Hatem Hosny, Sherien Abdelsalam, T. Mohsen, A. Afifi
Partial atrioventricular septal defects (PAVSD) account for three percent of all major congenital cardiac anomalies. It is surgically managed by patch closure of the primum atrial septal defect (ASD) and repair of the cleft left atrioventricular (AV) valve. Double orifice left AV valve, however, occurs in five percent of PAVSD and constitutes a management problem. We report here the echocardiographic presentation, illustrate the surgical findings and suggest technical tips for management of this rare condition.
{"title":"Double orifice left AV valve with partial atrio-ventricular septal defect","authors":"Hatem Hosny, Sherien Abdelsalam, T. Mohsen, A. Afifi","doi":"10.5339/AHCSPS.2011.18","DOIUrl":"https://doi.org/10.5339/AHCSPS.2011.18","url":null,"abstract":"Partial atrioventricular septal defects (PAVSD) account for three percent of all major congenital cardiac anomalies. It is surgically managed by patch closure of the primum atrial septal defect (ASD) and repair of the cleft left atrioventricular (AV) valve. Double orifice left AV valve, however, occurs in five percent of PAVSD and constitutes a management problem. We report here the echocardiographic presentation, illustrate the surgical findings and suggest technical tips for management of this rare condition.","PeriodicalId":416388,"journal":{"name":"Global Cardiology Science and Practice","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130565715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
التدقيق الطبي هو شكل من أشكال اكتساب المعارف الجديدة في ضوء نتائج المعالجات الطبية. وتختلف آراء الفلاسفة والعلماء بشأن اكتساب تلك المعارف. فالبعض يصر على أن الغرض الرئيسي لأي نظرية علمية هو التنبؤ بنتائج التجربة. ويطلق على تلك الرؤية "الذرائعية" حيث تفترض أن النظرية ما هي إلا ذريعة أو وسيلة للتنبؤ باستنتاجات جديدة. ظهرت "الفلسفة الوضعية" في الثلاثينات من القرن التاسع عشر كأحد أبرز نماذج تلك النظرية في المعارف العلمية، وما زالت تمثل وجهة نظر العديد من الفلاسفة إلى وقتنا الحاضر. وتقوم في الأساس على اعتبار كل الأفكار والحقائق غير ذات جدوى أو معنى طالما لا تندرج تحت الملاحظات أو الاستنتاجات. فالنظرية العلمية لا تهدف بالأساس إلى التوضيح أو التفسير بل إلى الاستنتاج والتنبؤ بنتائج النظرية.
{"title":"Reflections on outcome analyses: Introducing the concept of near misses","authors":"M. Leval","doi":"10.5339/AHCSPS.2011.12","DOIUrl":"https://doi.org/10.5339/AHCSPS.2011.12","url":null,"abstract":"التدقيق الطبي هو شكل من أشكال اكتساب المعارف الجديدة في ضوء نتائج المعالجات الطبية. وتختلف آراء الفلاسفة والعلماء بشأن اكتساب تلك المعارف. فالبعض يصر على أن الغرض الرئيسي لأي نظرية علمية هو التنبؤ بنتائج التجربة. ويطلق على تلك الرؤية \"الذرائعية\" حيث تفترض أن النظرية ما هي إلا ذريعة أو وسيلة للتنبؤ باستنتاجات جديدة. ظهرت \"الفلسفة الوضعية\" في الثلاثينات من القرن التاسع عشر كأحد أبرز نماذج تلك النظرية في المعارف العلمية، وما زالت تمثل وجهة نظر العديد من الفلاسفة إلى وقتنا الحاضر. وتقوم في الأساس على اعتبار كل الأفكار والحقائق غير ذات جدوى أو معنى طالما لا تندرج تحت الملاحظات أو الاستنتاجات. فالنظرية العلمية لا تهدف بالأساس إلى التوضيح أو التفسير بل إلى الاستنتاج والتنبؤ بنتائج النظرية.","PeriodicalId":416388,"journal":{"name":"Global Cardiology Science and Practice","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121352735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The embryonic heart initially consists of only two cell layers, the endocardium and the myocardium. The epicardium, which forms an epithelial layer on the surface of the heart, is derived from a cluster of mesothelial cells developing at the base of the venous inflow tract of the early embryonic heart. This cell cluster is termed the proepicardium and gives rise not only to the epicardium but also to epicardium- derived cells. These cells populate the myocardial wall and differentiate into smooth muscle cells and fibroblasts, while the contribution to the vascular endothelial lineage is uncertain. In this review we will discuss the signaling molecules involved in recruiting mesodermal cells to undergo proepicardium formation and guide these cells to the myocardial surface. Marker genes which are suitable to follow these cells during proepicardium formation and cell migration will be introduced. We will address whether the proepicardium consists of a homogenous cell population or whether different cell lineages are present. Finally the role of the epicardium as a source for cardiac stem cells and its importance in cardiac regeneration, in particular in the zebrafish and mouse model systems is discussed.
