Calcific aortic valve disease (CAVD) is the most common valvular disease in the developed world with currently no effective pharmacological treatment available. CAVD results from a complex, multifactorial process, in which valvular inflammation and fibro-calcific remodelling lead to valve thickening and cardiac outflow obstruction. The exact underlying pathophysiology of CAVD is still not fully understood, yet the development of CAVD shows many similarities with the pathophysiology of atherosclerotic cardiovascular disease (ASCVD), such as coronary artery disease. Innate immune cells play a crucial role in ASCVD and might also play a pivotal role in the development of CAVD. This review summarizes the current knowledge on the role of innate immune cells, both in the circulation and in the aortic valve, in the development of CAVD and the similarities and differences with ASCVD. Trained immunity and clonal haematopoiesis of indeterminate potential are proposed as novel immunological mechanisms that possibly contribute to the pathophysiology of CAVD and new possible treatment targets are discussed.

钙化性主动脉瓣疾病 (CAVD) 是发达国家中最常见的瓣膜病，目前尚无有效的药物治疗方法。CAVD 是由复杂的多因素过程引起的，其中瓣膜炎症和纤维钙化重塑导致瓣膜增厚和心脏流出道阻塞。CAVD 确切的潜在病理生理学仍未完全了解，但 CAVD 的发展显示出与动脉粥样硬化性心血管疾病 (ASCVD) 的病理生理学有许多相似之处，例如冠状动脉疾病。先天免疫细胞在 ASCVD 中起着至关重要的作用，也可能在 CAVD 的发展中起着关键作用。这篇综述总结了目前关于先天免疫细胞在循环和主动脉瓣中的作用的知识，CAVD的发展历程及与ASCVD的异同。训练有素的免疫力和不确定潜能的克隆造血被提议作为可能有助于 CAVD 病理生理学的新免疫学机制，并讨论了新的可能治疗目标。