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Aortic valve calcification – the role of inflammation and fibrosis


Pathogenesis of aortic valve calcificationis a multifunctional processassociated with various risk factors, while heart valve replacement is the only established treatment.Unfortunately, the real mechanism of the valve calcification remains still unknown. Herewith, we investigate the changes in molecular levelof aortic valve tissues in order to characterize the mineral deposits and understand the mechanism of aortic valve mineralization and stenosis.


30 aortic valves samples of patients (65-80 years), who underwent surgical aortic valve replacement due to aortic valve stenosis. A Nicolet 6700 thermoscientific spectrometer was used to record the infrared (FT-IR) spectra. The aortic valve surfaces were studied with Scanning Electron Microscopy (SEM-EDX), without any coating of the samples.


The infrared spectra showed intensity changes and shifts of characteristic bands concerning the peroxidation of lipids suggesting inflammation character of stenosis. The proteins and collagen changed their α-helix to random one.The mineral deposits were consistent of calcium phosphates, CaHPO4 and amorphous hydroxyapatite, depending on the chemical factors of the cells’ microenvironment. In the case of SEM showed that the cross-link bonds of collagen are the targetingsites where the minerals start the deposition.


The characteristic FT-IR absorption bands of calcified stenotic aortic valves showed hyperoxidation of membranes (a pro-inflammation stage), while the mineral deposits were consistent of low crystallinity biological HA (Ca10(PO4)6(OH)2), Ca2HPO4 and calcium phosphate of phospholipoprotein fragments. SEM-EDX data show substitution of calcium cations from magnesium cations leading to amorphous hydroxyapatites. This finding suggested that magnesium supplements could prevent the re-calcification of the implants.

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Correspondence to Chr Kotoulas.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated.

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Pissaridi, K., Dritsa, V., Anastassopoulou, J. et al. Aortic valve calcification – the role of inflammation and fibrosis. J Cardiothorac Surg 8 (Suppl 1), O32 (2013).

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