{"title":"Origin and fates of the proepicardium","authors":"J. Schlueter, T. Brand","doi":"10.5339/AHCSPS.2011.11","DOIUrl":"https://doi.org/10.5339/AHCSPS.2011.11","url":null,"abstract":"The embryonic heart initially consists of only two cell layers, the endocardium and the myocardium. The epicardium, which forms an epithelial layer on the surface of the heart, is derived from a cluster of mesothelial cells developing at the base of the venous inflow tract of the early embryonic heart. This cell cluster is termed the proepicardium and gives rise not only to the epicardium but also to epicardium- derived cells. These cells populate the myocardial wall and differentiate into smooth muscle cells and fibroblasts, while the contribution to the vascular endothelial lineage is uncertain. In this review we will discuss the signaling molecules involved in recruiting mesodermal cells to undergo proepicardium formation and guide these cells to the myocardial surface. Marker genes which are suitable to follow these cells during proepicardium formation and cell migration will be introduced. We will address whether the proepicardium consists of a homogenous cell population or whether different cell lineages are present. Finally the role of the epicardium as a source for cardiac stem cells and its importance in cardiac regeneration, in particular in the zebrafish and mouse model systems is discussed.","PeriodicalId":416388,"journal":{"name":"Global Cardiology Science and Practice","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128059918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The formation and remodeling of the embryonic valves is a complex and dynamic process that occurs within a constantly changing hemodynamic environment. Defects in embryonic and fetal valve remodeling are the leading cause of congenital heart defects, yet very little is known about how fibrous leaflet tissue is created from amorphous gelatinous masses called cushions. Microenvironmental cues such as mechanical forces and extracellular matrix composition play major roles in cell differentiation, but almost all research efforts in valvulogenesis center around genetics and molecular approaches. This review summarizes what is known about the dynamic mechanical and extracellular matrix microenvironment of the atrioventricular and semilunar valves during embryonic development and their possible guidance roles. A variety of new computational tools and sophisticated experimental techniques are progressing that enable precise microenvironmental alterations that are critical to complement genetic gain and loss of function approaches. Studies at the interface of mechanical and genetic signaling in embryonic valvulogenesis will likely pay significant dividends, not only in terms of increasing our mechanistic understanding, but also lead to the development of novel therapeutic strategies for patients with congenital valve abnormalities.
{"title":"The cycle of form and function in cardiac valvulogenesis","authors":"Stephanie E. Lindsey, J. Butcher","doi":"10.5339/AHCSPS.2011.10","DOIUrl":"https://doi.org/10.5339/AHCSPS.2011.10","url":null,"abstract":"The formation and remodeling of the embryonic valves is a complex and dynamic process that occurs within a constantly changing hemodynamic environment. Defects in embryonic and fetal valve remodeling are the leading cause of congenital heart defects, yet very little is known about how fibrous leaflet tissue is created from amorphous gelatinous masses called cushions. Microenvironmental cues such as mechanical forces and extracellular matrix composition play major roles in cell differentiation, but almost all research efforts in valvulogenesis center around genetics and molecular approaches. This review summarizes what is known about the dynamic mechanical and extracellular matrix microenvironment of the atrioventricular and semilunar valves during embryonic development and their possible guidance roles. A variety of new computational tools and sophisticated experimental techniques are progressing that enable precise microenvironmental alterations that are critical to complement genetic gain and loss of function approaches. Studies at the interface of mechanical and genetic signaling in embryonic valvulogenesis will likely pay significant dividends, not only in terms of increasing our mechanistic understanding, but also lead to the development of novel therapeutic strategies for patients with congenital valve abnormalities.","PeriodicalId":416388,"journal":{"name":"Global Cardiology Science and Practice","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126851848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
[first paragraph of article] ‘‘ Everything should be made as simple as possible, but not one bit simpler ’’ (Einstein) There is no shadow of doubt that statistics are an essential part of science and clinical practice, and therefore should be readily available to all concerned, in a comprehensible manner. In recent years, statistics have tended to deviate from this intention, with their perception of being complex and user-unfriendly. This misconception requires an urgent re-evaluation of statistics, with the aim of restoring their original image of simplicity, elegance and application. In this issue of the Journal, the two excellent articles by Marc de Leval & Ben Bridgewater and Sir Bruce Keogh serve the purposes of clarifying several aspects relating to the philosophy and applications of statistics. We strongly endorse their message, and attempt in this Editorial to present a simplified road map of the applications of statistics including the origins and utility of commonly used methodologies.
