesions and also in the calcification of the aortic orifice. Experimental data and retrospective clinical studies suggest, but without proof, that statins could slow th progression of the aortic stenosis. However, the first prospective trial, recently published, questions this hypothesis. Randomised multicenter trials are currently under way and should provide the answer to the role of stetins in the prevention of aortic stenosis.
退行性钙化性主动脉瓣狭窄是工业化国家最常见的瓣膜疾病。在过去十年中，实验研究增进了我们对这种疾病生理病理学的理解。最新数据涉及对其发病和进展模式的证明，这种模式类似于动脉粥样硬化。脂质异常，尤其是高胆固醇血症，在瓣膜病变的起始以及主动脉口钙化过程中都很重要。实验数据和回顾性临床研究表明（但未经证实），他汀类药物可能会减缓主动脉瓣狭窄的进展。然而，最近发表的第一项前瞻性试验对这一假设提出了质疑。目前正在进行随机多中心试验，这些试验应该会为他汀类药物在预防主动脉瓣狭窄中的作用提供答案。
