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Some aspects of pathogenesis and management of valvular heart diseases that are commonly treated with surgical interventions: aortic stenosis and mitral regurgitation
Fojt, Richard ; Moťovská, Zuzana (advisor) ; Špaček, Rudolf (referee) ; Kuchynka, Petr (referee)
Aortic stenosis (AS) and mitral regurgitation (MR) are the most common valvular heart diseases in the adult population. Additionally, they are the most likely to need surgical intervention. Treatment preceding surgical or percutaneous correction of a valvular defect is targeted primarily on symptoms, since causal pharmacological treatment is lacking. A detailed understanding of the mechanisms behind valvular heart disease is necessary to effectively intervene in the pathogenesis. Calcified aortic valve stenosis, currently considered an active process consisting of a wide range of cells, signaling molecules, and transcription factors, is largely consistent with the pathogenesis of atherosclerosis; however, about 50% of patients with calcified AS do not exhibit significant atherosclerosis. Our work was focused on measuring osteoprotegerin (OPG) levels in the tissue of calcified aortic valves. OPG acts as decoy receptor for RANKL and affects calcification and differentiation of various cells during progression of AS. We found significantly higher tissue levels of OPG in patients with isolated AS compared to patients with concurrent AS and coronary atherosclerosis. These findings support the hypothesis that there is a unique pathogenesis for each clinical manifestation of calcified aortic valve disease. MR is...
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Some aspects of pathogenesis and management of valvular heart diseases that are commonly treated with surgical interventions: aortic stenosis and mitral regurgitation
Fojt, Richard ; Moťovská, Zuzana (advisor) ; Špaček, Rudolf (referee) ; Kuchynka, Petr (referee)
Aortic stenosis (AS) and mitral regurgitation (MR) are the most common valvular heart diseases in the adult population. Additionally, they are the most likely to need surgical intervention. Treatment preceding surgical or percutaneous correction of a valvular defect is targeted primarily on symptoms, since causal pharmacological treatment is lacking. A detailed understanding of the mechanisms behind valvular heart disease is necessary to effectively intervene in the pathogenesis. Calcified aortic valve stenosis, currently considered an active process consisting of a wide range of cells, signaling molecules, and transcription factors, is largely consistent with the pathogenesis of atherosclerosis; however, about 50% of patients with calcified AS do not exhibit significant atherosclerosis. Our work was focused on measuring osteoprotegerin (OPG) levels in the tissue of calcified aortic valves. OPG acts as decoy receptor for RANKL and affects calcification and differentiation of various cells during progression of AS. We found significantly higher tissue levels of OPG in patients with isolated AS compared to patients with concurrent AS and coronary atherosclerosis. These findings support the hypothesis that there is a unique pathogenesis for each clinical manifestation of calcified aortic valve disease. MR is...
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