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INTERNATIONAL JOURNAL OF SCIENTIFIC DEVELOPMENT AND RESEARCH International Peer Reviewed & Refereed Journals, Open Access Journal ISSN Approved Journal No: 2455-2631 | Impact factor: 8.15 | ESTD Year: 2016 open access , Peer-reviewed, and Refereed Journals, Impact factor 8.15 |
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| Paper Title: | CALCIFIC AORTIC VALVE DISEASE- A NARRATIVE REVIEW |
| Authors Name: | MARY MANISHA MANNAM , Ajay Godwin Potnuri , Uma Rani Yadagiri |
| Unique Id: | IJSDR2209181 |
| Published In: | Volume 7 Issue 9, September-2022 |
| Abstract: | ABSTRACT: Calcific aortic valve disease is a slowly progressive disorder with a disease continuum that ranges from mild valve thickening without obstruction of blood flow, termed aortic sclerosis, to severe calcification with impaired leaflet motion, or aortic stenosis. Möenckeburg gave the first detailed description of CAVD in - calcium deposition on the valve cusps making them sclerotic. He also described two mechanisms to explain this phenomenon: degeneration within the layers of the valve leaflets nearest the sinuses of Valsalva that propagated toward the tips of the cusps. Sclerotic changes of the aorta that extended to involve the valve cusps. Typically, the leaflets are ≤1 mm thick and are comprised of an outer layer of valve endothelial cells (VECs) and 3 internal layers made up of valve interstitial cells (VICs). These layers are known as the fibrosa, spongiosa, and ventricularis to reflect their anatomic location, cellular and extracellular matrix composition, and biomechanical properties (Rajamannan et al., 2011). VICs are abundant in all layers of the heart valves, and are crucial to function. VICs synthesize ECM and MMPs. Adult heart valve VICs in situ have characteristics of resting fibroblasts - quiescent. VIC’s are activated during intrauterine valvular maturation (becomes quiescent after birth), abrupt changes in the mechanical stress state of valves and in disease states. Once activated, VICs can differentiate into a variety of other cell types, including myofibroblasts and osteoblasts, although valve osteoblasts may respond to cellular signals differently than skeletal osteoblasts. VECs resemble endothelial cells with phenotypic differences. VECs interact with VICs to maintain the valve integrity differential transcription by VECs on the opposite (i.e., aortic and ventricular) faces. These may contribute to the typical localization of early pathological AV calcification. VECs are activated by abnormal hemodynamic forces (such as hypertension, elevated stretch, or shear stresses). Interaction with activated VIC. Pathophysiology include congenital heart defect, lambl’s excrescences, papillary fibroelastoma, calcification of aortic valve (CAVD). Symptoms of CAVD are Chest pain (angina) or tightness, feeling faint or fainting with exertion, Shortness of breath, especially with exertion, Fatigue, especially during times of increased activity, Heart palpitations — sensations of a rapid, fluttering heartbeat, Heart murmur. Analysis of CAVD is done by two methods Echocardiographic Imaging for CAVD and Computed Tomography in Quantifying Calcification in CAVD. Cellular mechanisms of CAVD includes: Bone morphogenetic protein and Wnt signaling in valve interstitial cells (VICs), Endothelial-to-Mesenchymal Transition, Inflammation and Immune Response, Stem and Progenitor Cells. We also have few other processes associated with CAVD they are as follows: Matrix Vesicle Formation and Microcalcifications, Extracellular Matrix Remodeling, Angiogenesis and Neovascularization. Potential targets of CAVD are inflammation, sodium dependent phosphate transporter 1, oxidized LDL, osteoprotegerin, PPAR gamma, lipo protein (a), HDL cholesterol, apolipo protein A I mimetic peptide, angiotensin 2 type 1 receptor, hydroxytryptamine receptor 2B, cadherin-11, notch 1, P 2 Y purinoreceptor 2, cathepsin S. Evaluation of CAVD is done by few techniques to measure the aortic valve calcium content they are alizarin red, arsenazo 3, atomic absorption, energy dispersive X-ray spectroscopy, O- cresolphthalein complexone, raman spectroscopy, scanning electron microscopy, transmission electron microscopy, von kossa. |
| Keywords: | Calcific aortic valve disease, calcification, vesicles, aortic valve |
| Cite Article: | "CALCIFIC AORTIC VALVE DISEASE- A NARRATIVE REVIEW", International Journal of Science & Engineering Development Research (www.ijsdr.org), ISSN:2455-2631, Vol.7, Issue 9, page no.1119 - 1136, September-2022, Available :http://www.ijsdr.org/papers/IJSDR2209181.pdf |
| Downloads: | 000337215 |
| Publication Details: | Published Paper ID: IJSDR2209181 Registration ID:201890 Published In: Volume 7 Issue 9, September-2022 DOI (Digital Object Identifier): http://doi.one/10.1729/Journal.32192 Page No: 1119 - 1136 Publisher: IJSDR | www.ijsdr.org ISSN Number: 2455-2631 |
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