V.N. Kovalenko, E.G. Nesukay, E.Yu. Titov Acquired aortic stenosis: issues of etiology and pathogenesis

Aortic stenosis (AS) is the most frequent heart valvular pathology. It appears mainly in the elderly patients, occupies the third place among all cardiovascular diseases regarding prevalence, after hypertension and
coronary heart disease. The problem of AS becomes even more actual due to the increased life expectancy, more elderly persons, as well as high prevalence of major cardiovascular risk factors in population. Causes and
pathogenesis of aortic valve (АV) calcification and AS formation in patients of senior age remain quite unclear. The results of numerous experimental and epidemiological studies are discussed in the review. The possible
mechanisms of degenerative damage of АV and substantial differences between calcified AV and atherosclerosis are shown. It is considered that presence of different risk factors of atherosclerosis is important in activating triggering mechanisms important for development of AV calcification. AS pathogenesis includes following mechanisms: gene pathways of myofibroblast to osteoblast transformation, osteopontin expression and bone
mineralization and ectopic bone formation in AV. They play an important role in the subsequent decrease of AV area and obstruction at the valvular level.

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