{"title":"Statistics re-analysed: From complexity to simplicity and utility","authors":"J. Takkenberg, I. El-Hamamsy, M. Yacoub","doi":"10.5339/AHCSPS.2011.14","DOIUrl":"https://doi.org/10.5339/AHCSPS.2011.14","url":null,"abstract":"[first paragraph of article] ‘‘ Everything should be made as simple as possible, but not one bit simpler ’’ (Einstein) There is no shadow of doubt that statistics are an essential part of science and clinical practice, and therefore should be readily available to all concerned, in a comprehensible manner. In recent years, statistics have tended to deviate from this intention, with their perception of being complex and user-unfriendly. This misconception requires an urgent re-evaluation of statistics, with the aim of restoring their original image of simplicity, elegance and application. In this issue of the Journal, the two excellent articles by Marc de Leval & Ben Bridgewater and Sir Bruce Keogh serve the purposes of clarifying several aspects relating to the philosophy and applications of statistics. We strongly endorse their message, and attempt in this Editorial to present a simplified road map of the applications of statistics including the origins and utility of commonly used methodologies.","PeriodicalId":416388,"journal":{"name":"Global Cardiology Science and Practice","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133178418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Major advances in the evaluation and management of valvular heart disease, occurring principally over the past four decades, have resulted in marked improvement in the outcomes of patients with these conditions throughout the world. These advances have developed on several fronts, including development of imaging modalities (most notable ultrasound) that have provided essential data on natural history and predictors of outcome after operative intervention. This information provides cardiologists with the necessary clinical data, along with symptomatic status, to make informed decisions regarding frequency of repeat evaluations and ultimately timing of surgery. At that same time, the steady significant advances in cardiac surgery, including improved prosthetic valve design, evolution of valve repair and valve-sparing techniques, and enhanced methods for intraoperative myocardial preservation, have expanded operative windows to include surgery on both older patients and younger patients, and even patients who are asymptomatic. Rather than waiting to operate on patients when they are severely symptomatic and have impaired left ventricular function, which was the paradigm 50 years ago, the current clinical strategies are now moving toward earlier intervention before the onset of severe symptoms, left ventricular dysfunction and other adverse endpoints such as atrial fibrillation and pulmonary hypertension.
