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钙化性主动脉瓣狭窄的病理机制与治疗。

Pathological Mechanism and Treatment of Calcified Aortic Stenosis.

机构信息

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China, Nanjing 210006, China.

Department of Cardiology, Nanjing Heart Centre, Nanjing, China.

出版信息

Cardiol Rev. 2024;32(4):320-327. doi: 10.1097/CRD.0000000000000510. Epub 2024 Jun 6.

Abstract

Calcified aortic stenosis (AS) is one of the most common valvular heart diseases worldwide, characterized by progressive fibrocalcific remodeling and thickening of the leaflets, which ultimately leads to obstruction of blood flow. Its pathobiology is an active and complicated process, involving endothelial cell dysfunction, lipoprotein deposition and oxidation, chronic inflammation, phenotypic transformation of valve interstitial cells, neovascularization, and intravalvular hemorrhage. To date, no targeted drug has been proven to slow down or prevent disease progression. Aortic valve replacement is still the optimal treatment of AS. This article reviews the etiology, diagnosis, and management of calcified aortic stenosis and proposes novel potential therapeutic targets.

摘要

钙化性主动脉瓣狭窄(AS)是全球最常见的心脏瓣膜病之一,其特征为瓣叶进行性纤维-钙化重塑和增厚,最终导致血流受阻。其病理生物学是一个活跃而复杂的过程,涉及内皮细胞功能障碍、脂蛋白沉积和氧化、慢性炎症、瓣膜间质细胞表型转化、新生血管形成和瓣内出血。迄今为止,尚无靶向药物被证明能减缓或阻止疾病进展。主动脉瓣置换仍然是 AS 的最佳治疗方法。本文综述了钙化性主动脉瓣狭窄的病因、诊断和治疗,并提出了新的潜在治疗靶点。

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