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01-06-2007 | Original Article

Bone formation in cardiac valves: a histopathological study of 128 cases

Authors: Ivo Steiner, Petra Kašparová, Aleš Kohout, Jan Dominik

Published in: Virchows Archiv | Issue 6/2007

Abstract

In a series of 1,177 patients with surgical valve resection, there were 128 (10.9%) patients with the histological finding of bone and/or cartilage formation (bony metaplasia; heterotopic ossification) in the excised valve (119 aortic, 9 mitral). The incidence was higher in men (12.8%) than in women (8.5%). The bony metaplasia was always associated with valvular calcification. The metaplastic changes were encountered in all types of calcific aortic valve disease (senile, bicuspid valve, post-rheumatic). The marrow of the heterotopic lamellar bone was mostly composed of adipose tissue. Frequently, it showed chronic inflammation with polyclonal plasmocytic infiltration. Complete haematopoiesis was present only rarely.

Agmon Y, Khandheria BK, Meissner I, Sicks JRD, O’Fallon WM, Wiebers DO, Whisnant JP, Seward JB, Tajik AJ (2001) Aortic valve sclerosis and aortic atherosclerosis: different manifestations of the same disease? J Am Coll Cardiol 38:827–834PubMedCrossRef

Charokopos NA, Antonitsis P, Rouska E, Kostopoulos I, Charaf A, Spanos PK (2006) Cartilaginous and osseous metaplasia with bone marrow formation in the aortic valve of a patient with giant cell aortitis. Ann Thorac Surg 81:1877–1879PubMedCrossRef

Doherty TM, Asotra K, Fitzpatrick LA, Qiao JH, Wilkin DJ, Detrano RC, Dunstan CR, Shah PK, Rajavashisth TB (2003) Calcification in atherosclerosis: bone biology and chronic inflammation at the arterial crossroads. Proc Natl Acad Sci USA 10:11201–11206CrossRef

Feldman T, Glagov S, Carroll JD (1993) Restenosis following successful balloon valvuloplasty: bone formation in aortic valve leaflets. Catheter Cardiovasc Diagn 29:1–7CrossRef

Fernández Gonzáles AL, Montero JA, Martinez Monzonís A, Gil O, Alemany P (1997) Osseous metaplasia and hematopoietic bone marrow in a calcified aortic valve. Texas Heart Inst J 24:232

Freeman RV, Otto CM (2005) Spectrum of calcific aortic valve disease. Pathogenesis, disease progression, and treatment strategies. Circulation 111:3316–3326PubMedCrossRef

Groom DA, Starke WR (1990) Cartilaginous metaplasia in calcific aortic valve disease. Am J Clin Pathol 93:809–812PubMed

Hunt JL, Fairman R, Mitchell ME, Carpenter JP, Golden M, Khalapyan T, Wolfe M, Neschis D, Milner R, Scoll B, Cusack A, Mohler ER (2002) Bone formation in carotid plaques: a clinicopathological study. Stroke 33:1214–1219PubMedCrossRef

Jeziorska M, McCollum C, Woolley DE (1998) Observations on bone formation and remodelling in advanced atherosclerotic lesions of human carotid arteries. Virchows Arch 433:559–565PubMedCrossRef

10.

Mazzone A, Epistolato MC, Gianetti J, Castagnini M, Sassi C, Ceravolo R, Bevilacqua S, Gevilacqua S, Glauber M, Biagini A, Tanganelli P (2006) Biologic features (inflammation and neoangiogenesis) and atherosclerotic risk factors in carotid plaques and calcified aortic valve stenosis. Two different sites of the same disease? Am J Clin Pathol 126:494–502PubMed

11.

Mirzaie M, Schultz M, Schwartz P, Coulibaly M, Schöndube F (2003) Evidence of woven bone formation in heart valve disease. Ann Thorac Cardiovasc Surg 9:163–169PubMed

12.

Mohler ER, Gannon F, Reynolds C, Zimmerman R, Keane MG, Kaplan FS (2001) Bone formation and inflammation in cardiac valves. Circulation 103:1522–1528PubMed

13.

Mohler ER (2004) Mechanisms of aortic valve calcification. Am J Cardiol 94:1396–1402PubMedCrossRef

14.

O’Brien KD, Kuusisto J, Reichenbach DD, Ferguson M, Giachelli C, Alpers CE, Otto CM (1995) Osteopontin is expressed in human aortic valvular lesions. Circulation 92:2163–2168PubMed

15.

Rajamannan NM, Subramaniam M, Rickard D, Stock SR, Donovan J, Springett M, Orszulak T, Fullerton DA, Tajik AJ, Bonow RO, Spelsberg T (2003) Human aortic valve calcification is associated with an osteoblast phenotype. Circulation 107:2181–2184PubMedCrossRef

16.

Ross R (1999) Atherosclerosis—an inflammatory disease. N Engl J Med 340:115–126PubMedCrossRef

17.

Schoen FJ (2005) Cardiac valves and valvular pathology. Update on function, disease, repair, and replacement. Cardiovasc Pathol 14:189–194PubMedCrossRef

18.

Schoen FJ (2006) New frontiers in the pathology and therapy of heart valve disease: 2006 Society for Cardiovascular Pathology, Distinguished Achievement Award Lecture, United States–Canadian Academy of Pathology, Atlanta, GA, February 12, 2006. Cardiovasc Pathol 15:271–279PubMedCrossRef

19.

Soini Y, Salo T, Satta J (2003) Angiogenesis is involved in the pathogenesis of nonrheumatic aortic valve stenosis. Hum Pathol 34:756–763PubMedCrossRef

Title: Bone formation in cardiac valves: a histopathological study of 128 cases
Authors: Ivo Steiner
Petra Kašparová
Aleš Kohout
Jan Dominik
Publication date: 01-06-2007
Publisher: Springer-Verlag
Published in: Virchows Archiv / Issue 6/2007
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-007-0430-7

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Bone formation in cardiac valves: a histopathological study of 128 cases

Abstract

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