Molecular Mechanisms of Aortic Valve Pathology
The aortic valve is a dynamic structure composed of valve interstitial cells (VICs) and valve endothelial cells (VECs), which contribute to maintain and repair the extracellular matrix (ECM). Disorders of the aortic valve, such as calcific aortic valve disease (CAVD), are characterized by the re-expression of embryonic genes involved in valvulogenesis and actively participate to the pathologic remodeling of the ECM. Studies performed in the last several years have underlined that inflammation and lipid signaling pathways are intertwined in promoting the fibrocalcific remodeling process of the aortic valve. Altered blood flow dynamics along with genetic factors are involved in disorders associated with bicuspid aortic valve (BAV), a valve with two leaflets instead of three. The control of osteogenesis in the aortic valve is complex and involves different signaling cascades such as NF-κB, NOTCH, and Wnt pathways. In this chapter, we are reviewing the basic concepts related to the biology of the aortic valve and the pathobiology behind the development of CAVD and BAV.
KeywordsAortic valve Valve interstitial cells Calcific aortic valve disease Aortic stenosis Bicuspid aortic valve Calcification Pathology
The work of the authors is supported by Canadian Institutes of Health Research grants to P.M. (MOP114893, MOP114893, MOP114893, MOP365029), the Heart and Stroke Foundation of Canada, and the Quebec Heart and Lung Institute Fund. P.M. holds a FRQS Research Chair on the Pathobiology of Calcific Aortic Valve Disease.
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