Pathophysiological Calcification - Clinical Relevance and Molecular Mechanisms

Cardiovascular calcification, the pathological mineral deposition in heart valves and arteries, is a predictor and risk factor for cardiovascular morbidity and mortality - a global health problem. Cardiovascular calcification represents an `unmet need' in cardiovascular medicine, as there are currently no therapeutic approaches that can stop or modify this process. This review article summarizes the manifestations of cardiovascular calcification with their clinical relevance, focusing mainly on arterial microcalcification of the tunica intima and macrocalcification of the tunica media and the aortic heart valve. The cellular and molecular mechanisms that regulate cardiovascular calcification are diverse and show parallels to bone metabolism. In addition to the classic signaling pathways, the role of epigenetic changes are discussed. Finally, open questions are identified, whose answers are essential to develop therapeutic approaches for preventing and treating cardiovascular calcification that do not affect bone health.