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PanVascular Medicine pp 327–341Cite as

Vascular Calcification

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Abstract

Vascular calcification is a detrimental pathology ubiquitously present in a number of vascular disease processes. Anatomically, vascular calcification is recognized in the intima or the media of the arterial wall although both sites may be involved simultaneously. Intimal calcification is exclusively associated with atherosclerosis while medial calcification is clinically manifest as arterial stiffening and hypertension in the context of diabetes mellitus, aging, and chronic kidney disease (CKD).

Vascular smooth muscle cells (VSMCs) are central to the mechanisms of vascular calcification which shares many similarities with developmental osteogenesis. Key features include osteogenic transformation of VSMCs with secretion of mineralization-competent microvesicles and dysregulated expression of calcification inhibitors. Detailed understanding of these mechanisms has identified novel putative therapeutic targets for preventing and treating vascular disease.

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Abbreviations

Calcification:

Deposition of mineral salts in the vessel walls, mostly hydroxyappatite.

Intima:

The inner layer of the vessel wall composed of endothelial cells and vascular smooth muscle cells. Thickened in atherosclerosis.

Media:

The central layer of the vessel wall composed of vascular smooth muscle cells which regulates vessel contraction.

Microvesicles:

Small membrane bound bodies containing protein and nucleic acid that are released by cells into the extracellular environment.

Osteogenic:

Having bone cell-like properties.

Synthetic:

Term typically used to describe for vascular smooth muscle cells that are no longer contractile but have proliferative and migratory capacity.

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Further Reading

  • Joshi NV, Vesey AT, Williams MC, Shah AS, Calvert PA, Craighead FH, Yeoh SE, Wallace W, Salter D, Fletcher AM, van Beek EJ, Flapan AD, Uren NG, Behan MW, Cruden NL, Mills NL, Fox KA, Rudd JH, Dweck MR, Newby DE (2014) 18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: a prospective clinical trial. Lancet 383(9918):705–713. doi:10.1016/S0140-6736(13)61754-7. Epub 2013 Nov 11. PMID: 24224999

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  • Lanzer P, Boehm M, Sorribas V, Thiriet M, Janzen J, Zeller T, St Hilaire C, Shanahan C (2014) Medial vascular calcification revisited: review and perspectives. Eur Heart J 35(23):1515–1525. doi10.1093/eurheartj/ehu163. Epub 2014 Apr 16. PMID: 24740885

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  • Otsuka F, Sakakura K, Yahagi K, Joner M, Virmani R (2014) Has our understanding of calcification in human coronary atherosclerosis progressed? Arterioscler Thromb Vasc Biol 34(4):724–736. doi:10.1161/ATVBAHA.113.302642. Epub 2014 Feb 20. Review. Erratum in: Arterioscler Thromb Vasc Biol. 2014 Jul;34(7):e17. PMID: 24558104

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  • Shanahan CM (2013) Mechanisms of vascular calcification in CKD-evidence for premature ageing? Nat Rev Nephrol 9(11):661–670. doi:10.1038/nrneph.2013.176, Epub 2013 Sep 10. PMID: 24018414

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Authors and Affiliations

  1. James Black Centre, King’s College London, King’s College Hospital, London, UK

    Sundeep Singh Kalra

  2. Cardiovascular Division, King’s College London, James Black Centre, 125 Coldharbour Lane, London, SE5 9NU, UK

    Catherine Shanahan

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  1. Sundeep Singh Kalra
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  2. Catherine Shanahan
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  1. Division of Cardiovascular Disease Department of Internal Medicine, Health Care Center Bitterfeld, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Kalra, S.S., Shanahan, C. (2015). Vascular Calcification. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_217

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