Ginghină Carmen, Florian Anca, Beladan C, Iancu M, Călin Andreea, Popescu B A, Jurcuţ Ruxandra
Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Rom J Intern Med. 2009;47(4):319-29.
Calcific (degenerative) aortic valve disease is the most common etiology of acquired aortic valve stenosis. Historically, it was seen as a degenerative, "senile-like" process, resulting from aging--"wearing and tearing"--of the aortic valve. However, several lines of evidence suggest that calcific valve disease is not simply due to age-related degeneration but, rather, it is an active disease process with identifiable initiating factors, clinical and genetic risk factors, and cellular and molecular pathways that mediate disease progression. Histopathologically, the early lesions of aortic valve sclerosis resemble arterial atherosclerotic plaques. Furthermore, atherosclerotic risk factors and clinical atherosclerotic cardiovascular disease are independently associated with aortic sclerosis suggesting that it represents an atherosclerosis-like process involving the aortic valve. Until now, the only established treatment for symptomatic aortic valve stenosis has been valve replacement. Newer therapies that may modify or reduce the likelihood of developing aortic valve disease are highly desirable and are currently under investigation. In this article we tried to review the available data on calcific aortic valve disease, starting from histological and pathogenic aspects and finishing with therapeutic implications, in order to characterize its relationship with the atherosclerotic process.
钙化（退行性）主动脉瓣疾病是获得性主动脉瓣狭窄最常见的病因。从历史上看，它被视为一种退行性的“老年样”过程，是由主动脉瓣的老化——“磨损”——导致的。然而，有几条证据表明，钙化性瓣膜疾病并非仅仅由于与年龄相关的退变，相反，它是一个活跃的疾病过程，有可识别的起始因素、临床和遗传风险因素，以及介导疾病进展的细胞和分子途径。从组织病理学角度看，主动脉瓣硬化的早期病变类似于动脉粥样硬化斑块。此外，动脉粥样硬化风险因素和临床动脉粥样硬化性心血管疾病与主动脉硬化独立相关，这表明它代表了一个涉及主动脉瓣的动脉粥样硬化样过程。到目前为止，有症状的主动脉瓣狭窄唯一已确立的治疗方法是瓣膜置换。非常需要能够改变或降低患主动脉瓣疾病可能性的新疗法，目前这些疗法正在研究中。在本文中，我们试图回顾关于钙化性主动脉瓣疾病的现有数据，从组织学和发病机制方面开始，以治疗意义作为结束，以便描述其与动脉粥样硬化过程的关系。
