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Updated: Jun 2, 2026
Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Cardiovascular calcification: an inflammatory disease
1Center for Interdisciplinary Cardiovascular Sciences, Brigham and Women's Hospital, Boston, MA 02115, USA.
Insights
Cardiovascular calcification, a risk factor for heart disease, is an active inflammatory process, not passive degeneration. Inflammation and calcification create a feedback loop driving disease progression.
Area of Science:
- Cardiovascular Biology
- Inflammation Research
- Metabolic Disease Mechanisms
Background:
- Cardiovascular calcification is a significant risk factor for morbidity and mortality.
- It is now understood as an active, inflammation-driven process rather than passive degeneration.
- A positive feedback loop between inflammation and calcification is implicated in disease progression.
Purpose of the Study:
- To review the evidence supporting cardiovascular calcification as an inflammation-dependent process.
- To discuss the underlying mechanisms linking inflammation to vascular and valvular calcification.
- To highlight the progression of research from histopathology to molecular imaging.
Main Methods:
- Review of histopathological studies identifying inflammatory cells in early lesions.
- Analysis of in vitro studies on smooth muscle cell osteogenic differentiation and mineralization.
- Examination of evidence from animal models and molecular imaging techniques.
Main Results:
- Early lesions in cardiovascular calcification show accumulation of macrophages and T lymphocytes.
- In vitro studies demonstrate inflammatory stimulation of smooth muscle cell calcification.
- Animal models and molecular imaging provide strong support for an inflammatory basis of the disease.
Conclusions:
- Cardiovascular calcification is fundamentally an inflammatory disease.
- Similar mechanisms may underlie both calcific aortic valve disease and atherosclerotic arterial calcification.
- Further research is needed to fully elucidate the complex mechanisms involved.
Abstract:
Cardiovascular calcification is an independent risk factor for cardiovascular morbidity and mortality. This disease of dysregulated metabolism is no longer viewed as a passive degenerative disease, but instead as an active process triggered by pro-inflammatory cues. Furthermore, a positive feedback loop of calcification and inflammation is hypothesized to drive disease progression in arterial calcification. Both calcific aortic valve disease and atherosclerotic arterial calcification may possess similar underlying mechanisms. Early histopathological studies first highlighted the contribution of inflammation to cardiovascular calcification by demonstrating the accumulation of macrophages and T lymphocytes in `early' lesions within the aortic valves and arteries. A series of in vitro work followed, which gave a mechanistic insight into the stimulation of smooth muscle cells to undergo osteogenic differentiation and mineralization. The emergence of novel technology, in the form of animal models and more recently molecular imaging, has enabled accelerated progression of this field, by providing strong evidence regarding the concept of this disorder as an inflammatory disease. Although there are still gaps in our knowledge of the mechanisms behind this disorder, this review discusses the various studies that have helped form the concept of the inflammation-dependent cardiovascular calcification paradigm.
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