Hu Jiahui, Lei Hao, Liu Leiling, Xu Danyan
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.
Front Cell Dev Biol. 2022 Jan 27;10:812368. doi: 10.3389/fcell.2022.812368. eCollection 2022.
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.
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。
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