More recently, it has been reported that exosome-derived miR-342 from intermittent hypoxia-exposed valvular interstitial cells inhibits the eIF2α/ATF4 signaling pathway and the osteogenic differentiation and progression of calcified aortic valve disease (CAVD) [80], an inflammatory disease with similarities to atherosclerosis. This evidence concerns the gene ATF4 and congenital bilateral aplasia of vas deferens from CFTR mutation.