心跳：预防钙化性主动脉瓣狭窄的治疗靶点,Heart

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心跳：预防钙化性主动脉瓣狭窄的治疗靶点
Heart ( IF 5.1 ) Pub Date : 2020-08-26 , DOI: 10.1136/heartjnl-2020-318014
Catherine M Otto ₁

Affiliation

与华盛顿大学心脏病学系 Catherine M Otto 教授的通信，西雅图，WA 98195，美国；cmotto@uw edu 目前对钙化性主动脉瓣狭窄 (CAVS) 的管理仅限于通过瓣膜置换术缓解终末期疾病左心室流出道梗阻目前的研究表明，这种关联不是由 Lp-PLA2 介导的，并强调了仔细审查病理生理学途径中的生物因素是否仅仅是生物标志物或实际上代表一个可行的因果目标的重要性表 1 正在进行的医学随机临床试验主动脉瓣狭窄的治疗研究目标治疗脂质驱动的炎症通路 PCSK9 抑制剂在主动脉瓣狭窄的进展中 (NCT03051360) 含载脂蛋白 B 的脂蛋白；PCSK9 基于此分析，作者提出了 RHD 孕妇的风险评分（表 2）表 2 新的预后评分（DEVI 评分）可预测风湿性瓣膜性心脏病孕妇的复合不良心脏结局预测评分既往心血管事件* +4 0 肺动脉高压 + 4 0 服用心脏药物 −1 0 重度二尖瓣狭窄 +4 0 中度二尖瓣狭窄 +2 0 轻度二尖瓣狭窄 +1 0 人工心脏瓣膜 +2 0 分数是通过将每个参数的存在及其范围的单个分数相加来计算的（最小值-最大值）为 0-12药物 -1 0 重度二尖瓣狭窄 +4 0 中度二尖瓣狭窄 +2 0 轻度二尖瓣狭窄 +1 0 人工心脏瓣膜 +2 0 分数是通过将每个参数的存在及其范围（最小值-最大值）的单个分数相加来计算的是 0–12药物 -1 0 重度二尖瓣狭窄 +4 0 中度二尖瓣狭窄 +2 0 轻度二尖瓣狭窄 +1 0 人工心脏瓣膜 +2 0 分数是通过将每个参数的存在及其范围（最小值-最大值）的单个分数相加来计算的是 0–12

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Heartbeat: therapeutic targets for prevention of calcific aortic valve stenosis

Correspondence to Professor Catherine M Otto, Division of Cardiology, University of Washington, Seattle, WA 98195, USA;cmotto@uw edu Current management of calcific aortic valve stenosis (CAVS) is limited to palliation of end-stage disease with valve replacement to relieve left ventricular outflow obstruction The current study suggests that this association is not mediated by Lp-PLA2 and underlines the importance of scrutinising whether biological factors within pathophysiological pathways are merely biomarkers or actually represent a feasible and causal target ’Table 1 Ongoing randomised clinical trials of medical therapies in aortic stenosis Study Target Treatment Lipid-driven inflammation pathways PCSK9 inhibitors in the progression of aortic stenosis (NCT03051360) ApoB-containing lipoproteins;PCSK9 Based on this analysis, the authors propose a risk score from pregnant women with RHD (table 2) Table 2 New prognostic score (DEVI’s score) to predict composite adverse cardiac outcome in pregnant women with rheumatic valvular heart disease Predictor Score Prior cardiovascular event* +4 0 Pulmonary hypertension +4 0 Taking cardiac medications −1 0 Severe mitral stenosis +4 0 Moderate mitral stenosis +2 0 Mild mitral stenosis +1 0 Prosthetic heart valve +2 0 Score is calculated by adding the individual score for the presence of each parameter and its range (minimum–maximum) is 0–12

更新日期：2020-08-26

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