Center for Interdisciplinary Cardiovascular Sciences, 3 Blackfan Circle, 17th Floor, Center for Life Sciences Boston, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Center for Excellence in Vascular Biology, 3 Blackfan Circle, 17th Floor, Center for Life Sciences Boston, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Nat Rev Cardiol. 2014 Apr;11(4):218-31. doi: 10.1038/nrcardio.2014.1. Epub 2014 Jan 21.
Calcific aortic valve disease (CAVD) is a major contributor to cardiovascular morbidity and mortality and, given its association with age, the prevalence of CAVD is expected to continue to rise as global life expectancy increases. No drug strategies currently exist to prevent or treat CAVD. Given that valve replacement is the only available clinical option, patients often cope with a deteriorating quality of life until diminished valve function demands intervention. The recognition that CAVD results from active cellular mechanisms suggests that the underlying pathways might be targeted to treat the condition. However, no such therapeutic strategy has been successfully developed to date. One hope was that drugs already used to treat vascular complications might also improve CAVD outcomes, but the mechanisms of CAVD progression and the desired therapeutic outcomes are often different from those of vascular diseases. Therefore, we discuss the benchmarks that must be met by a CAVD treatment approach, and highlight advances in the understanding of CAVD mechanisms to identify potential novel therapeutic targets.
钙化性主动脉瓣疾病（CAVD）是心血管发病率和死亡率的主要原因，并且鉴于其与年龄的相关性，随着全球预期寿命的增加，CAVD 的患病率预计将继续上升。目前尚无药物策略可预防或治疗 CAVD。鉴于瓣膜置换术是唯一可行的临床选择，因此患者的生活质量往往会逐渐下降，直到瓣膜功能下降需要进行干预。认识到 CAVD 是由活跃的细胞机制引起的，这表明可以针对潜在途径来治疗该疾病。但是，迄今为止尚未成功开发出这种治疗策略。人们曾希望已经用于治疗血管并发症的药物也可能改善 CAVD 的预后，但是 CAVD 进展的机制和所需的治疗效果通常与血管疾病不同。因此，我们讨论了 CAVD 治疗方法必须满足的基准，并强调了对 CAVD 机制的理解的进展，以确定潜在的新治疗靶标。
