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Ectopic mineralization in heart valves: new insights from and procalcific models and promising perspectives on noncalcifiable bioengineered valves.

作者信息

Bonetti Antonella, Marchini Maurizio, Ortolani Fulvia

机构信息

Department of Medicine, University of Udine, Udine, Italy.

出版信息

J Thorac Dis. 2019 May;11(5):2126-2143. doi: 10.21037/jtd.2019.04.78.


DOI:10.21037/jtd.2019.04.78
PMID:31285908
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6588779/
Abstract

Ectopic calcification of native and bioprosthetic heart valves represents a major public health problem causing severe morbidity and mortality worldwide. Valve procalcific degeneration is known to be caused mainly by calcium salt precipitation onto membranes of suffering non-scavenged cells and dead-cell-derived products acting as major hydroxyapatite nucleators. Although etiopathogenesis of calcification in native valves is still far from being exhaustively elucidated, it is well known that bioprosthesis mineralization may be primed by glutaraldehyde-mediated toxicity for xenografts, cryopreservation-related damage for allografts and graft immune rejection for both. Instead, mechanical valves, which are free from calcification, are extremely thrombogenic, requiring chronic anticoagulation therapies for transplanted patients. Since surgical substitution of failed valves is still the leading therapeutic option, progressive improvements in tissue engineering techniques are crucial to attain readily available valve implants with good biocompatibility, proper functionality and long-term durability in order to meet the considerable clinical demand for valve substitutes. Bioengineered valves obtained from acellular non-valvular scaffolds or decellularized native valves are proving to be a compelling alternative to mechanical and bioprosthetic valve implants, as they appear to permit repopulation by the host's own cells with associated tissue remodelling, growth and repair, besides showing less propensity to calcification and adequate hemodynamic performances. In this review, insights into valve calcification onset as revealed by and procalcific models are updated as well as advances in the field of valve bioengineering.

摘要

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[1]
Ectopic mineralization in heart valves: new insights from and procalcific models and promising perspectives on noncalcifiable bioengineered valves.

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[6]
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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
Ultrastructural and Immunohistochemical Detection of Hydroxyapatite Nucleating Role by rRNA and Nuclear Chromatin Derivatives in Aortic Valve Calcification: In Vitro and In Vivo Pro-Calcific Animal Models and Actual Calcific Disease in Humans.

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[10]
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本文引用的文献

[1]
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Cells Tissues Organs. 2017

[2]
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PLoS One. 2017-8-1

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[10]
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Prog Biophys Mol Biol. 2016-11

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