Lazaros George, Toutouzas Konstantinos, Drakopoulou Maria, Boudoulas Harisios, Stefanadis Christodoulos, Rajamannan Nalini
First Department of Cardiology, Medical School of Athens University, Hippokration Hospital, Athens, Greece.
Expert Rev Cardiovasc Ther. 2013 Jul;11(7):863-77. doi: 10.1586/14779072.2013.811978.
Several similarities exist between atherosclerosis in the vasculature and chronic degenerative changes in valvular structures. It has been suggested that aortic valve sclerosis (AVS) and mitral annulus calcification (MAC) are manifestations of a generalized atherosclerosis, have similar pathogenesis, share common risk factors and are observed with higher prevalence in patients with different forms of atherosclerotic vascular disease. Moreover, recent studies have shown a close relation of MAC and AVS with adverse cardiovascular and cerebrovascular outcomes. However, many patients with AVS or MAC do not have coexisting peripheral vascular atherosclerosis and vice versa. Lipid-reducing therapy has been uniformly unsuccessful in slowing valvular calcification. Thus, whether valve calcifications are the result of a more generalized atherosclerosis, or reflect a primary degenerative process, progressing with advancing age, still remains. From a clinical point of view, it is of great importance to identify common links between valve calcification and vascular atherosclerosis with a view to assess whether the detection of AVS, MAC or both are indicative of subclinical atherosclerosis and predicts cardiovascular or cerebrovascular events. Thus, in this article, the authors review current evidence regarding the association between AVS and MAC with vascular atherosclerosis.
血管中的动脉粥样硬化与瓣膜结构的慢性退行性变之间存在若干相似之处。有人提出，主动脉瓣硬化（AVS）和二尖瓣环钙化（MAC）是全身性动脉粥样硬化的表现，具有相似的发病机制，共享共同的危险因素，并且在患有不同形式动脉粥样硬化性血管疾病的患者中更普遍地观察到。此外，最近的研究表明MAC和AVS与不良心血管和脑血管结局密切相关。然而，许多患有AVS或MAC的患者并没有并存的外周血管动脉粥样硬化，反之亦然。降脂治疗在减缓瓣膜钙化方面一直未能取得成功。因此，瓣膜钙化是更广泛的动脉粥样硬化的结果，还是反映了随着年龄增长而进展的原发性退行性过程，仍然存在疑问。从临床角度来看，识别瓣膜钙化与血管动脉粥样硬化之间的共同联系非常重要，以便评估检测到AVS、MAC或两者是否表明存在亚临床动脉粥样硬化并预测心血管或脑血管事件。因此，在本文中，作者回顾了关于AVS和MAC与血管动脉粥样硬化之间关联的现有证据。
