Senescence-associated metabolic alterations aggravate calcific aortic valve disease

Calcific aortic valve disease is initiated by endothelial NAD+ insufficiency and magnified by metabolically diverse macrophages. This compartmentalized NAD+ circuit couples inflammaging to matrix catastrophe. Early NAD+ repletion via nicotinamide mononucleotide and interventions targeting NAMPT warrant clinical evaluation as potential therapies for calcific aortic valve disease.