Calcific Aortic Valve Disease and Aortic Stenosis

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 13286

Special Issue Editor


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Guest Editor
Department of Heart Surgery, Heinrich-Heine-University, Duesseldorf, Germany
Interests: aortic valve stenosis and calcific aortic valve disease; extracellular vesicles in cardiovascular diseases; endothelial to mesenchymal transition of vascular endothelial cells; purinergic signaling; 3D-cell culture and tissue culture models

Special Issue Information

Dear Colleagues,

This Special Issue, “Calcific Aortic Valve Disease and Aortic Stenosis”, will mainly focus on novel insights into the key mechanisms underlying calcific aortic valve disease (CAVD).

CAVD is as a slow and progressive (but also an active and regulated) process involving the creation of calcium nodules, lipoprotein accumulation, and chronic inflammation. Despite substantial progress in recent years, there is still no solid evidence that the progression of CAVD can be prevented with any medical treatment, and consequently, aortic valve replacement (AVR) remains the gold standard for the treatment of symptomatic aortic stenosis (AS).

We cordially invite authors in the field to submit original research or review articles pertaining to this important and rapidly progressing field. Potential topics include, but are not limited to:

  • Novel basic mechanisms in the initiation and progression of CAVD;
  • Biomarkers in CAVD;
  • Cardiac regeneration;
  • Myofibroblastic and osteogenic differentiation of valvular interstitial cells (VICs);
  • Extracellular matrix (ECM) signaling and remodeling in CAVD;
  • Novel in-vivo and in-vitro models to investigate basic mechanisms in CAVD;
  • Functionality and plasticity of valvular endothelial cells (VECs);
  • Endothelial-to-mesenchymal transition;
  • Role of extracellular vesicles (EVs) in the pathogenesis of CAVD;
  • Therapeutic approaches to preventing CAVD progression.

Dr. Andreas Weber
Guest Editor

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Keywords

  • calcific aortic valve disease
  • calcification
  • biomineralization
  • extracellular vesicles
  • extracellular matrix remodeling
  • endothelial-to-mesenchymal transition
  • osteogenic differentiation

Published Papers (4 papers)

