Unveiling the intricacies of cardiac valve pathophysiology

IntroductionHeart valves have long been regarded as uncomplicated, avascular, and passive structures. However, we hypothesise that their structure and function are complex. Therefore, we have reviewed the available literature to gain a profound understanding of their cellular composition and (patho)...

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Main Authors: Johannes H. Jedrzejczyk, Oline Hjertensgaard, Victor G. Puelles, J. Michael Hasenkam
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1570271/full
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author Johannes H. Jedrzejczyk
Johannes H. Jedrzejczyk
Oline Hjertensgaard
Oline Hjertensgaard
Victor G. Puelles
Victor G. Puelles
Victor G. Puelles
J. Michael Hasenkam
J. Michael Hasenkam
author_facet Johannes H. Jedrzejczyk
Johannes H. Jedrzejczyk
Oline Hjertensgaard
Oline Hjertensgaard
Victor G. Puelles
Victor G. Puelles
Victor G. Puelles
J. Michael Hasenkam
J. Michael Hasenkam
author_sort Johannes H. Jedrzejczyk
collection DOAJ
description IntroductionHeart valves have long been regarded as uncomplicated, avascular, and passive structures. However, we hypothesise that their structure and function are complex. Therefore, we have reviewed the available literature to gain a profound understanding of their cellular composition and (patho)physiological behaviour.MethodsA systematic search for articles related to the anatomy, histology, and physiology of heart valves was conducted using PubMed and Google Scholar, as well as a manual search of journals and websites. All publications were screened by title and abstract, and potentially eligible articles were reviewed in full text to assess their relevance.ResultsCardiac valves comprise a complex, three-layered structure composed of an intricate network of cells. Valvular endothelial cells cover the atrial and ventricular sides of the valves. Valvular endothelial cells are morphologically and functionally distinct from vascular endothelial cells and play a crucial role in maintaining valve function. The three-valve layers, lamina fibrosa, spongiosa, and ventricularis, exhibit distinct biomechanical properties due to their varying extracellular matrix components and valvular interstitial cells. Valvular interstitial cells can be divided into four subtypes, each exhibiting specific cellular functions essential for normal valve physiology. However, pathological stimuli can cause aberrant activation of the valvular interstitial cells, leading to valve calcification and stenosis.ConclusionThe intricate interplay of cellular components within cardiac valves is vital for maintaining normal valve function and structural integrity, but also contributes to valve pathology. A holistic understanding of heart valves, integrating cellular, molecular, and neural perspectives, is needed in the future.
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spelling doaj-art-8ed6dabc14e543cba0b37ec8d4e89fdb2025-08-20T03:32:20ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.15702711570271Unveiling the intricacies of cardiac valve pathophysiologyJohannes H. Jedrzejczyk0Johannes H. Jedrzejczyk1Oline Hjertensgaard2Oline Hjertensgaard3Victor G. Puelles4Victor G. Puelles5Victor G. Puelles6J. Michael Hasenkam7J. Michael Hasenkam8Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Medicine, Aarhus University, Aarhus, DenmarkDepartment of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Medicine, Aarhus University, Aarhus, DenmarkDepartment of Clinical Medicine, Aarhus University, Aarhus, DenmarkDepartment of Pathology, Aarhus University Hospital, Aarhus, DenmarkIII. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, GermanyDepartment of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Medicine, Aarhus University, Aarhus, DenmarkIntroductionHeart valves have long been regarded as uncomplicated, avascular, and passive structures. However, we hypothesise that their structure and function are complex. Therefore, we have reviewed the available literature to gain a profound understanding of their cellular composition and (patho)physiological behaviour.MethodsA systematic search for articles related to the anatomy, histology, and physiology of heart valves was conducted using PubMed and Google Scholar, as well as a manual search of journals and websites. All publications were screened by title and abstract, and potentially eligible articles were reviewed in full text to assess their relevance.ResultsCardiac valves comprise a complex, three-layered structure composed of an intricate network of cells. Valvular endothelial cells cover the atrial and ventricular sides of the valves. Valvular endothelial cells are morphologically and functionally distinct from vascular endothelial cells and play a crucial role in maintaining valve function. The three-valve layers, lamina fibrosa, spongiosa, and ventricularis, exhibit distinct biomechanical properties due to their varying extracellular matrix components and valvular interstitial cells. Valvular interstitial cells can be divided into four subtypes, each exhibiting specific cellular functions essential for normal valve physiology. However, pathological stimuli can cause aberrant activation of the valvular interstitial cells, leading to valve calcification and stenosis.ConclusionThe intricate interplay of cellular components within cardiac valves is vital for maintaining normal valve function and structural integrity, but also contributes to valve pathology. A holistic understanding of heart valves, integrating cellular, molecular, and neural perspectives, is needed in the future.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1570271/fullvalvular heart diseasecardiac valvescardiac valve physiologycardiac valve pathophysiologyvalve endothelial cellsvalve interstitial cells
spellingShingle Johannes H. Jedrzejczyk
Johannes H. Jedrzejczyk
Oline Hjertensgaard
Oline Hjertensgaard
Victor G. Puelles
Victor G. Puelles
Victor G. Puelles
J. Michael Hasenkam
J. Michael Hasenkam
Unveiling the intricacies of cardiac valve pathophysiology
Frontiers in Cardiovascular Medicine
valvular heart disease
cardiac valves
cardiac valve physiology
cardiac valve pathophysiology
valve endothelial cells
valve interstitial cells
title Unveiling the intricacies of cardiac valve pathophysiology
title_full Unveiling the intricacies of cardiac valve pathophysiology
title_fullStr Unveiling the intricacies of cardiac valve pathophysiology
title_full_unstemmed Unveiling the intricacies of cardiac valve pathophysiology
title_short Unveiling the intricacies of cardiac valve pathophysiology
title_sort unveiling the intricacies of cardiac valve pathophysiology
topic valvular heart disease
cardiac valves
cardiac valve physiology
cardiac valve pathophysiology
valve endothelial cells
valve interstitial cells
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1570271/full
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