Aortic sclerosis pathophysiology

Overview
Calcific aortic valve disease includes both aortic sclerosis and aortic stenosis.

In patients with calcific aortic valve disease, microscopic examination reveals lipoprotein accumulation, macrophage and T-cellular infiltration, basement membrane disruption and extracellular matrix formation that lead to progressive thickening of the aortic valve.

Pathophysiology

 * Otto et al, demonstrated the following histological characteristics observed in patients with aortic sclerosis:
 * Subendothelial thickening on the aortic side of the leaflet, between the basement membrane and elastic lamina
 * Presence of large amounts of intracellular and extracellular neutral lipids and fine, stippled mineralization
 * Disruption of the basement membrane overlying the lesion
 * Regions of the fibrosa adjacent to these lesions were characterized by thickening and by protein, lipid, and calcium accumulation


 * Aortic sclerosis is non-obstructive degeneration of the aortic valve developed consequently to calcification of the aortic valve and macrophage accumulation which is dependent on the synthesis of osteopontin protein.


 * Disturbances in mineral metabolism such as higher serum phosphate concentration has shown to contribute to the development of aortic sclerosis.