Intramural stress as a causative factor in atherosclerotic lesions of the aortic valve

Inhibition of atherosclerosis associated with reduction of arterial intramural stress in rabbits.

“…In the aortic valves of rabbits fed a high-cholesterol diet, atherosclerotic lesions developed only on the pressure-bearing part of the leaflet. 28 Although the entire leaflet is subjected to the effects of blood flow, only a part of the leaflet bears the load of closing pressure and has the highest intramural stress. 28 In humans, atherosclerotic lesions develop more frequently in the lower extremities 29 where static pressure and, most likely, stress are greater when standing than in the upper extremities.…”

“…28 Although the entire leaflet is subjected to the effects of blood flow, only a part of the leaflet bears the load of closing pressure and has the highest intramural stress. 28 In humans, atherosclerotic lesions develop more frequently in the lower extremities 29 where static pressure and, most likely, stress are greater when standing than in the upper extremities. The principle of reducing intramural stress by controlling geometry was applied clinically by Barra et al 30 when he placed constrictive mesh on the vein graft to prevent distention under arterial pressure and observed that these grafts performed better than those not covered.…”

Association Between Mitral Annular Calcification and Stroke

“…15) Systemic arterial atherosclerosis is also associated with the deposition of fatty plaques on the aortic surface of the aortic valve cups and the ventricular surface of the posterior mitral leaflet. 16) These findings suggest that coronary atherosclerosis, MAC, and aortic valve calcium in the elderly might have a similar etiology. In an editorial on the senile cardiac calcification syndrome, Roberts 15) claimed that since calcific deposits in the mitral annular area are observed only in a population that develops significant coronary atherosclerosis, MAC in the elderly might also be a form of atherosclerosis.…”

Choice of Surgical Strategy in Patients With Severe Aortic Stenosis and Concomitant Coronary Artery Disease

“…[8] показали, что у 100 % людей, имеющих кальциноз аортального или ми-трального клапанов, также имеются кальцифика-ции в одной или более коронарных артериях. Эта находка в дальнейшем была подтверждена путем патологоанатомических исследований, показав-ших, что скопления пенистых клеток, присущих ранним стадиям атеросклероза, могут быть обна-ружены как в эндотелии коронарных артерий, так и в створках АоК даже у лиц 20-30 лет [3,9].…”