Calcific Aortic Valve Disease: Part 1--Molecular Pathogenetic Aspects, Hemodynamics, and Adaptive Feedbacks.

Journal Article (Journal Article;Review)

Aortic valvular stenosis (AVS), produced by calcific aortic valve disease (CAVD) causing reduced cusp opening, afflicts mostly older persons eventually requiring valve replacement. CAVD had been considered "degenerative," but newer investigations implicate active mechanisms similar to atherogenesis--genetic predisposition and signaling pathways, lipoprotein deposits, chronic inflammation, and calcification/osteogenesis. Consequently, CAVD may eventually be controlled/reversed by lifestyle and pharmacogenomics remedies. Its management should be comprehensive, embracing not only the valve but also the left ventricle and the arterial system with their interdependent morphomechanics/hemodynamics, which underlie the ensuing diastolic and systolic LV dysfunction. Compared to even a couple of decades ago, we now have an increased appreciation of genomic and cytomolecular pathogenetic mechanisms underlying CAVD. Future pluridisciplinary studies will characterize better and more completely its pathobiology, evolution, and overall dynamics, encompassing intricate feedback processes involving specific signaling molecules and gene network cascades. They will herald more effective, personalized medicine treatments of CAVD/AVS.

Full Text

Duke Authors

Cited Authors

  • Pasipoularides, A

Published Date

  • April 2016

Published In

Volume / Issue

  • 9 / 2

Start / End Page

  • 102 - 118

PubMed ID

  • 26891845

Pubmed Central ID

  • PMC4833551

Electronic International Standard Serial Number (EISSN)

  • 1937-5395

Digital Object Identifier (DOI)

  • 10.1007/s12265-016-9679-z


  • eng

Conference Location

  • United States