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首页> 外文期刊>Infectious Disorders - Drug Targets (Formerly Current Drug Targets - Infectious Disorders) >Prediction of Degeneration of Native and Bioprosthetic Aortic Valves:Issue-Related Particularities of Diabetes Mellitus
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Prediction of Degeneration of Native and Bioprosthetic Aortic Valves:Issue-Related Particularities of Diabetes Mellitus

机译：天然和生物假体主动脉瓣退化的预测：糖尿病的相关问题

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Degenerative aortic valve stenosis is the leading cause of heart valve disease in elderly resulting in significant morbidity and mortality. Although aortic stenosis has been recognized as a complex inflammatory and well-regulated process, its exact pathomechanisms are still largely unknown. Assessment by Echocardiography, Electron Beam Computed Tomography and Multislice Computed Tomography is useful for monitoring of disease progression. However, better knowledge of main determinants is essential to enable both prediction and prevention of the disease.nnIt has been suggested that the process of heart valve degeneration is associated with the risk factors of atherosclerosis and shares many histological and molecular characteristics. Morphologic, cellular and sub-cellular examinations of degenerative aortic valves revealed endothelial derangement, inflammatory infiltrates of macrophages, T-lymphocytes and foam cells, non-physiologic lipid / lipoprotein / protein deposits, as well as dramatically altered extra-cellular matrix composition and expression profiles of checkpoint- and ”tissue remodeling“-genes.nnMetabolic disorder - Diabetes mellitus - is considered to predispose to degenerative valve disease and is associated with faster degeneration of bioprosthetic valves. Oxidative stress is implicated in progressive chronic degenerative processes secondary to diabetes. Moreover, diabetic patients are a high-risk group for infectious disorders. Increased prevalence of infectious endocarditis in patients with type 2 Diabetes mellitus contributes considerably to both acute aortic insufficiency and chronic progressive degeneration of valvular tissue. Cholesterol lowering drugs were demonstrated to be able to retard this progression.nnThis review considers prognostic factors for prediction of progressive degenerative processes and novel targets to prevent calcification of aortic valves.
机译：退化性主动脉瓣狭窄是老年人心脏瓣膜疾病的主要原因，导致明显的发病率和死亡率。尽管主动脉瓣狭窄已被认为是一个复杂的炎症过程，并且受到良好的调节，但其确切的致病机理仍然未知。通过超声心动图，电子束计算机断层扫描和多层计算机断层扫描进行评估可用于监测疾病进展。然而，对主要决定因素的更好了解对于实现该疾病的预测和预防至关重要。nn有人提出，心脏瓣膜变性的过程与动脉粥样硬化的危险因素有关，并具有许多组织学和分子学特征。退化性主动脉瓣的形态学，细胞和亚细胞检查显示内皮排列紊乱，巨噬细胞，T淋巴细胞和泡沫细胞的炎性浸润，非生理性脂质/脂蛋白/蛋白质沉积，以及细胞外基质组成和表达显着改变检验点和“组织重塑”基因的概况。nn代谢紊乱-糖尿病-被认为易患瓣膜变性疾病，并与生物瓣膜的更快变性有关。氧化应激与继发于糖尿病的进行性慢性退化过程有关。此外，糖尿病患者是感染性疾病的高危人群。 2型糖尿病患者中感染性心内膜炎的患病率增加对急性主动脉瓣关闭不全和慢性渐进性瓣膜组织变性都有很大贡献。降低胆固醇的药物被证明能够延缓这种进展。这篇综述考虑了预测进行性退行性变的预后因素和防止主动脉瓣钙化的新靶标。

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