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脂蛋白(a),钙化性主动脉瓣疾病中的致命因素。

Lipoprotein(a), a Lethal Player in Calcific Aortic Valve Disease.

作者信息

Hu Jiahui, Lei Hao, Liu Leiling, Xu Danyan

机构信息

Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.

Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.

出版信息

Front Cell Dev Biol. 2022 Jan 27;10:812368. doi: 10.3389/fcell.2022.812368. eCollection 2022.


DOI:10.3389/fcell.2022.812368
PMID:35155427
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8830536/
Abstract

Calcified aortic valve disease (CAVD) is the most common valvular cardiovascular disease with increasing incidence and mortality. The primary treatment for CAVD is surgical or transcatheter aortic valve replacement and there remains a lack of effective drug treatment. Recently, lipoprotein (a) (Lp(a)) has been considered to play a crucial role in CAVD pathophysiology. Multiple studies have shown that Lp(a) represents an independent risk factor for CAVD. Moreover, Lp(a) mediates the occurrence and development of CAVD by affecting aortic valve endothelial dysfunction, indirectly promoting foam cell formation through oxidized phospholipids (OxPL), inflammation, oxidative stress, and directly promotes valve calcification. However, there is a lack of clinical trials with Lp(a) reduction as a primary endpoint. This review aims to explore the relationship and mechanism between Lp(a) and CAVD, and focuses on the current drugs that can be used as potential therapeutic targets for CAVD.

摘要

钙化性主动脉瓣疾病(CAVD)是最常见的心脏瓣膜病,其发病率和死亡率呈上升趋势。CAVD的主要治疗方法是外科手术或经导管主动脉瓣置换术,目前仍缺乏有效的药物治疗。近年来,脂蛋白(a)[Lp(a)]被认为在CAVD的病理生理过程中起关键作用。多项研究表明,Lp(a)是CAVD的独立危险因素。此外,Lp(a)通过影响主动脉瓣内皮功能障碍介导CAVD的发生和发展,通过氧化磷脂(OxPL)间接促进泡沫细胞形成、炎症、氧化应激,并直接促进瓣膜钙化。然而,目前缺乏以降低Lp(a)为主要终点的临床试验。本综述旨在探讨Lp(a)与CAVD之间的关系及机制,并重点关注目前可作为CAVD潜在治疗靶点的药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d9e/8830536/6e71a2d3d03a/fcell-10-812368-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d9e/8830536/356995ca1383/fcell-10-812368-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d9e/8830536/1fc1c1aff617/fcell-10-812368-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d9e/8830536/6e71a2d3d03a/fcell-10-812368-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d9e/8830536/356995ca1383/fcell-10-812368-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d9e/8830536/1fc1c1aff617/fcell-10-812368-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d9e/8830536/6e71a2d3d03a/fcell-10-812368-g003.jpg

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Lipoprotein(a), a Lethal Player in Calcific Aortic Valve Disease.

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Rev Cardiovasc Med. 2025-5-20

[2]
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[3]
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J Clin Med. 2025-4-25

[4]
Poor Sympathetic Compensation During Active Standing Increases the Risk of Morbidity-Mortality in the Post-Surgery of Patients with Severe Calcific Aortic Stenosis.

Biology (Basel). 2025-1-30

[5]
Lipoprotein(a) and thromboembolism: current state of knowledge and unsolved issues.

Arch Med Sci. 2024-12-13

[6]
Macrophages in Calcific Aortic Valve Disease: Paracrine and Juxtacrine Disease Drivers.

Biomolecules. 2024-12-2

[7]
The Role of Lp-PLA2 as a Mediator Between Serum Magnesium and Zinc Levels and Cardiovascular Risk in Patients With Metabolic Syndrome.

Cureus. 2024-10-22

[8]
Non-Conventional Risk Factors: "Fact" or "Fake" in Cardiovascular Disease Prevention?

Biomedicines. 2023-8-23

[9]
Lipoprotein(a) and calcific aortic valve disease initiation and progression: a systematic review and meta-analysis.

Cardiovasc Res. 2023-7-6

[10]
Approach to the Patient With a Suboptimal Statin Response: Causes and Algorithm for Clinical Management.

J Clin Endocrinol Metab. 2023-8-18

本文引用的文献

[1]
2021 ESC/EACTS Guidelines for the management of valvular heart disease.

Eur Heart J. 2022-2-12

[2]
The Expression Regulation and Biological Function of Autotaxin.

Cells. 2021-4-19

[3]
Lipoprotein(a), LDL-cholesterol, and hypertension: predictors of the need for aortic valve replacement in familial hypercholesterolaemia.

Eur Heart J. 2021-6-7

[4]
Lipoprotein-associated phospholipase A2 activity, genetics and calcific aortic valve stenosis in humans.

Heart. 2020-9

[5]
Lipoprotein(a) and calcific aortic valve stenosis: A systematic review.

Prog Cardiovasc Dis. 2020-6-8

[6]
An Exploratory Analysis of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibition and Aortic Stenosis in the FOURIER Trial.

JAMA Cardiol. 2020-6-1

[7]
Atherogenic Lipoprotein(a) Increases Vascular Glycolysis, Thereby Facilitating Inflammation and Leukocyte Extravasation.

Circ Res. 2020-5-8

[8]
ApoCIII-Lp(a) complexes in conjunction with Lp(a)-OxPL predict rapid progression of aortic stenosis.

Heart. 2020-5

[9]
Lipoprotein(a) Reduction in Persons with Cardiovascular Disease.

N Engl J Med. 2020-1-1

[10]
Correlation of Micro-Computed Tomography Assessment of Valvular Mineralisation with Histopathological and Immunohistochemical Features of Calcific Aortic Valve Disease.

J Clin Med. 2019-12-21

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