{"title":"Valvular heart disease: Patient needs and practice guidelines","authors":"R. Bonow","doi":"10.5339/AHCSPS.2011.5","DOIUrl":"https://doi.org/10.5339/AHCSPS.2011.5","url":null,"abstract":"Major advances in the evaluation and management of valvular heart disease, occurring principally over the past four decades, have resulted in marked improvement in the outcomes of patients with these conditions throughout the world. These advances have developed on several fronts, including development of imaging modalities (most notable ultrasound) that have provided essential data on natural history and predictors of outcome after operative intervention. This information provides cardiologists with the necessary clinical data, along with symptomatic status, to make informed decisions regarding frequency of repeat evaluations and ultimately timing of surgery. At that same time, the steady significant advances in cardiac surgery, including improved prosthetic valve design, evolution of valve repair and valve-sparing techniques, and enhanced methods for intraoperative myocardial preservation, have expanded operative windows to include surgery on both older patients and younger patients, and even patients who are asymptomatic. Rather than waiting to operate on patients when they are severely symptomatic and have impaired left ventricular function, which was the paradigm 50 years ago, the current clinical strategies are now moving toward earlier intervention before the onset of severe symptoms, left ventricular dysfunction and other adverse endpoints such as atrial fibrillation and pulmonary hypertension.","PeriodicalId":416388,"journal":{"name":"Global Cardiology Science and Practice","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116738159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Achieving competence in transoesophageal echocardiography (TOE) requires a clear understanding of cardiac anatomy as well as an ability to correlate two-dimensional (2D) echocardiographic images with the three-dimensional (3D) structures which they represent. Training in the technique is a long process, which may also be hampered by insufficient access to teaching in the clinical environment. These challenges would be met by a simulator which demonstrates detailed cardiac anatomy with a previously unavailable degree of accuracy. Methods: A TOE simulator system was created by collaboration with a wide range of clinical specialists and a post-production company skilled in the generation of computer graphics and special effects for the film industry. The core of the system is an animated, accurate and detailed virtual heart. Echocardiographic simulation was developed to provide a real-time display of ultrasound images alongside the 3D anatomical correlate of the imaging plane. Results: A freely interactive animated model of the heart was created as the basis for ultrasound simulation. Creation of a mannequin simulator which drives the software allowed reproduction of the practical experience of the TOE procedure. Conclusions: Partnership with groups with a wide diversity of skills can result in a simulator teaching tool of high fidelity.
{"title":"Modelling transoesophageal echo","authors":"S. Wright","doi":"10.5339/AHCSPS.2011.2","DOIUrl":"https://doi.org/10.5339/AHCSPS.2011.2","url":null,"abstract":"Background: Achieving competence in transoesophageal echocardiography (TOE) requires a clear understanding of cardiac anatomy as well as an ability to correlate two-dimensional (2D) echocardiographic images with the three-dimensional (3D) structures which they represent. Training in the technique is a long process, which may also be hampered by insufficient access to teaching in the clinical environment. These challenges would be met by a simulator which demonstrates detailed cardiac anatomy with a previously unavailable degree of accuracy. Methods: A TOE simulator system was created by collaboration with a wide range of clinical specialists and a post-production company skilled in the generation of computer graphics and special effects for the film industry. The core of the system is an animated, accurate and detailed virtual heart. Echocardiographic simulation was developed to provide a real-time display of ultrasound images alongside the 3D anatomical correlate of the imaging plane. Results: A freely interactive animated model of the heart was created as the basis for ultrasound simulation. Creation of a mannequin simulator which drives the software allowed reproduction of the practical experience of the TOE procedure. Conclusions: Partnership with groups with a wide diversity of skills can result in a simulator teaching tool of high fidelity.","PeriodicalId":416388,"journal":{"name":"Global Cardiology Science and Practice","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128075306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Gessat, T. Frauenfelder, L. Altwegg, J. Grünenfelder, V. Falk
Transcatheter aortic valve implantation (T-AVI) has shown good results in high-risk patients with severe aortic stenosis. Throughout the whole process of T-AVI, different imaging modalities are indispensable. Preoperatively, multislice computed tomography, angiography and transesophageal echo (TEE) are utilized for patient selection, valve selection, approach selection and the planning of implant placement. Intraoperatively, angiography and TEE are used for controlling placement of the guidewire and valve positioning. Quality control and follow-up require TEE imaging and can require additional CT or angiography studies. In the first half of this paper, we discuss the applicability of different imaging modalities for T-AVI in the light of the current best practice. In the second half of this paper, we present an overview on research projects in medical engineering which aim at development of image-based methods for increasing patient safety during T-AVI. Template-based implantation planning, as it is applied in dental, orthopedic and other surgical disciplines, is proposed as an aid during implant selection in order to help reduce the incidence of complications such as atrioventricular node block and paravalvular leaks. Current research tries to apply state-of-the-art engineering techniques, such as computational fluid dynamics to optimize valve selection and positioning. For intraoperative assistance during valve positioning, real-time image processing methods are proposed to track target landmarks and the stented valve.
