冠状动脉钙化的相关研究进展
于祥浩,于波
摘要(Abstract):
<正>冠状动脉钙化(coronary artery calcifi cation,CAC)是指矿物质异常沉积在冠状动脉壁,其广泛存在于冠心病(coronary heartdisease,CHD)患者中,是CHD患者未来发生不良心血管事件的预测因子[1]。研究表明,CAC的程度与冠状动脉粥样硬化程度、未来心脏事件的发生率密切相关[2]。钙化病变的形成是一个受炎症(代谢综合征、2型糖尿病等)刺激的活跃过程。钙化病变的早期阶段,炎性因子可激活血管细胞出现成骨分化和矿化,晚期钙化与巨噬细胞含量呈负相关[3]。本文将根据近年来CAC的研究进展,从流行病学与危险因素、病理机制、诊断方法以及治疗等方面对CAC作一综述。
关键词(KeyWords): 冠状动脉钙化;钙化机制;斑块稳定性;生物标志物
基金项目(Foundation): 国家重点研发计划资助项目(2016YFC1301101);; 国家自然基金重大仪器研制项目(81827806)
作者(Author): 于祥浩,于波
参考文献(References):
- [1]Criqui MH,Denenberg JO,Lx JH,et al.Calcium density of coronary artery plaque and risk of incident cardiovascular events.JAMA,2014,311(3):271-278.
- [2]Demer LL,Tintut Y. Vascular calcification:pathobiology of amultifaceted disease.Circulation,2008,117(22):2938-2948.
- [3]New SE,Aikawa E.Molecular imaging insights into early inflammatory stages of arterial and aortic valve calcification.Circ Res,2011,108(11):1381-1391.
- [4]McClelland RL,Chung H,Detrano R,et al.Distribution of coronary artery calcium by race,gender,and age:results from the Multi-Ethnic Study of Atherosclerosis(MESA).Circulation,2006,113(1):30-37.
- [5]Wong ND,Nelson JC,Granston T,et al.Metabolic syndrome,diabetes,and incidence and progression of coronary calcium:the Multi-Ethnic Study of Atherosclerosis study.JACC Cardiovasc Imaging,2012,5(4):358-366.
- [6]Pandey AK,Blaha MJ,Sharma K,et al.Family history of coronary heart disease and the incidence and progression of coronary artery calcification:Multi-Ethnic Study of Atherosclerosis(MESA).Athero Sclerosis,2014,232(2):369-376.
- [7]Ahmed HM,Blaha MJ,Nasir K,et al.Low-risk lifestyle,coronary calcium,cardiovascular events,and mortality:results from MESA.Am J Epidemiol,2013,178(1):12-21.
- [8] Bild DE,Detrano R,Peterson D,et al.Ethnic differences in coronary calcification:the Multi-Ethnic Study of Atherosclerosis(MESA).Circulation,2005,111(10):1313-1320.
- [9]Huang CC,Lloyd-Jones DM,Guo X,et al.Gene expression variation between African Americans and whites is associated with coronaty artety calcification:the multiethnic study of atherosclerosis.Physiol Genomics,2011,43(13):836-843.
- [10]Chang Y,Ryu S,Sung KC,et al.Alcoholic and non-alcoholic fatty liver disease and associations with coronary artery calcification:evidence from the Kangbuk Samsung Health Study.Gut,2019,68(9):1667-1675.
- [11]Chen J,Budoff MJ,Reilly MP,et al.Coronary artery calcification and risk of cardiovascular disease and death among patients with chronic kidney disease.JAMA Cardiol,2017,2(6):E1-E9.
- [12] Kaufman JD,Adar SD,Barr RG.et al.Association between air pollution and coronary artery calcification within six metropolitan areas in the USA(the Multi-Ethnic Study of Atherosclerosis and Air Pollution):a longitudinal cohort study.Lancet,2016,388(10045):696-704.
- [13]曹晔萱,赵肸,张惠雯,等.血浆前蛋白转化酶枯草杆菌蛋白酶kexin9型水平与冠状动脉钙化的关系.中国循环杂志,2018,33(2):134-137.
- [14]Shanahan CM.Inflammation ushers in calcification:a cycle of damage and protection?Circulation,2007,116(24):2782-2785.
- [15]Leopold J.MicroRNAs regulate vascular medial calcification Cells,2014,3(4):963-980.
- [16]Taibi F,Metzinger-Le Meuth V,Massy ZA,et al.MiR-223:An inflammatory oncormr enters the cardiovascular field.Biochim BiophysActa,2014,1842(7):1001-1009.
- [17] Mackenzie NCW,Staines KA,Zhu D,et al.miRNA-221and miRNA-222 synergistically function to promote vascular calcification Cell Biochem Funct,2014,32(2):209-216.
- [18]Dhore CR,Cleutjens JP,Lutgens E,et al.Differential expression of bone matrix regulatory proteins in human atherosclerotic plaques.Arterioscler Thromb Vase Biol,2001,21(12):1998-2003.
- [19]Wang X,Matsumura M,Mintz GS,et al.In vivo calcium detection by comparing optical coherence tomography,intravascular ultrasound,and angiography.JACC Cardiovasc imaging,2017,10(8):869-879.
