Aortic valve: do its nervous and contractile elements have any role?

Recent knowledge on aortic valve physiology and its cellular and ultrastructural characteristics lead us to believe that the opening and closing mechanism is not only the result of the different pressures between the aorta and left ventricle but it is also a function of the interaction between elastic forces acting on a complex structure such as the valve. The latter consists of cells with muscular properties and of some elements capable of dynamically modifying their properties. These cells, which can regenerate themselves, seem to be closely related to nerve endings whose exact function at the valvular level is yet to be defined. The aim of this paper was to review the most recent literature on the aortic valve nervous and ultrastructural properties as they are related to the physiological and pathophysiological patterns.