{"title":"Transcatheter aortic valve implantation. Role of imaging","authors":"M. Gessat, T. Frauenfelder, L. Altwegg, J. Grünenfelder, V. Falk","doi":"10.5339/AHCSPS.2011.3","DOIUrl":"https://doi.org/10.5339/AHCSPS.2011.3","url":null,"abstract":"Transcatheter aortic valve implantation (T-AVI) has shown good results in high-risk patients with severe aortic stenosis. Throughout the whole process of T-AVI, different imaging modalities are indispensable. Preoperatively, multislice computed tomography, angiography and transesophageal echo (TEE) are utilized for patient selection, valve selection, approach selection and the planning of implant placement. Intraoperatively, angiography and TEE are used for controlling placement of the guidewire and valve positioning. Quality control and follow-up require TEE imaging and can require additional CT or angiography studies. In the first half of this paper, we discuss the applicability of different imaging modalities for T-AVI in the light of the current best practice. In the second half of this paper, we present an overview on research projects in medical engineering which aim at development of image-based methods for increasing patient safety during T-AVI. Template-based implantation planning, as it is applied in dental, orthopedic and other surgical disciplines, is proposed as an aid during implant selection in order to help reduce the incidence of complications such as atrioventricular node block and paravalvular leaks. Current research tries to apply state-of-the-art engineering techniques, such as computational fluid dynamics to optimize valve selection and positioning. For intraoperative assistance during valve positioning, real-time image processing methods are proposed to track target landmarks and the stented valve.","PeriodicalId":416388,"journal":{"name":"Global Cardiology Science and Practice","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121151242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The last 30 years have witnessed unprecedented advances in scientific knowledge across a range of disciplines. Many of these have impacted profoundly on the practice of modern medicine, and the trend is likely to continue and gain momentum, particularly in the post-genomic era and with the advent of personalized medicine.
{"title":"A new journal is born","authors":"M. Yacoub","doi":"10.5339/AHCSPS.2011.1","DOIUrl":"https://doi.org/10.5339/AHCSPS.2011.1","url":null,"abstract":"The last 30 years have witnessed unprecedented advances in scientific knowledge across a range of disciplines. Many of these have impacted profoundly on the practice of modern medicine, and the trend is likely to continue and gain momentum, particularly in the post-genomic era and with the advent of personalized medicine.","PeriodicalId":416388,"journal":{"name":"Global Cardiology Science and Practice","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126674323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aortic valve stenosis is the most common form of acquired valvular disease, with a prevalence of 1% to 2% in people over the age of 65 years. Untreated, the presence of severe symptoms is associated with a life expectancy of less than 5 years. Relatively little is known about the role of the cells within the valve or the regulatory pathways that are involved in the onset and progression of the disease. The aim of this article is to review the role played by valve interstitial and endothelial cells and highlight the role of pathways and individual mediators that have been implicated in playing a role in the disease process. This includes mediators that regulate pro- and anti-calcification mechanisms. The clinical significance of calcium within the valve is discussed, as are the therapeutic opportunities that may allow for development of a medical therapy for aortic stenosis. Understanding the molecular and cellular mechanism of valve calcification will allow development of alternative therapies to surgical replacement of the valve and improve prognosis of patients with aortic stenosis.
{"title":"Molecular and cellular mechanisms of valve calcification","authors":"A. Chester","doi":"10.5339/AHCSPS.2011.4","DOIUrl":"https://doi.org/10.5339/AHCSPS.2011.4","url":null,"abstract":"Aortic valve stenosis is the most common form of acquired valvular disease, with a prevalence of 1% to 2% in people over the age of 65 years. Untreated, the presence of severe symptoms is associated with a life expectancy of less than 5 years. Relatively little is known about the role of the cells within the valve or the regulatory pathways that are involved in the onset and progression of the disease. The aim of this article is to review the role played by valve interstitial and endothelial cells and highlight the role of pathways and individual mediators that have been implicated in playing a role in the disease process. This includes mediators that regulate pro- and anti-calcification mechanisms. The clinical significance of calcium within the valve is discussed, as are the therapeutic opportunities that may allow for development of a medical therapy for aortic stenosis. Understanding the molecular and cellular mechanism of valve calcification will allow development of alternative therapies to surgical replacement of the valve and improve prognosis of patients with aortic stenosis.","PeriodicalId":416388,"journal":{"name":"Global Cardiology Science and Practice","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128062062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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