- [20]Friedrich GJ,Moes NY,M(u|")hlberger VA,et al.Detection of intralesional calcium by intracoronary ultrasound depends on the histologic pattern.Am Heart J,1994,128(3):435-441.
- [21]Lee JB,Mintz GS,Lisauskas JB,et al.Histopathologic validation of the intravascular ultrasound diagnosis of calcified coronary artery nodules.Am J Cardiol,2011,108(11):1547-1551.
- [22]Amano H,Ikeda T,Toda M,et al.Assessment of angiographic coronary calcification and plaque composition in virtual histology intravascular ultrasound.J Interv Cardiol,2015,28(2):205-214.
- [23]Kume T,Okura H,Kawamoto T,et al.Assessment of the coronary calcification by optical coherence tomography.EuroIntervention,2011,6(6):768-772.
- [24] Mehanna E,Bezerra HG,Prabhu D,et al.Volumetric characterization of human coronary calcification by frequency-domain optical coherence tomography.Circulation,2013,77(9):2334-2340.
- [25]Blaha MJ,Mortensen MB,Kianoush S,et al.Coronary artery calcium scoring:is it time for a change in methodology?J Am Coll CardiolImg,2017,10(8):923-937.
- [26]Hecht H,Blaha MJ,Berman DS,et al.Clinical indications for coronary artery calcium scoring in asymptomatic patients:expert consensus statement from the Society of Cardiovascular Computed Tomography.J Cardiovasc Comput Tomogr,2017,11(2):157-168.
- [27]Criqui MH,Denenberg JO,Ix JH,et al.Calcium density of coronary artery plaque and risk of incident cardiovascular events.JAMA,2014,31(13):271-278.
- [28]Dweck MR,Chow MW,Joshi NV,et al.Coronary arterial18F-sodium fluoride uptake:a novel marker of plaque biology.J Am Coll Cardiol,2012,59(17):1539-1548.
- [29]Kataoka Y,Wolski K,Uno K,et al.Spotty calcification as a marker of accelerated progression of coronary atherosclerosis:insights from serial intravascular ultrasound.J Am Coll Cardiol,2012,59(18):1592-1597.
- [30]Kataoka Y,Puri R,Hammadah M,et al.Spotty calcification and plaque vulnerability in vivo:frequency-domain optical coherence tomography analysis.Cardiovasc Diagn Ther,2014,4(6):460-469.
- [31]Kelly-AmoldA,Maldonado N,Laudier D,et al. Revised microcalcification hypothesis for fibrous cap rupture in human coronary arteries.Proc Natl Acad SciUSA,2013,110(26):10741-10746.
- [32]Mauriello A,Servadei F,Zoccai GB,et al.Coronary calcification identifies the vulnerable patient rather than the vulnerable Plaque.Atherosclerosis,2013,229(1):124-129.
- [33]Kwiecinski J,Tzolos E,Adamson PD.Coronary 18F-sodium fluoride uptake predicts outcomes in patients with coronary artery disease.J Am Coll Cardiol,2020,75(24):3061-3074.
- [34]Jono S,Ikari Y,Vermeer C,et al.Matrix Gla protein is associated with coronary artery calcification as assessed by electron-beam computed tomography.Thromb Haemost,2004,91(4):790-794.
- [35]Park B,Lee YJ.Association of serum carbohydrate antigen 19-9 level with arterial stiffness and coronaty artery calcification in middle-aged and older adults:a cross-sectional study.J Hypertens,2020,38(1):95-101.
- [36]Hashemi J,Joshaghani HR,Akaberi A,et al.Potential correlation between circulating fetuin-A and pentraxin-3 with biochemical parameters of calcification in hemodialysis patients.Arch Iran Med,2017,20(12):752-755.
- [37]Henein M,Granasen G,Wiklund U,et al.High dose long-term Statin therapy accelerate coronary artery calcification Int J Cardiol,2015,184:581-586.
- [38]Puri R,Nicholls SJ,Shao M,et al.Impact of statins on serial coronary calcification during atheroma progression and regression.J Am Coll Cardiol,2015,65(13):1273-1282.
- [39]Elmariah S,Delaney JA,O’ Brien KD,et al.Bisphosphonate use and prevalence of valvular and vascular calcification in Women MESA(The Multi-Ethnic Study of Atherosclerosis).J Am Coll Cardiol,2010,56(21):1752-1759.
- [40]Kawahara T,Nishikawa M,Kawahara C,et al.Atorvastatin,etidronate,or both in patients at high risk for atherosclerotic aortic plaques:a randomized,controlled trial.Circulation,2013,127(23):2327-2335.
- [41]Vossen LM,Schurgers LJ,van Varik BJ,et al.Menaquinone-7supplementation to reduce vascular calcification in patients with coronary artery disease:rationale and study protocol(VitaK-CAC T rial).Nutrients,2015,7(11):8905-8915.
- [42]Lerma DA,Prasad S,Alotti N,et al.Denosumab could be a potential inhibitor of valvular interstitial cells calcification in vitro.Int J Cardiovasc Res,2016,5(1).
- [43]Tomey MI,Kini AS,Sharma SK.Current status of rotational atherectomy.JACC Cardiovasc Interv,2014,7(4):345-353.