Chapter 9 - Calcific and Degenerative Heart Valve Disease

Abstract

The global impact of the spectrum of valvular heart diseases is a serious but under-recognized health problem. While the prevalence of rheumatic heart disease has declined in the developed countries, calcific and degenerative valve disease is on the rise due to population aging. No medical therapies exist to prevent or slow this disease progression, and invasive and costly surgical interventions are the only effective treatments. In the last two decades significant efforts have been made in elucidating the cellular pathobiology, development, and biomechanics of heart valves, and new understanding of the developmental pathways underlying molecular and cellular mechanisms of calcific and degenerative valve disorders has emerged. In addition, the use of novel imaging methods and animal models has provided better appreciation of key events occurring in vivo. This chapter will integrate our current knowledge of cellular and molecular pathways and biomechanical factors involved in the initiation and progression of calcific aortic valve disease and mitral valve degeneration in humans.