Abstract | OBJECTIVES: In this study, we sought to determine the metabolic markers associated with structural valve degeneration (SVD). BACKGROUND: METHODS: We included 197 patients who underwent aortic valve replacement with a bioprosthetic valve and had echocardiographic follow-up to evaluate valve function. Moreover, explanted BPs (n = 39) were analysed by immunohistochemistry for the expression of Lp-PLA2. RESULTS: After a mean follow-up of 7·9 ±0·2 years, forty-one patients (21%) were identified as developing SVD. Patients with SVD had significantly higher plasma level of Lp-PLA2 mass (151·8 ± 9·2 ng/mL vs. 133·2 ± 3·4 ng/mL, P = 0·03) and activity (27·6 ± 0·9 nmol/min/mL vs. 25·0 ± 0·4 nmol/min/mL, P = 0·005). Multivariate analysis revealed that Lp-PLA2 activity (OR: 1·09, 95% CI: 1·01-1·18; P = 0·03) was the strongest independent predictor of SVD. Immunohistochemistry studies of explanted BP showed that 77% of explanted BPs had the expression of Lp-PLA2, which correlated with the density of macrophages (CD68), and ox-LDL levels in bioprosthetic tissues. CONCLUSIONS: Increased blood plasma activity of Lp-PLA2 is associated with higher prevalence of SVD. These findings open new avenues for the identification of patients at risk for SVD and for the development of pharmacotherapy aiming at the prevention of SVD.
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Authors | Ablajan Mahmut, Haïfa Mahjoub, Marie-Chloé Boulanger, Dominique Fournier, Jean-Pierre Després, Philippe Pibarot, Patrick Mathieu |
Journal | European journal of clinical investigation
(Eur J Clin Invest)
Vol. 44
Issue 2
Pg. 136-45
(Feb 2014)
ISSN: 1365-2362 [Electronic] England |
PMID | 24328921
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd. |
Chemical References |
- 1-Alkyl-2-acetylglycerophosphocholine Esterase
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Topics |
- 1-Alkyl-2-acetylglycerophosphocholine Esterase
(physiology)
- Aged
- Aortic Valve Insufficiency
(etiology, surgery)
- Aortic Valve Stenosis
(etiology, surgery)
- Bioprosthesis
- Cross-Sectional Studies
- Echocardiography, Doppler
- Female
- Graft Occlusion, Vascular
(etiology)
- Heart Valve Prosthesis
- Humans
- Male
- Prospective Studies
- Prosthesis Failure
(etiology)
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