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Published on: February 4, 2021
Monitoring calcific aortic valve disease: the role of biomarkers
G Latsios1, D Tousoulis, E Androulakis
11st Cardiology Unit, Hippokration Hospital, Athens University Medical School, Athens, Greece. glatsios@hotmail.com
Insights
Calcific aortic valve disease is an active biological process, not just passive degeneration. Research highlights inflammation, oxidized lipids, and bone formation as key features, with ongoing study into risk factors and biomarkers.
Area of Science:
- Cardiovascular Medicine
- Pathology
- Biochemistry
Background:
- Calcific aortic valve disease (CAVD) is a prevalent condition in the elderly, contributing to significant morbidity and mortality.
- Historically viewed as passive calcification, CAVD is now understood as an active biological process.
- Key histological features include inflammation, oxidized lipids, and extracellular matrix remodeling leading to bone formation.
Purpose of the Study:
- To review the current understanding of calcific aortic valve disease.
- To identify established and potential risk factors for calcific aortic stenosis.
- To explore the utility of advanced monitoring tools and biomarkers for risk stratification and prognosis.
Main Methods:
- Literature review of recent studies on calcific aortic valve disease.
- Analysis of histological hallmarks and pathological mechanisms.
- Examination of epidemiological data on risk factors.
- Assessment of emerging diagnostic and prognostic tools.
Main Results:
- CAVD involves active biological pathways, including inflammation and lipid oxidation.
- Established risk factors include lipids, hypertension, male gender, renal failure, and diabetes.
- Molecular imaging and biomarkers show potential for improved risk stratification and prognosis assessment, though their roles are still under investigation.
Conclusions:
- Calcific aortic valve disease is an active, complex pathological process.
- Further research is needed to fully elucidate the role of biomarkers and molecular imaging in clinical practice.
- Improved risk stratification and prognosis assessment are crucial for managing patients with CAVD.
Abstract:
Calcific aortic valve disease is a common disease in the elderly associated with significant morbidity and mortality. It was once described as a passive degenerative process during which serum calcium attaches to the valve surface and binds to the leaflet. However, during the last decade mounting evidence demonstrated that this disease has an active biologic process with numerous signaling pathways. The histological hallmarks seem to be inflammation, oxidized lipids-also detectable in aortic valve lesions-and a remodeling of the extracellular matrix leading to bone formation. Over the years, growing evidence has indicated the risk factors for calcific aortic stenosis including lipids, hypertension, male gender, renal failure, and diabetes. Additional monitoring tools, such as molecular imaging, could improve risk stratification, while assessment of severity and prognosis of patients with chronic aortic regurgitation, is desirable. Also, several studies have investigated the role of biomarkers regarding their utility in the screening of calcific aortic valve disease and their putative clinical value, though their role still remains undetermined.
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