Curr Probl Cardiol. 2010 Jun;35(6):284-306. doi: 10.1016/j.cpcardiol.2010.02.002.
Calcific aortic stenosis is the most frequent heart valve disease and the main indication for valve replacement in western countries. For centuries attributed to a passive wear and tear process, it is now recognized that aortic stenosis is an active inflammatory and potentially modifiable pathology, with similarities to atherosclerosis. Statins were first-line candidates for slowing down progression of the disease, as established drugs in primary and secondary cardiovascular prevention. Despite promising animal experiments and nonrandomized human trials, the prospective randomized trials SEAS and SALTIRE did not confirm the expected benefit. We review SEAS and SALTIRE starting with the preceding studies and discuss basic science experiments covering the major known contributors to the pathophysiology of calcific aortic valve disease, to conclude with a hypothesis on the absent effect of statins, and suggestions for further research paths.
钙化性主动脉瓣狭窄是最常见的心脏瓣膜病，也是西方国家瓣膜置换的主要适应证。几个世纪以来，人们一直认为它是一种被动的磨损过程，而现在人们已经认识到，主动脉瓣狭窄是一种主动的炎症性疾病，具有潜在的可调节性，与动脉粥样硬化有相似之处。他汀类药物作为减缓疾病进展的一线药物，在一级和二级心血管预防中已被证实是有效的。尽管有前景的动物实验和非随机的人体试验，但 SEAS 和 SALTIRE 前瞻性随机试验并未证实预期的益处。我们从之前的研究开始回顾 SEAS 和 SALTIRE，并讨论涵盖钙化性主动脉瓣疾病病理生理学主要已知贡献者的基础科学实验，最后提出关于他汀类药物无效的假设，并为进一步的研究途径提出建议。
