Schoen Frederick J
Department of Pathology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
Circulation. 2008 Oct 28;118(18):1864-80. doi: 10.1161/CIRCULATIONAHA.108.805911.
Considerable progress has been made in recent years toward elucidating a conceptual framework that integrates the dynamic functional structure, mechanical properties, and pathobiological behavior of the cardiac valves. This communication reviews the evolving paradigm of a continuum of heart valve structure, function, and pathobiology and explores its implications. Specifically, we discuss (1) the interactions of valve biology and biomechanics (eg, correlations of function with structure at the cell, tissue, and organ levels and mechanical considerations, development, endothelial cell and interstitial cell biology, extracellular matrix biology, homeostasis, and adaptation to environmental change); (2) mechanisms of disease (eg, valve cell and matrix pathobiology in congenital anomalies, aortic valve calcification, and mitral valve prolapse); (3) considerations in replacement and repair (eg, cell/matrix biology of tissue valve substitutes and their degeneration and durability of repairs); and (4) the potential for tissue engineering approaches to therapeutic regeneration of the cardiac valves. Opportunities for research and clinical translation are highlighted.
近年来，在阐明一个整合心脏瓣膜动态功能结构、力学特性和病理生物学行为的概念框架方面取得了相当大的进展。本通讯回顾了心脏瓣膜结构、功能和病理生物学连续统一体不断演变的范式，并探讨了其影响。具体而言，我们讨论了：（1）瓣膜生物学与生物力学的相互作用（例如，细胞、组织和器官水平上功能与结构的相关性以及力学考量、发育、内皮细胞和间质细胞生物学、细胞外基质生物学、内稳态以及对环境变化的适应性）；（2）疾病机制（例如，先天性异常、主动脉瓣钙化和二尖瓣脱垂中的瓣膜细胞和基质病理生物学）；（3）置换和修复方面的考量（例如，组织瓣膜替代物的细胞/基质生物学及其退变和修复的耐久性）；以及（4）心脏瓣膜治疗性再生的组织工程方法的潜力。文中突出了研究和临床转化的机会。
