Lee Hae Young, Lim Soyeon, Park Sungha
Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
Institute for Bio-Medical Convergence, College of Medicine, Catholic Kwandong University, Gangneung, Korea.
Korean Circ J. 2021 Feb;51(2):114-125. doi: 10.4070/kcj.2020.0517.
Arterial calcification, characterized by calcium phosphate deposition in the arteries, can be divided into intimal calcification and medial calcification. The former is the predominant form of calcification in coronary artery plaques; the latter mostly affects peripheral arteries and aortas. Both forms of arterial calcification have strong correlations with adverse cardiovascular events. Intimal microcalcification is associated with increased risk of plaque disruption while the degree of burden of coronary calcification, measured by coronary calcium score, is a marker of overall plaque burden. Continuous research on vascular calcification has been performed during the past few decades, and several cellular and molecular mechanisms and therapeutic targets were identified. However, despite clinical trials to evaluate the efficacy of drug therapies to treat vascular calcification, none have been shown to have efficacy until the present. Therefore, more extensive research is necessary to develop appropriate therapeutic strategies based on a thorough understanding of vascular calcification. In this review, we mainly focus on intimal calcification, namely the pathobiology of arterial calcification, and its clinical implications.
动脉钙化，其特征为动脉中磷酸钙沉积，可分为内膜钙化和中膜钙化。前者是冠状动脉斑块中钙化的主要形式；后者主要影响外周动脉和主动脉。两种形式的动脉钙化都与不良心血管事件密切相关。内膜微钙化与斑块破裂风险增加有关，而通过冠状动脉钙化积分测量的冠状动脉钙化负担程度是总体斑块负担的一个指标。在过去几十年里，对血管钙化进行了持续研究，确定了几种细胞和分子机制以及治疗靶点。然而，尽管进行了评估药物治疗血管钙化疗效的临床试验，但迄今为止尚无一种药物显示出疗效。因此，有必要进行更广泛的研究，以便在全面了解血管钙化的基础上制定适当的治疗策略。在本综述中，我们主要关注内膜钙化，即动脉钙化的病理生物学及其临床意义。
