{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:29:35Z","timestamp":1785421775526,"version":"3.56.0"},"reference-count":42,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011785","name":"Natural Science Foundation of Guangxi","doi-asserted-by":"publisher","award":["2025GXNSFAA069056"],"award-info":[{"award-number":["2025GXNSFAA069056"]}],"id":[{"id":"10.13039\/501100011785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82360066"],"award-info":[{"award-number":["82360066"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"award":["82360066"],"award-info":[{"award-number":["82360066"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017691","name":"Guangxi Key Research and Development Program","doi-asserted-by":"crossref","award":["GuiKe AB24010153"],"award-info":[{"award-number":["GuiKe AB24010153"]}],"id":[{"id":"10.13039\/501100017691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Cardiovasc. Dev. Dis.","JCDD"],"abstract":"<jats:p>Bicuspid aortic valve (BAV) disease is a lifelong disorder in which congenital anatomy, tissue susceptibility, abnormal flow, and acquired fibrocalcific remodeling produce heterogeneous valve and aortic outcomes. This narrative review examined peer-reviewed literature indexed in PubMed\/MEDLINE through June 2026 to evaluate how circulating proteomics could complement established imaging-based risk assessment. Published studies of incident aortic stenosis consistently implicate integrated stress, inflammation, apoptosis, and extracellular-matrix remodeling, with recurrent signals including GDF15, MMP12, and natriuretic peptides. These data support a long preclinical molecular phase, but existing proteomic models were developed predominantly in general aortic stenosis populations and cannot be transferred directly to BAV. We propose a five-layer framework integrating valve morphology and function, aortic phenotype and growth, flow and wall mechanics, molecular activity, and patient-specific lifetime context. In the near term, proteomics is best used for cohort enrichment, mechanistic phenotyping, and trial design rather than intervention decisions. Prospective BAV-specific cohorts, standardized imaging, repeated sampling, competing-risk analysis, external calibration, and demonstration of management-changing utility are required before clinical implementation. Molecular phenotyping should refine, not replace, guideline-based imaging and shared decision-making.<\/jats:p>","DOI":"10.3390\/jcdd13070344","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T09:20:39Z","timestamp":1784712039000},"page":"344","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Valve Anatomy to Molecular Trajectories: Integrating Proteomics into Precision Care for Bicuspid Aortic Valve Disease"],"prefix":"10.3390","volume":"13","author":[{"given":"Cheng","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yugui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baoshi","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyong","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.pcad.2020.06.006","article-title":"Speaking a common language: Introduction to a standard terminology for the bicuspid aortic valve and its aortopathy","volume":"63","author":"Michelena","year":"2020","journal-title":"Prog. 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