Aortic Valve Defect as an Independent Risk Factor for Endothelial Dysfunction

Endothelial dysfunction (ED) has been identified as a precursor to micro- and macroangiopathic complications and an independent risk factor for major adverse cardiac events (MACEs). Recent studies have identified a novel risk factor for ED: severe aortic stenosis (AS). Traditionally linked to other...

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Main Authors: Mateusz Malina, Waldemar Banasiak, Adrian Doroszko
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Cells
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Online Access:https://www.mdpi.com/2073-4409/14/12/885
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author Mateusz Malina
Waldemar Banasiak
Adrian Doroszko
author_facet Mateusz Malina
Waldemar Banasiak
Adrian Doroszko
author_sort Mateusz Malina
collection DOAJ
description Endothelial dysfunction (ED) has been identified as a precursor to micro- and macroangiopathic complications and an independent risk factor for major adverse cardiac events (MACEs). Recent studies have identified a novel risk factor for ED: severe aortic stenosis (AS). Traditionally linked to other established risk factors for endothelial cell dysregulation, AS has emerged as a contributor to ED, which is supported by the improvement of endothelial function following transcatheter (TAVR) or surgical (SAVR) interventions. Furthermore, the observation of ED in patients with a dysfunctional bicuspid aortic valve (BAV) at a younger age suggests a distinct impact of AS on ED. A promising hypothesis is a hemodynamic theory suggesting that changes in the shear stress of the ascending aortic wall and peripheral vessels, along with subclinical hemolysis caused by turbulent blood flow, could lead to reduced nitric oxide (NO) bioavailability. Current hypotheses on ED have yet to consider the influence of concomitant aortic stenosis in BAV. Additionally, studies examining potential intravascular hemolysis in BAV patients or the impact of surgical treatment of this defect on endothelial function are scarce. The aim of this review is to summarize the current knowledge on the mechanisms underlying ED in patients with AS or BAV and to identify possible directions for future research.
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spelling doaj-art-7e3a9fafccd04e6689bf316bbcbb36262025-08-20T02:24:42ZengMDPI AGCells2073-44092025-06-01141288510.3390/cells14120885Aortic Valve Defect as an Independent Risk Factor for Endothelial DysfunctionMateusz Malina0Waldemar Banasiak1Adrian Doroszko2Clinical Department of Cardiology, Centre of Heart Diseases, 4th Military Hospital, 50-981 Wroclaw, PolandClinical Department of Cardiology, Centre of Heart Diseases, 4th Military Hospital, 50-981 Wroclaw, PolandClinical Department of Cardiology, Centre of Heart Diseases, 4th Military Hospital, 50-981 Wroclaw, PolandEndothelial dysfunction (ED) has been identified as a precursor to micro- and macroangiopathic complications and an independent risk factor for major adverse cardiac events (MACEs). Recent studies have identified a novel risk factor for ED: severe aortic stenosis (AS). Traditionally linked to other established risk factors for endothelial cell dysregulation, AS has emerged as a contributor to ED, which is supported by the improvement of endothelial function following transcatheter (TAVR) or surgical (SAVR) interventions. Furthermore, the observation of ED in patients with a dysfunctional bicuspid aortic valve (BAV) at a younger age suggests a distinct impact of AS on ED. A promising hypothesis is a hemodynamic theory suggesting that changes in the shear stress of the ascending aortic wall and peripheral vessels, along with subclinical hemolysis caused by turbulent blood flow, could lead to reduced nitric oxide (NO) bioavailability. Current hypotheses on ED have yet to consider the influence of concomitant aortic stenosis in BAV. Additionally, studies examining potential intravascular hemolysis in BAV patients or the impact of surgical treatment of this defect on endothelial function are scarce. The aim of this review is to summarize the current knowledge on the mechanisms underlying ED in patients with AS or BAV and to identify possible directions for future research.https://www.mdpi.com/2073-4409/14/12/885aortic stenosisbicuspid aortic valveendothelial function
spellingShingle Mateusz Malina
Waldemar Banasiak
Adrian Doroszko
Aortic Valve Defect as an Independent Risk Factor for Endothelial Dysfunction
Cells
aortic stenosis
bicuspid aortic valve
endothelial function
title Aortic Valve Defect as an Independent Risk Factor for Endothelial Dysfunction
title_full Aortic Valve Defect as an Independent Risk Factor for Endothelial Dysfunction
title_fullStr Aortic Valve Defect as an Independent Risk Factor for Endothelial Dysfunction
title_full_unstemmed Aortic Valve Defect as an Independent Risk Factor for Endothelial Dysfunction
title_short Aortic Valve Defect as an Independent Risk Factor for Endothelial Dysfunction
title_sort aortic valve defect as an independent risk factor for endothelial dysfunction
topic aortic stenosis
bicuspid aortic valve
endothelial function
url https://www.mdpi.com/2073-4409/14/12/885
work_keys_str_mv AT mateuszmalina aorticvalvedefectasanindependentriskfactorforendothelialdysfunction
AT waldemarbanasiak aorticvalvedefectasanindependentriskfactorforendothelialdysfunction
AT adriandoroszko aorticvalvedefectasanindependentriskfactorforendothelialdysfunction