Abstract: Calcific aortic valve disease (CAVD) is currently the third most common cardiovascular disease in developed countries, following coronary heart disease and hypertension, with a high incidence rate and fatality rate among the elderly population aged ≥65 years old. Recent studies have shown that macrophages play a key role in the progression of CAVD. This article summarizes the research progress on the macrophage-to-mesenchymal transition in CAVD, bidirectional communication between macrophages and valve mesenchymal cells, the initiation mechanism of macrophages in autologous valve calcification and bioprosthetic valve failure, as well as the regulatory target of macrophage polarization in calcified valves. Finally, this article proposes that valvular calcification is a stereoscopic and regulatable process, future research should be strengthened on the mechanisms by which macrophages influence valvular calcification, aiming to identify non-surgical therapeutic targets for CAVD and explore new directions for the development of anti-degeneration bioprosthetic valve materials.

Key words: calcific aortic valve disease, macrophages, mesenchymal cells, bioprosthetic valve