Bicuspid aortic valve, atherosclerosis and changes of lipid metabolism: Are there pathological molecular links?

Area of Science:

• Cardiovascular Medicine
• Genetics and Genomics
• Molecular Biology

Background:

• Bicuspid aortic valve (BAV) is a congenital heart defect associated with a spectrum of cardiovascular diseases.
• These include aortic valve disease, aortic dilatation, dissection, rupture, and coronary atherosclerosis.
• Altered hemodynamics and molecular mechanisms contribute to BAV-associated pathologies.

Purpose of the Study:

• To review the molecular mechanisms underlying atherosclerosis in BAV patients.
• To identify key pathways involved in the progression of BAV-associated diseases.
• To explore potential therapeutic targets for personalized BAV patient management.

Main Methods:

• Literature review of current evidence on BAV pathogenesis.
• Analysis of molecular pathways implicated in atherosclerosis and aortopathies.
• Synthesis of data on dyslipidemia and inflammatory pathways in BAV.

Main Results:

• BAV is associated with activated molecular mechanisms promoting atherosclerosis.
• Dyslipidemia (high LDL cholesterol, high lipoprotein (a)) is a significant factor.
• Pro-inflammatory pathways, including NLRP3 inflammasome and TLR4, play a pivotal role.

Conclusions:

• Molecular mechanisms, particularly dyslipidemia and inflammation, are crucial in BAV disease progression.
• Understanding these pathways can improve BAV patient prognosis and follow-up.
• Novel pharmacological strategies targeting these mechanisms may prevent disease advancement.