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Research

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17 pages, 5820 KiB  
Article
Reproducible In Vitro Tissue Culture Model to Study Basic Mechanisms of Calcific Aortic Valve Disease: Comparative Analysis to Valvular Interstitials Cells
by Andreas Weber, Melissa Pfaff, Friederike Schöttler, Vera Schmidt, Artur Lichtenberg and Payam Akhyari
Biomedicines 2021, 9(5), 474; https://doi.org/10.3390/biomedicines9050474 - 26 Apr 2021
Cited by 11 | Viewed by 3040
Abstract
The hallmarks of calcific aortic valve disease (CAVD), an active and regulated process involving the creation of calcium nodules, lipoprotein accumulation, and chronic inflammation, are the significant changes that occur in the composition, organization, and mechanical properties of the extracellular matrix (ECM) of [...] Read more.
The hallmarks of calcific aortic valve disease (CAVD), an active and regulated process involving the creation of calcium nodules, lipoprotein accumulation, and chronic inflammation, are the significant changes that occur in the composition, organization, and mechanical properties of the extracellular matrix (ECM) of the aortic valve (AV). Most research regarding CAVD is based on experiments using two-dimensional (2D) cell culture or artificially created three-dimensional (3D) environments of valvular interstitial cells (VICs). Because the valvular ECM has a powerful influence in regulating pathological events, we developed an in vitro AV tissue culture model, which is more closely able to mimic natural conditions to study cellular responses underlying CAVD. AV leaflets, isolated from the hearts of 6–8-month-old sheep, were fixed with needles on silicon rubber rings to achieve passive tension and treated in vitro under pro-degenerative and pro-calcifying conditions. The degeneration of AV leaflets progressed over time, commencing with the first visible calcified domains after 14 d and winding up with the distinct formation of calcium nodules, heightened stiffness, and clear disruption of the ECM after 56 d. Both the expression of pro-degenerative genes and the myofibroblastic differentiation of VICs were altered in AV leaflets compared to that in VIC cultures. In this study, we have established an easily applicable, reproducible, and cost-effective in vitro AV tissue culture model to study pathological mechanisms underlying CAVD. The valvular ECM and realistic VIC–VEC interactions mimic natural conditions more closely than VIC cultures or 3D environments. The application of various culture conditions enables the examination of different pathological mechanisms underlying CAVD and could lead to a better understanding of the molecular mechanisms that lead to VIC degeneration and AS. Our model provides a valuable tool to study the complex pathobiology of CAVD and can be used to identify potential therapeutic targets for slowing disease progression. Full article
(This article belongs to the Special Issue Calcific Aortic Valve Disease and Aortic Stenosis)
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17 pages, 3213 KiB  
Article
Heme-Mediated Activation of the Nrf2/HO-1 Axis Attenuates Calcification of Valve Interstitial Cells
by Enikő Balogh, Arpan Chowdhury, Haneen Ababneh, Dávid Máté Csiki, Andrea Tóth and Viktória Jeney
Biomedicines 2021, 9(4), 427; https://doi.org/10.3390/biomedicines9040427 - 15 Apr 2021
Cited by 16 | Viewed by 4105
Abstract
Calcific aortic valve stenosis (CAVS) is a heart disease characterized by the progressive fibro-calcific remodeling of the aortic valves, an actively regulated process with the involvement of the reactive oxygen species-mediated differentiation of valvular interstitial cells (VICs) into osteoblast-like cells. Nuclear factor erythroid [...] Read more.
Calcific aortic valve stenosis (CAVS) is a heart disease characterized by the progressive fibro-calcific remodeling of the aortic valves, an actively regulated process with the involvement of the reactive oxygen species-mediated differentiation of valvular interstitial cells (VICs) into osteoblast-like cells. Nuclear factor erythroid 2-related factor 2 (Nrf2) regulates the expression of a variety of antioxidant genes, and plays a protective role in valve calcification. Heme oxygenase-1 (HO-1), an Nrf2-target gene, is upregulated in human calcified aortic valves. Therefore, we investigated the effect of Nrf2/HO-1 axis in VIC calcification. We induced osteogenic differentiation of human VICs with elevated phosphate and calcium-containing osteogenic medium (OM) in the presence of heme. Heme inhibited Ca deposition and OM-induced increase in alkaline phosphatase and osteocalcin (OCN) expression. Heme induced Nrf2 and HO-1 expression in VICs. Heme lost its anti-calcification potential when we blocked transcriptional activity Nrf2 or enzyme activity of HO-1. The heme catabolism products bilirubin, carbon monoxide, and iron, and also ferritin inhibited OM-induced Ca deposition and OCN expression in VICs. This study suggests that heme-mediated activation of the Nrf2/HO-1 pathway inhibits the calcification of VICs. The anti-calcification effect of heme is attributed to the end products of HO-1-catalyzed heme degradation and ferritin. Full article
(This article belongs to the Special Issue Calcific Aortic Valve Disease and Aortic Stenosis)
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8 pages, 841 KiB  
Communication
Elements of Immunoglobulin E Network Associate with Aortic Valve Area in Patients with Acquired Aortic Stenosis
by Daniel P. Potaczek, Aleksandra Przytulska-Szczerbik, Stanisława Bazan-Socha, Artur Jurczyszyn, Ko Okumura, Chiharu Nishiyama, Anetta Undas and Ewa Wypasek
Biomedicines 2021, 9(1), 23; https://doi.org/10.3390/biomedicines9010023 - 31 Dec 2020
Cited by 1 | Viewed by 2094
Abstract
Allergic mechanisms are likely involved in atherosclerosis and its clinical presentations, such as coronary artery disease (CAD). It has been previously reported that CAD severity associates with serum levels of immunoglobulin E (IgE), the molecule that, along with its high-affinity receptor (FcԑRI), plays [...] Read more.
Allergic mechanisms are likely involved in atherosclerosis and its clinical presentations, such as coronary artery disease (CAD). It has been previously reported that CAD severity associates with serum levels of immunoglobulin E (IgE), the molecule that, along with its high-affinity receptor (FcԑRI), plays a central role in allergic reactions. Considering multiple pathophysiological similarities between atherosclerosis and acquired aortic (valve) stenosis (AS), we speculated that allergic pathways could also contribute to the AS mechanisms and grading. To validate this hypothesis, we first checked whether total serum IgE levels associate with echocardiographic markers of AS severity. Having found a positive correlation between serum IgE and aortic valve area (AVA), we further speculated that also total IgE-determining genetic polymorphisms in FCER1A, a locus encoding an allergen-biding FcԑRI subunit, are related to acquired AS severity. Indeed, the major allele of rs2251746 polymorphism, known to associate with higher IgE levels, turned out to correlate with larger AVA, a marker of less severe AS. Our findings surprisingly suggest a protective role of IgE pathways against AS progression. IgE-mediated protective mechanisms in AS require further investigations. Full article
(This article belongs to the Special Issue Calcific Aortic Valve Disease and Aortic Stenosis)
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Review

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15 pages, 1698 KiB  
Review
The Haemodynamic and Pathophysiological Mechanisms of Calcific Aortic Valve Disease
by Lydia Hanna, Chlöe Armour, Xiao Yun Xu and Richard Gibbs
Biomedicines 2022, 10(6), 1317; https://doi.org/10.3390/biomedicines10061317 - 3 Jun 2022
Cited by 1 | Viewed by 3137
Abstract
The aortic valve (AoV) is the outflow valve for the left heart [...] Full article
(This article belongs to the Special Issue Calcific Aortic Valve Disease and Aortic Stenosis)
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