From the Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Germany (P.R.G., M.R.H., D.C., S.T.N., S.Z., G.N., F.J.).
Clinic for Internal Medicine II, University Hospital Cologne, Germany (M.A.).
Arterioscler Thromb Vasc Biol. 2020 Apr;40(4):885-900. doi: 10.1161/ATVBAHA.119.313067. Epub 2020 Mar 12.
Aortic valve stenosis is the most prevalent heart valve disease worldwide. Although interventional treatment options have rapidly improved in recent years, symptomatic aortic valve stenosis is still associated with high morbidity and mortality. Calcific aortic valve stenosis is characterized by a progressive fibro-calcific remodeling and thickening of the aortic valve cusps, which subsequently leads to valve obstruction. The underlying pathophysiology is complex and involves endothelial dysfunction, immune cell infiltration, myofibroblastic and osteoblastic differentiation, and, subsequently, calcification. To date, no pharmacotherapy has been established to prevent aortic valve calcification. However, novel promising therapeutic targets have been recently identified. This review summarizes the current knowledge of pathomechanisms involved in aortic valve calcification and points out novel treatment strategies.
主动脉瓣狭窄是全球最常见的心脏瓣膜病。尽管近年来介入治疗选择迅速改善，但有症状的主动脉瓣狭窄仍然与高发病率和死亡率相关。钙化性主动脉瓣狭窄的特征是主动脉瓣瓣叶进行性纤维-钙化重塑和增厚，随后导致瓣膜阻塞。潜在的病理生理学是复杂的，涉及内皮功能障碍、免疫细胞浸润、成纤维细胞和成骨细胞分化，以及随后的钙化。迄今为止，尚无药物疗法被确立用于预防主动脉瓣钙化。然而，最近已经确定了一些有前途的新治疗靶点。这篇综述总结了目前对主动脉瓣钙化相关发病机制的认识，并指出了新的治疗策略。
