Pathologische Gefäßkalzifizierung – klinische Relevanz und molekulare Mechanismen

Zusammenfassung

Die kardiovaskuläre Kalzifizierung stellt als pathologische Mineralablagerung in Herzklappen und Arterien einen Prädiktor und Risikofaktor für die kardiovaskuläre Morbidität und Mortalität dar – ein globales Gesundheitsproblem. Die kardiovaskuläre Kalzifizierung ist ein ‚Unmet need‘ in der kardiovaskulären Medizin, da es bisher keine therapeutischen Ansatzpunkte gibt, die diesen Prozess aufhalten oder modifizieren können. Diese Übersichtsarbeit fasst die Manifestationsformen der kardiovaskulären Kalzifizierung mit ihren klinischen Relevanzen zusammen. Dabei wird der Fokus insbesondere auf die arterielle Mikrokalzifizierung der Tunica intima, sowie Makrokalzifizierung der Tunica media und der Aortenklappe gelegt. Die zellulären und molekularen Mechanismen, die die kardiovaskuläre Kalzifizierung regulieren, sind vielfältig und zeigen Parallelen zum Knochenstoffwechsel. Neben den klassischen Signalwegen, wird die Rolle epigenetischer Veränderungen diskutiert. Letztlich werden offene Fragen aufgezeigt, deren Beantwortung wichtig ist, um Therapieansätze zur Prävention und Behandlung kardiovaskulärer Kalzifizierung entwickeln zu können, die die Knochengesundheit nicht beeinflussen.

Abstract

Cardiovascular calcification, the pathological mineral deposition in heart valves and arteries, is a predictor and risk factor for cardiovascular morbidity and mortality – a global health problem. Cardiovascular calcification represents an ‘unmet need’ in cardiovascular medicine, as there are currently no therapeutic approaches that can stop or modify this process. This review article summarizes the manifestations of cardiovascular calcification with their clinical relevance, focusing mainly on arterial microcalcification of the tunica intima and macrocalcification of the tunica media and the aortic heart valve. The cellular and molecular mechanisms that regulate cardiovascular calcification are diverse and show parallels to bone metabolism. In addition to the classic signaling pathways, the role of epigenetic changes are discussed. Finally, open questions are identified, whose answers are essential to develop therapeutic approaches for preventing and treating cardiovascular calcification that do not affect bone health.

Schlüsselwörter

kardiovaskular - Kalzifizierung - Gefäß - Herzklappe

Key words

cardiovascular - calcification - artery - aortic valve

Publikationsverlauf

Eingereicht: 05. September 2022

Angenommen: 15. Oktober 2022

Artikel online veröffentlicht:
14. Dezember 2022

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