Osteogenesis in calcified aortic valve disease: From histopathological observation towards molecular understanding

Calcified aortic valve disease (CAVD) is the most common heart valve disease in aged patients, with a disease continuum that ranges from mild valve thickening to severe calcification. In the past, calcification in CAVD was considered degenerative because of the time-dependent wear-and-tear of the leaflets with passive calcium deposition. Now, insights into the histopathological features, clinical data, and molecular mechanisms of CAVD have been greatly highlighted by findings that valvular calcification is a tightly regulated process resembling the osteogenic process. In this review, we focus on osteogenesis (bone formation) during the progression of CAVD and highlight the recent advances in understanding the cellular and molecular mechanisms of osteogenesis in valvular calcification.