Calcific Aortic Valve Disease

Due to population aging, calcific aortic valve disease (CAVD) has become the most common heart valve disease in Western countries. No therapies exist to slow this disease progression, and surgical valve replacement is the only effective treatment. Calcific Aortic Valve Disease covers the contemporary understanding of basic valve biology and the mechanisms of CAVD, provides novel insights into the genetics, proteomics, and metabolomics of CAVD, depicts new strategies in heart valve tissue engineering and regenerative medicine, and explores current treatment approaches. As we are on the verge of understanding the mechanisms of CAVD, we hope that this book will enable readers to comprehend our current knowledge and focus on the possibility of preventing disease progression in the future.

This book describes the field of osteocardiology, an exciting and new sub-discipline within cardiovascular science, which will become the cornerstone for defining the timing and treatment of cardiovascular calcification in the future. With the advent of large cohort databases and experimental mechanistic studies, research has elucidated evidence confirming that traditional cardiovascular risk factors are responsible for the development of atherosclerotic calcification and identified the critical elements of atherosclerosis, including foam cell formation, vascular smooth muscle cell proliferation and extracellular matrix synthesis, which over time forms bone in the heart. Osteocardiology: Cardiac Bone Formation is a practical overview of bone formation in the heart and is destined to become the cornerstone for education of medical students, residents, fellows, graduate students, physician scientists and scientists, for future research and ongoing development in medical therapies to slow or halt the progression of bone formation in the heart.

Calcific aortic valve stenosis is the most frequent valvular heart disease in Western countries, affecting up to 13% of individuals over 75 years. The disease is associated with considerable morbidity and mortality. It is characterized by fibro-calcification of aortic valve cusps and concomitant left ventricular remodelling due to chronic pressure overload, which can evolve into overt heart failure. It progresses very slowly until the onset of symptoms, the indication for aortic valve replacement. Today, about 300,000 aortic valve replacements are performed annually worldwide, either via surgery or transcatheter implantation. This is the only treatment shown to improve survival. There is no pharmacological treatment to prevent or slow disease progression. Major risk factors include older age, congenital anomalies of the aortic valve (bicuspid valve), male gender, hypertension, dyslipidaemia, smoking, and diabetes. However, how these factors contribute to the disease in unclear. Due to the disease itself, patients are at increased risk of both thrombosis and bleeding, which, in addition to advanced age and comorbidities, makes antithrombotic management of these patients difficult. Regarding valve prostheses, the ideal prosthesis either mechanical or biological still does not exist. Clinically available prostheses can lead to major complications, thrombosis or infection, which necessitate reoperation or cause death in 50-60% of patients within 10 years post-implantation. Hence, there are major unmet medical needs in CAVS and more basic and translational research is definitely required. Our Research Topic depicts major challenges and research paths that could be followed to address these major health needs.

Much has evolved in the field of aortic valve disease because of the increase in knowledge in the last decade, especially in the area of its management. This book "Aortic Valve" is comprised of 18 chapters covering basic science, general consideration of aortic valve disease, infective endocarditis, aortic sclerosis and aortic stenosis, bioprosthetic valve, transcatheter aortic valve implantation and a special section on congenital anomalies of the aortic valve. We hope this book will be particularly useful to cardiologists and cardiovascular surgeons and trainees. We also believe that this book will be a valuable resource for radiologists, pathologists, cardiovascular anesthesiologists, and other healthcare professionals who have a special interest in treating patients with aortic valve disease. We are certain that information in this book will help to provide virtually most new areas of aortic valve disease that will be employed in the current era.

The book systematically describes the clinical and scientific aspects of cardiovascular calcification. Chapters detail the mechanisms associated with arterial and valve calcification, relevant risk factors, pathophysiology and the latest therapeutic techniques. Recent diagnostic technological developments including how computed tomography (CT) scanning can be utilized along with Agatston score to quantify coronary arterial calcification when investigating whether a patient for sub-clinical atherosclerosis are covered. The correlation with the presence of arterial calcification and extent of coronary stenosis is also explored. Cardiovasular Calcification details relevant aspects of the basic science and reviews the latest pathological and therapeutic techniques used in treating patients with cardiovascular calcification. It is therefore an essential resource for practicing cardiologists, cardiac surgeons, vascular specialists and radiologists.

The book covers the basic science and clinical aspects of cardiovascular calcification and bone mineralization. Cardiovascular calcification is the leading predictor of cardiovascular morbidity and mortality, with a predictive value more significant than blood lipid levels. The presence of calcific mineral in cardiovascular tissues alters biomechanical performance, increasing workload on the heart and potentiating atherosclerotic plaque rupture and subsequent heart attack and stroke. This book examines the role of calcification in cardiovascular disease covering topics such as calcification in the atherosclerotic plaques and aortic valves arteries and valves, aortic valve replacement, peripheral artery disease, imaging of early calcification and target discovery. In addition, various forms of ectopic calcification as well as mechanisms of bone mineralization are discussed. Cardiovascular Calcification and Bone Mineralization is an essential resource for clinicians, researchers, and other medical professionals in cardiology, pathology, and biomedical engineering.

Challenges for the treatment of valvular heart disease include the growing need for effective yet less invasive interventions and therapies to treat these progressive conditions. With the development of potential new treatments, it is crucial for cardiac physicians to be well informed on the pathophysiology, assessment, treatment options and their outcomes of valvular diseases. Written by a highly experienced and internationally recognized group of cardiologists, cardiac surgeons, and researchers, Valvular Heart Disease offers insights into the widely varying hemodynamic effects and clinical course of heart valve conditions, as well as the contemporary management of these conditions. Offering a broad perspective on these diseases, Valvular Heart Disease expands on the recent guidelines developed by the major heart societies in the United State and Europe.

This is the first textbook to focus on Aortopathy, a new clinical concept for a form of vasculopathy. The first section of the book starts from discussing general concept and history of Aortopathy, and then deals with its pathophysiology, manifestation, intrinsic factor, clinical implication, management and prevention. The second part closely looks at various disorders of the Aortopathy such as bicuspid aortic valve and coarctation of aorta. The book editors have published a lot of works on the topic and have been collecting relating data in the field of congenital heart disease for the past 20 years, thus present the book with confidence. The topic - an association of aortic pathophysiological abnormality, aortic dilation and aorto-left ventricular interaction - is getting more and more attention among cardiovascular physicians. This is the first book to refer for cardiologists, pediatric cardiologists, surgeons, ACHD specialists, etc. to acquire thorough knowledge on Aortopathy.