Evolving Concepts of Cardiac Valve Dynamics : The Continuum of Development, Functional Structure, Pathobiology, and Tissue Engineering

Considerable progress has been made in recent years toward elucidating a conceptual framework that integrates the dynamic functional structure, mechanical properties, and pathobiological behavior of the cardiac valves. This communication reviews the evolving paradigm of a continuum of heart valve st...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2008-10, Vol.118 (18), p.1864-1880
Main Author: SCHOEN, Frederick J
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Bioprosthesis - trends
Blood and lymphatic vessels
Cardiology. Vascular system
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Heart
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Heart Valve Diseases - pathology
Heart Valve Diseases - physiopathology
Heart Valve Diseases - surgery
Heart Valve Prosthesis - trends
Heart Valves - pathology
Heart Valves - physiology
Humans
Medical sciences
Tissue Engineering - trends
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Summary:Considerable progress has been made in recent years toward elucidating a conceptual framework that integrates the dynamic functional structure, mechanical properties, and pathobiological behavior of the cardiac valves. This communication reviews the evolving paradigm of a continuum of heart valve structure, function, and pathobiology and explores its implications. Specifically, we discuss (1) the interactions of valve biology and biomechanics (eg, correlations of function with structure at the cell, tissue, and organ levels and mechanical considerations, development, endothelial cell and interstitial cell biology, extracellular matrix biology, homeostasis, and adaptation to environmental change); (2) mechanisms of disease (eg, valve cell and matrix pathobiology in congenital anomalies, aortic valve calcification, and mitral valve prolapse); (3) considerations in replacement and repair (eg, cell/matrix biology of tissue valve substitutes and their degeneration and durability of repairs); and (4) the potential for tissue engineering approaches to therapeutic regeneration of the cardiac valves. Opportunities for research and clinical translation are highlighted.
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.108.805911