Liu Feng, Cai Haipeng
Department of Cardiology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China.
Front Pharmacol. 2025 Apr 28;16:1583267. doi: 10.3389/fphar.2025.1583267. eCollection 2025.
Calcific aortic valve disease (CAVD) is a progressive disease, of which the 2-year mortality is >50% for symptomatic disease. However, there are currently no pharmacotherapies to prevent the progression of CAVD unless transcatheter or surgical aortic valve replacement is performed. The prevalence of diabetes among CAVD has increased rapidly in recent decades, especially among those undergoing aortic valve replacement. Diabetes and its comorbidities, such as hypertension, hyperlipidemia, chronic kidney disease and ageing, participated jointly in the initiation and progression of CAVD, which increased the management complexity in patients with CAVD. Except from hyperglycemia, the molecular links between diabetes and CAVD included inflammation, oxidative stress and endothelial dysfunction. Traditional cardiovascular drugs like lipid-lowering agents and renin-angiotensin system blocking drugs have proven to be unsuccessful in retarding the progression of CAVD in clinical trials. In recent years, almost all kinds of glucose-lowering medications have been specifically assessed for decelerating the development of CAVD. Based on the efficacy for atherosclerotic cardiovascular disease and CAVD, this review summarized current knowledge about glucose-lowering medications as promising treatment options with the potential to retard CAVD.
钙化性主动脉瓣疾病（CAVD）是一种进行性疾病，有症状患者的2年死亡率>50%。然而，除非进行经导管或外科主动脉瓣置换，否则目前尚无药物疗法可预防CAVD的进展。近几十年来，CAVD患者中糖尿病的患病率迅速上升，尤其是在接受主动脉瓣置换的患者中。糖尿病及其合并症，如高血压、高脂血症、慢性肾脏病和衰老，共同参与了CAVD的发生和发展，这增加了CAVD患者的管理复杂性。除高血糖外，糖尿病与CAVD之间的分子联系还包括炎症、氧化应激和内皮功能障碍。在临床试验中，降脂药物和肾素-血管紧张素系统阻断药物等传统心血管药物已被证明在延缓CAVD进展方面未取得成功。近年来，几乎所有种类的降糖药物都已针对延缓CAVD的发展进行了专门评估。基于对动脉粥样硬化性心血管疾病和CAVD的疗效，本综述总结了目前关于降糖药物作为有望延缓CAVD进展的治疗选择的知识。
