Experimental models have demonstrated that low-density lipoprotein receptor-related protein 5, an important coreceptor in canonical Wnt signaling, regulates the expression of bone matrix proteins in the aortic valve and vasculature.20 Furthermore, Caira et al have suggested the involvement of Wnt signaling in the calcification of human aortic valves.21 Our study, showing markedly elevated serum levels of the Wnt modulators DKK-1, WIF-1, and sFRP-3 in patients with symptomatic AS associated with long-term mortality, supports the involvement of Wnt signaling in the development of AS. This evidence concerns the gene DKK1 and aortic stenosis.