Aortic valve: mechanical environment and mechanobiology.

Area of Science:

• Cardiovascular Biology
• Biomechanical Engineering
• Translational Medicine

Background:

• The aortic valve (AV) is subjected to complex mechanical forces during each cardiac cycle.
• These forces regulate AV tissue structure through continuous remodeling.
• Pathological conditions like hypertension and bicuspid AV (BAV) alter the mechanical environment, initiating detrimental processes like inflammation and calcification.

Purpose of the Study:

• To review the current understanding of the local mechanical environment of the aortic valve.
• To explore the effects of this mechanical environment on valve biology.
• To focus on in vitro and ex vivo experimental approaches.

Main Methods:

• Review of existing literature on aortic valve (AV) hemodynamics and mechanics.
• Analysis of in vitro and ex vivo studies investigating AV mechanical environment.
• Synthesis of findings related to AV tissue remodeling, inflammation, and calcification.

Main Results:

• Mechanical forces critically regulate AV tissue phenotype and structure.
• Endothelial cells are key sensors of mechanical alterations, initiating downstream molecular events.
• Pathological conditions significantly disrupt the normal mechanical environment, leading to valve dysfunction.

Conclusions:

• The molecular mechanisms linking mechanical environment alterations to AV disease remain incompletely understood.
• Further research into these mechanisms is essential for developing effective therapeutic strategies.
• In vitro and ex vivo studies provide valuable insights into AV mechanics and biology.