Journal
CIRCULATION RESEARCH
Volume 108, Issue 12, Pages 1510-1524Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCRESAHA.110.234237
Keywords
biomechanics; calcific aortic valve disease; extracellular matrix; matricellular signaling; matricrine signaling
Funding
- Canadian Institutes of Health Research [MOP-102721]
- Heart and Stroke Foundation of Ontario [NA6654]
- Natural Science and Engineering Research Council of Canada (NSERC) [RGPIN 327627-06]
- Canada Research Chair in Mechanobiology
- NSERC
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The hallmarks of calcific aortic valve disease (CAVD) are the significant changes that occur in the organization, composition, and mechanical properties of the extracellular matrix (ECM), ultimately resulting in stiffened stenotic leaflets that obstruct flow and compromise cardiac function. Increasing evidence suggests that ECM maladaptations are not simply a result of valve cell dysfunction; they also contribute to CAVD progression by altering cellular and molecular signaling. In this review, we summarize the ECM changes that occur in CAVD. We also discuss examples of how the ECM influences cellular processes by signaling through adhesion receptors (matricellular signaling), by regulating the presentation and availability of growth factors and cytokines to cells (matricrine signaling), and by transducing externally applied forces and resisting cell-generated tractional forces (mechanical signaling) to regulate a wide range of pathological processes, including differentiation, fibrosis, calcification, and angiogenesis. Finally, we suggest areas for future research that should lead to new insights into bidirectional cell-ECM interactions in the aortic valve, their contributions to homeostasis and pathobiology, and possible targets to slow or prevent the progression of CAVD. (Circ Res. 2011;108:1510-1524.)
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