Association between circulating oxidized low-density lipoprotein and fibro-calcific remodeling of the aortic valve in aortic stenosis

Claude Cote ¹, Philippe Pibarot ¹, Jean-Pierre Despres ¹, Dania Mohty ¹, Amelie Cartier ², Benoit Arsenault ¹, Christian Couture ¹ and Patrick Mathieu ^1*

¹ Laval Hospital, Canada
² Lavla Hospital, Canada

^* To whom correspondence should be addressed. E-mail: patrick.mathieu{at}chg.ulaval.ca.

Accepted 20 July 2007

Abstract

Introduction Aortic stenosis (AS) is the most common valvular heart disease in westernized societies. AS is a disease process akin to atherosclerosis in which calcification and tissue remodeling play a crucial role. In patients with moderate/severe AS, we sought to determine if the remodeling process would be in relationship with transvalvular gradients and circulating oxidized low-density lipoprotein (ox-LDL) levels.

Methods In 105 patients with AS, the aortic valve and blood plasma were collected at the time of valve replacement surgery. The degree of valve tissue remodeling was assess using a scoring system (Score: 1-4) and the amount of calcium within the valve cusps was determined. Standard plasma lipid profile as well as the size of LDL particles and the plasma level of circulating ox-LDL (4E6 antibody) were determined.

Results After adjustment for covariables, aortic remodeling score was significantly related to transvalvular gradients measured by Doppler-echocardiography before surgery. Patients with higher valve remodeling score had higher circulating ox-LDL levels (score 2: 27.3 ± 2.6 U/L; score 3: 32.2 ± 2.3 U/L; score 4: 38.3±2.3 U/L; p=0.02). After correction for age, gender, hypertension and HDL-C, the plasma level of ox-LDL remained significantly associated with the aortic valve remodeling score (p=0.0009). The plasma level of ox-LDL was significantly associated with LDL-C (r=0.40; p<0.0001), apoB (r=0.59; p<0.0001), triglyceride (r=0.39; p<0.0001), Apo A-I (r=0.23; p=0.01) and cholesterol in small (<255 Å) LDL particles (r=0.22; p=0.02). After correction for covariables, circulating ox-LDL levels remained significantly associated with apoB (p=0.0003) and triglyceride (p=0.01) levels.

Conclusion Increased level of circulating ox-LDL is associated with worse fibro-calcific remodeling of valvular tissue in AS. It remains to be determined whether circulating ox-LDL is a risk marker for a highly atherogenic profile and/or a circulating molecule which is actively involved in the pathogenesis of calcific aortic valve disease.

Keywords: Aortic remodeling, Aortic stenosis, ox-LDL

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

Relevant Article

Low-density lipoprotein and aortic stenosis

Nalini M Rajamannan
Heart 2008 94: 1111-1112. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Bosse, Y., Miqdad, A., Fournier, D., Pepin, A., Pibarot, P., Mathieu, P. (2009). Refining Molecular Pathways Leading to Calcific Aortic Valve Stenosis by Studying Gene Expression Profile of Normal and Calcified Stenotic Human Aortic Valves. Circ Cardiovasc Genet 2: 489-498 [Abstract] [Full Text]  
• Yontar, O C, Yilmaz, M B (2009). Lipoprotein levels and the progression of aortic valvular disease. Heart 95: 938-938 [Full Text]  
• Mathieu, P, Pibarot, P, Despres, J-P (2009). . Heart 95: 938-939 [Full Text]  
• Parolari, A., Loardi, C., Mussoni, L., Cavallotti, L., Camera, M., Biglioli, P., Tremoli, E., Alamanni, F. (2009). Nonrheumatic calcific aortic stenosis: an overview from basic science to pharmacological prevention. Eur. J. Cardiothorac. Surg. 35: 493-504 [Abstract] [Full Text]  
• Rajamannan, N. M (2008). Low-density lipoprotein and aortic stenosis. Heart 94: 1111-1112 [Full Text]