**Author details**

L. Mourino-Alvarez1 , C.M. Laborde1,2 and M.G. Barderas1,3

1 Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, SESCAM, Toledo, Spain

2 Laboratory of Biochemistry, Hospital Nacional de Paraplejicos, SESCAM, Toledo, Spain

3 Proteomic Unit, Hospital Nacional de Paraplejicos, SESCAM, Toledo, Spain

### **References**


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that are more active in AV. The characterization of physiological proteins and metabolites in this tissue and the creation of a complete database with the results from the descriptive studies, may serve as a reference material for further studies. This would facilitate the searching for potential markers for early diagnosis of the disease, thus being able to predict which people

This work was supported by grants from the Instituto de Salud Carlos III (FIS PI070537, PI11/02239), Fondos Feder-Redes temáticas de Investigación Cooperativa en Salud (RD06/0014/1015), grants from Fundación para la Investigación Sanitaria de Castilla-La

1 Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, SESCAM,

2 Laboratory of Biochemistry, Hospital Nacional de Paraplejicos, SESCAM, Toledo, Spain

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**Author details**

L. Mourino-Alvarez1

Toledo, Spain

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**Chapter 7**

**Genetics of Bicuspid Aortic Valve and Calcific Aortic**

**Aortic valve malformation is a spectrum including Bicuspid Aortic Valve.** Aortic valve malformation has been appreciated since the Renaissance when artists advanced our under‐ standing of anatomy and specifically, Leonardo da Vinci illustrated and described variants of aortic valve morphology [1]. Aortic valve malformation is the most common cardiovascular malformation (CVM), and bicuspid aortic valve (BAV, MIM#109730) is the most common type of aortic valve malformation. BAV is present at birth and is characterized by two rather than three cusps. The incidence of BAV is 1-2% in the general population and affects an estimated 3 million people [2,3]. BAV itself is subclinical and the valve is typically functional, making BAV an endophenotype. Two patterns of BAV morphology are commonly observed: ~70% of isolated cases have fusion of the right and left (RL) coronary cusps with the remainder consisting almost entirely of those with fusion of the right and non (RN) coronary cusps [4,5]. Rarely, cases have shown fusion of the left and non (LN) coronary cusps. In addition to BAV subtypes, there is a spectrum of aortic valve malformation (Figure 1), ranging from various types of unicuspid to quadricuspid aortic valves with the three BAV morphology patterns and a thickened tricommissural aortic valve representing intermediate phenotypes [7]. Presently, it remains unclear to what degree these variations of malformation represent true differences.

**Calcific Aortic Valve Disease is a growing public health problem.** Aortic valve disease is defined by abnormal valve function. Valve disease may manifest as *stenosis*, an obstruction to normal forward blood flow, or *insufficiency*, a defective closure resulting in backward blood flow. Valve disease tends to progress. Ultimately, ventricular function can be compromised. Aortic valve stenosis is the most common manifestation of CAVD and classically presents as angina, syncope and heart failure. The diagnosis can be made clinically and confirmed by echocardiography, which quantifies the severity, and, over time, the progression of disease [8].

> © 2013 Hinton; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

**Valve Disease**

Robert B. Hinton

http://dx.doi.org/10.5772/55506

Additional information is available at the end of the chapter

**1. The clinical taxonomy: Malformation vs. disease**

