Division of Experimental Medicine, McGill University.
Preventive and Genomic Cardiology, McGill University Health Centre and Research Institute.
Curr Opin Endocrinol Diabetes Obes. 2019 Apr;26(2):96-102. doi: 10.1097/MED.0000000000000471.
Recent literature is examined to identify established and emerging risk factors for valvular calcification, specifically calcific aortic valve disease and mitral annular calcification.
Strong evidence implicates older age, male sex, cigarette smoking, elevated blood pressure, dyslipidaemia, adiposity, and mineral metabolism as risk factors for calcific aortic valve disease. Emerging evidence suggests family history and lipoprotein(a) are additional risk factors. Recently, large-scale genome-wide analyses have identified robust associations for LPA, PALMD, and TEX41 with aortic stenosis. Factors predisposing to mitral annular calcification are less well characterized. Older age, cigarette smoking, increased BMI, kidney dysfunction, and elevated triglycerides are associated with greater risk of mitral annular calcification, but conflicting evidence exists for sex and C-reactive protein.
Established and emerging risk factors for calcific aortic valve disease, including some that overlap with atherosclerosis, may represent targets for pharmacological intervention. Mitral annular calcification is comparatively less well understood though some atherosclerosis risk factors do appear to increase risk.
本文旨在通过分析近期文献，明确瓣膜钙化（尤其是主动脉瓣钙化和二尖瓣环钙化）的既定和新兴风险因素。
大量证据表明，年龄较大、男性、吸烟、血压升高、血脂异常、肥胖和矿物质代谢异常是主动脉瓣钙化的危险因素。新出现的证据表明，家族史和脂蛋白(a)也是额外的危险因素。最近，大规模全基因组分析已经确定了 LPA、PALMD 和 TEX41 与主动脉瓣狭窄之间存在强有力的关联。导致二尖瓣环钙化的因素尚未得到很好的描述。年龄较大、吸烟、体重指数增加、肾功能不全和甘油三酯升高与二尖瓣环钙化的风险增加相关，但性别和 C 反应蛋白的证据相互矛盾。
已确定和新兴的主动脉瓣钙化风险因素，包括一些与动脉粥样硬化重叠的因素，可能是药物干预的靶点。相比之下，二尖瓣环钙化的理解程度较差，但一些动脉粥样硬化的危险因素似乎确实会增加风险。
