The contribution of amyloid deposition in the aortic valve to calcification and aortic stenosis

Calcific aortic valve disease (CAVD) and stenosis have a complex pathogenesis, and no therapies are available that can halt or slow their progression. Several studies have shown the presence of apolipoprotein-related amyloid deposits in close proximity to calcified areas in diseased aortic valves. In this Perspective, we explore a possible relationship between amyloid deposits, calcification and the development of aortic valve stenosis. These amyloid deposits might contribute to the amplification of the inflammatory cycle in the aortic valve, including extracellular matrix remodelling and myofibroblast and osteoblast-like cell proliferation. Further investigation in this area is needed to characterize the amyloid deposits associated with CAVD, which could allow the use of antisense oligonucleotides and/or isotype gene therapies for the prevention and/or treatment of CAVD. Calcific aortic valve disease and stenosis have a complex pathogenesis, and no therapies are available that can halt or slow their progression. In this Perspective, Narula and colleagues explore a possible relationship between amyloid deposition, calcification and the development of aortic valve stenosis.