| [ Summary ] |
Vascular calcification (VC) is the ectopic accumulation of calcium phosphate salts in the arterial wall and is associated with adverse cardiovascular events. Two types of VC have been described: intimal and medial calcification. Intimal calcification develops as a consequence of atherosclerosis and may contribute to plaque rupture, leading to coronary ischemic events. On the other hand, medial calcification is nonatherosclerotic and preferentially occurs along elastic fibers. Consequently, medial calcification increases arterial stiffness, systolic blood pressure, and pulse pressure, resulting in left ventricular hypertrophy, diastolic dysfunction, and cardiac failure. In the development of both types of VC, similar mechanisms may work, such as differentiation of vascular smooth muscle cells into osteoblast-like cells and matrix vesicles-mediated mineralization. However, the promoting factors for intimal and medial calcification may differ; inflammatory factors accelerate intimal calcification, while metabolic factors facilitate medial calcification. In aging, diabetes, and chronic kidney disease, both factors may promote progression of intimal as well as medial calcification. |