钙化性主动脉瓣疾病发病机制及临床诊治研究进展

随着人口的老龄化和风湿热发病率的降低,钙化性主动脉瓣疾病(calcific aortic valve disease,CAVD)的发病率在我国呈逐年上升的趋势,已成为老年人最常见的心脏瓣膜病.CAVD以往被视为是一种与瓣膜退行性变、钙盐沉积相关的被动过程,但最新研究发现CAVD的发生实际是一个涉及内皮损伤、脂质浸润、慢性炎症、基质重塑、细胞分化、进展性钙化及新生血管形成等复杂变化的主动过程,一些基因的变异在其发生发展中也扮演重要角色.CAVD的临床诊治措施目前也取得了一系列进展,包括一些延缓或阻断CAVD进展干预靶点的发现以及经导管主动脉瓣置换术(transcatheter aortic valve implantation,TAVI)的临床应用,都为防治CAVD提供了新思路.本文主要就CAVD发病机制的最新研究进展进行综述,并展望了CAVD未来的诊治方向.

Calcific aortic valve disease: a review of the pathogenesis and therapeutical trends

The incidence of calcific aortic valve disease (CAVD) has increased dramatically as a result of the decline in rheumatic fever and the increase in aging population. In addition, CAVD has been regarded as the most common aortic valve disease among the aged population in China. CAVD was thought to be an irreversible passive process relating to valve degeneration and calcium accumulation before, However, latest research shows that CAVDSis a complex active process, which related to vascular endothelial injury,SlipidSinfiltration, chronic inflammation, matrix remodeling, cell differentiation,Sprogressive bone formationSand neovascularization.SBesides, genetic mutation may also play a significant role in the process. Furthermore new therapeutic target and novel technology such as TAVI have been achieved some significances in prevention and treatment for CAVD. This review will focus on current understanding of the pathogenesis and future medical therapies for CAVD.