When the liver hardens the heart: Valvular calcification as an emerging cardiohepatic phenotype in cirrhosis

Figure 1 Mechanistic pathways linking liver cirrhosis to valvular calcification. Liver cirrhosis promotes valvular calcification through interconnected inflammatory, metabolic, vascular, and iron-dependent pathways that converge on osteogenic differentiation of valvular interstitial cells (VICs). These processes collectively drive VIC trans differentiation toward an osteoblast-like phenotype, culminating in progressive aortic and mitral valve calcification. ROS: Reactive oxygen species; IL: Interleukin; TNF-α: Tumor necrosis factor-alpha.