Valve disease and particularly calcific aortic valve disease (CAVD) and diabetes (DM) are progressive diseases constituting a global health burden for all aging societies (Progress in Cardiovascular Diseases. 2014;56(6):565: Circulation Research. 2021;128(9):1344). Compared to non-diabetic individuals (The Lancet. 2008;371(9626):1800: The American Journal of Cardiology. 1983;51(3):403: Journal of the American College of Cardiology. 2017;69(12):1523), the diabetic patients have a significantly greater propensity for cardiovascular disorders and faster degeneration of implanted bioprosthetic aortic valves. Previously, using an original experimental model, the diabetic-hyperlipemic hamsters, we have shown that the earliest alterations induced by these conditions occur at the level of the aortic valves and, with time these changes lead to calcifications and CAVD. However, there are no pharmacological treatments available to reverse or retard the progression of aortic valve disease in diabetes, despite the significant advances in the field. Therefore, it is critical to uncover the mechanisms of valve disease progression, find biomarkers for diagnosis and new targets for therapies. This review aims at presenting an update on the basic research in CAVD in the context of diabetes. We provide an insight into the accumulated data including our results on diabetes-induced progressive cell and molecular alterations in the aortic valve, new potential biomarkers to assess the evolution and therapy of the disease, advancement in targeted nanotherapies, tissue engineering and the potential use of circulating endothelial progenitor cells in CAVD.

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糖尿病主动脉瓣疾病：分子机制和新疗法

瓣膜疾病，尤其是钙化性主动脉瓣疾病 (CAVD) 和糖尿病 (DM) 是构成所有老龄化社会的全球健康负担的进行性疾病（心血管疾病进展。2014；56（6）：565：循环研究。2021；128（ 9）：1344）。与非糖尿病患者相比（《柳叶刀》。2008；371（9626）：1800：美国心脏病学杂志。1983；51（3）：403：美国心脏病学会杂志. 2017;69(12):1523)，糖尿病患者患心血管疾病的倾向明显更大，植入的生物主动脉瓣退化更快。以前，使用原始实验模型，糖尿病高血脂仓鼠，我们已经证明，由这些条件引起的最早改变发生在主动脉瓣水平，随着时间的推移，这些变化会导致钙化和 CAVD。然而，尽管该领域取得了重大进展，但没有可用于逆转或延缓糖尿病主动脉瓣疾病进展的药物治疗。因此，揭示瓣膜疾病进展的机制、寻找用于诊断的生物标志物和新的治疗靶点至关重要。本综述旨在介绍糖尿病背景下 CAVD 基础研究的最新进展。