Study on the structure and composition of aortic valve calcific deposits. etiological aspects

The structures and chemical compositions of valve calcific deposits were investigated. The deposits was chosen arbitrarily and subjected to chemical analysis, observation with scanning microscope, semi-quantitative determination of Ca, Mg, Na, K, P and C elements by energy dispersive X-ray, X-ray diffraction and Fourier transform infrared spectroscopy carried out. These deposits were found to have non-uniform internal structures composed of layers of a structureless aspidinic inorganic material, substantial amounts of voluminous organic material and in a few samples small spheres were also present. Two groups of deposits with distinctly different chemical compositions were identified: one group with a low Ca/P molar ratio (1.59) and the other group with a high (1.82) Ca/P molar ratio. The deposits belonging to the group with a low Ca/P molar ratio contain higher concentration of magnesium and consist of increased amount of amorphous calcium phosphate. The deposits with a high Ca/P molar ratio contain low concentration of magnesium and consist predominantly of carbonated hydroxyapatite. The inorganic material was identified as a poorly crystalline carbonate hydroxyapatite containing molecular water of the average formula Ca9.1Mg0.4(Na,K)(PO4)5.8(CO3)0.3(OH)2. The actual chemical composition of the apatitic solid phase varies not only from deposit to deposit but also within the same deposit. The non-uniform internal structure of the deposits, the occasional presence of spherical particles and the variable point composition of the individual deposits indicate that their formation did not proceed under more or less constant conditions.