Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Am J Physiol Heart Circ Physiol. 2010 Jan;298(1):H5-15. doi: 10.1152/ajpheart.00824.2009. Epub 2009 Oct 23.
Recent epidemiologic studies have revealed the risk factors associated for vascular atherosclerosis, including the male sex, smoking, hypertension, and elevated serum cholesterol, similar to the risk factors associated with the development of AV stenosis. An increasing number of models of experimental hypercholesterolemia demonstrate features of atherosclerosis in the AV, which are similar to the early stages of vascular atherosclerotic lesions. Experimental and clinical studies demonstrate that the hypercholesterolemic AV develops an atherosclerotic lesion which is proliferative and expresses high levels of osteoblast bone markers which mineralize over time to form bone. Calcification, the end-stage process of the disease, is necessary to understand as a prognostic indicator in the modification of this cellular process before it is too late. In summary, these findings suggest that medical therapies may have a potential role in patients in the early stages of this disease process to slow the progression to severe aortic stenosis and to delay the timing of the need for surgery. The translation of these experimental studies to clinical practice will be important to understand the potential for medical therapy for this disease process.
最近的流行病学研究揭示了与血管动脉粥样硬化相关的危险因素，包括男性、吸烟、高血压和血清胆固醇升高，这些危险因素与 AV 狭窄的发展相关。越来越多的实验性高胆固醇血症模型在 AV 中表现出动脉粥样硬化的特征，类似于血管动脉粥样硬化病变的早期阶段。实验和临床研究表明，高胆固醇血症的 AV 会发展出一种动脉粥样硬化病变，这种病变具有增生性，并表达高水平的成骨细胞骨标志物，随着时间的推移会矿化形成骨。钙化是疾病的终末期过程，需要了解它作为预后指标在这个细胞过程变得过于严重之前进行干预的重要性。总之，这些发现表明，在疾病的早期阶段，药物治疗可能对患者有一定的作用，可以减缓向严重主动脉瓣狭窄的进展，并延迟手术的时机。将这些实验研究转化为临床实践对于理解这种疾病过程的药物治疗潜力非常重要。
