Tissue-resident C-reactive protein within degenerative aortic valves: correlation with serum CRP levels and modification by statins

Dirk Skowasch ^1*, Stephanie Schrempf ¹, Claus J Preusse ¹, James A Likungu ¹, Armin Welz ¹, Berndt Lüderitz ¹ and Gerhard Bauriedel ¹

¹ Heart Center University of Bonn, Germany

^* To whom correspondence should be addressed. E-mail: dirk.skowasch{at}ukb.uni-bonn.de.

Accepted 11 August 2005

Abstract

Objective: We sought to assess aortic valve probes for valvular C-reactive protein (CRP) presence, a relationship between valvular and serum CRP, and a possible modification of CRP by statin medication.

Setting: Heart Centre University of Bonn in Germany.

Patients and design: Endstage, degenerative valve tissue was taken from a total of 86 patients, 57 non-rheumatic aortic valve stenosis (AS), 24 degenerative aortic valve bioprostheses (BP), 5 non-stenosed controls, and from 4 non-implanted bioprostheses. We studied presence and localization of CRP, by use of immunostaining and morphometric analysis. Serum CRP levels were measured preoperatively.

Results: The majority of AS and BP valves exhibited cells labelled by CRP, consistently restricted to the valvular fibrosa. The expression of CRP was markedly higher in BP compared to AS (P=0.03). Notably, non-stenosed aortic valves and non-implanted bioprostheses did not show CRP signalling. Serum CRP was also increased with BP (P=0.02) and showed a significant correlation with the valvular CRP expression (r=0.54; P<0.001). As the main finding, when categorizing in patients with (n=26) or without statin treatment (n=55), both valvular CRP expression (P=0.02) and serum CRP levels (P=0.04) were found to be lower in the statin group.

Conclusions: C-reactive protein was found in a large collective of degenerative aortic valves, more frequently in bioprostheses than in native cusps. Serum CRP levels may reflect inflammatory processes within the aortic valve. The association of statin treatment with both decreased valvular and serum CRP levels may explain known pleiotropic effects of statins in patients with aortic stenosis.

Keywords: C-reactive protein, aortic stenosis, inflammation, valve bioprosthesis

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Antonini-Canterin, F., Leiballi, E., Enache, R., Popescu, B. A., Rosca, M., Cervesato, E., Piazza, R., Ginghina, C., Nicolosi, G. L. (2009). Hydroxymethylglutaryl Coenzyme-A Reductase Inhibitors Delay the Progression of Rheumatic Aortic Valve Stenosis: A Long-Term Echocardiographic Study. J Am Coll Cardiol 53: 1874-1879 [Abstract] [Full Text]  
• Novaro, G. M., Katz, R., Aviles, R. J., Gottdiener, J. S., Cushman, M., Psaty, B. M., Otto, C. M., Griffin, B. P. (2007). Clinical Factors, But Not C-Reactive Protein, Predict Progression of Calcific Aortic-Valve Disease: The Cardiovascular Health Study. J Am Coll Cardiol 50: 1992-1998 [Abstract] [Full Text]  
• Stone, P. H. (2007). C-Reactive Protein to Identify Early Risk for Development of Calcific Aortic Stenosis: Right Marker? Wrong Time?. J Am Coll Cardiol 50: 1999-2001 [Full Text]  
• Udvarnoki, K., Cervenak, L., Uray, K., Hudecz, F., Kacskovics, I., Spallek, R., Singh, M., Fust, G., Prohaszka, Z. (2007). Antibodies against C-Reactive Protein Cross-React with 60-Kilodalton Heat Shock Proteins. CVI 14: 335-341 [Abstract] [Full Text]  
• Skowasch, D., Nickenig, G., Bauriedel, G. (2006). Progenitor Cells and Valve Degeneration. Circ. Res. 98: e71-e71 [Full Text]