title: Review of molecular and mechanical interactions in the aortic valve and aorta: implications for the shared pathogenesis of aortic valve disease and aortopathy.
abstract: Aortic valve disease (AVD) and aortopathy are associated with substantial morbidity and mortality, representing a significant cardiovascular healthcare burden worldwide. These mechanobiological structures are morphogenetically related and function in unison from embryonic development through mature adult tissue homeostasis, serving both coordinated and distinct roles. In addition to sharing common developmental origins, diseases of the aortic valve and proximal thoracic aorta often present together clinically. Current research efforts are focused on identifying etiologic factors and elucidating pathogenesis, including genetic predisposition, maladaptive cell-matrix remodeling processes, and hemodynamic and biomechanical perturbations. Here, we review the impact of these processes as they pertain to translational research efforts, emphasizing the overlapping relationship of these two disease processes. The successful application of new therapeutic strategies and novel tissue bioprostheses for AVD and/or aortopathy will require an understanding and integration of molecular and biomechanical processes for both diseases.
authors.affiliation: Division of Cardiology, the Heart Institute, Cincinnati Children's Hospital Medical Center, 240 Albert Sabin Way, MLC 7020, Cincinnati, OH, 45229, USA.
authors.forename: Varun K
authors.initials: VK
authors.lastname: Krishnamurthy
authors.forename: Richard C
authors.initials: RC
authors.lastname: Godby
authors.forename: G R
authors.initials: GR
authors.lastname: Liu
authors.forename: J Michael
authors.initials: JM
authors.lastname: Smith
authors.forename: Loren F
authors.initials: LF
authors.lastname: Hiratzka
authors.forename: Daria A
authors.initials: DA
authors.lastname: Narmoneva
authors.forename: Robert B
authors.initials: RB
authors.lastname: Hinton
mesh_terms: D001011:Aorta / Q000033:anatomy & histology / Q000502:physiology*; D001018:Aortic Diseases / Q000209:etiology* / Q000235:genetics; D001021:Aortic Valve / Q000033:anatomy & histology / Q000502:physiology*; D000082882:Bicuspid Aortic Valve Disease; D001703:Biophysics; D004547:Elastic Tissue / Q000502:physiology; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics; D006801:Humans; D008958:Models, Molecular; D008962:Models, Theoretical; D038081:Organogenesis; D011509:Proteoglycans / Q000502:physiology; D020257:Ventricular Remodeling / Q000502:physiology
chemical_list: D011509:Proteoglycans