Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
Fitzwilliam College, University of Cambridge, Cambridge CB3 0DG, UK.
Genes (Basel). 2024 Oct 10;15(10):1309. doi: 10.3390/genes15101309.
Calcific aortic stenosis is the most prevalent valvular abnormality in the Western world. Factors commonly associated with calcific aortic stenosis include advanced age, male sex, hypertension, diabetes and impaired renal function. This review synthesises the existing literature on genetic associations with calcific aortic stenosis. A systematic search was conducted in the PubMed, Ovid and Cochrane libraries from inception to 21 July 2024 to identify human studies investigating the genetic factors involved in calcific aortic stenosis. From an initial pool of 1392 articles, 78 were selected for full-text review and 31 were included in the final qualitative synthesis. The risk of bias in these studies was assessed using the Newcastle Ottawa Scale. Multiple genes have been associated with calcific aortic stenosis. These genes are involved in different biological pathways, including the lipid metabolism pathway (, , , , , ), the inflammatory pathway (, ), the calcification pathway (, ) and the endocrine pathway (, , , , ). Additional genes such as , and influence different pathways. Mechanistically, these genes may promote a pro-inflammatory and pro-calcific environment in the aortic valve itself, leading to increased osteoblastic activity and subsequent calcific degeneration of the valve. Numerous genetic associations contribute to calcific aortic stenosis. Recognition of these associations can enhance risk stratification for individuals and their first-degree relatives, facilitate family screening, and importantly, pave the way for targeted therapeutic interventions focusing on the identified genetic factors. Understanding these genetic factors can also lead to gene therapy to prevent calcific aortic stenosis in the future.
钙化性主动脉瓣狭窄是西方世界最常见的瓣膜异常。与钙化性主动脉瓣狭窄相关的常见因素包括年龄较大、男性、高血压、糖尿病和肾功能受损。本综述综合了现有关于钙化性主动脉瓣狭窄遗传相关性的文献。从 2024 年 7 月 21 日开始,在 PubMed、Ovid 和 Cochrane 图书馆中进行了系统检索,以确定研究钙化性主动脉瓣狭窄相关遗传因素的人类研究。从最初的 1392 篇文章中,选择了 78 篇进行全文审查,并纳入了 31 篇进行最终的定性综合分析。使用纽卡斯尔-渥太华量表评估这些研究的偏倚风险。 多个基因与钙化性主动脉瓣狭窄有关。这些基因参与不同的生物学途径,包括脂质代谢途径(、、、、、)、炎症途径(、)、钙化途径(、)和内分泌途径(、、、、)。其他基因如、和影响不同的途径。从机制上讲,这些基因可能在主动脉瓣本身中促进促炎和促钙化环境,导致成骨细胞活性增加,随后瓣膜发生钙化性退行性变。 许多遗传相关性导致钙化性主动脉瓣狭窄。对这些相关性的认识可以增强个体及其一级亲属的风险分层,促进家庭筛查,重要的是,为针对已确定遗传因素的靶向治疗干预铺平道路。了解这些遗传因素也可以为未来预防钙化性主动脉瓣狭窄的基因治疗铺平道路。
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