scholarly journals Expression of osteoprotegerin and soluble ligand of receptor of kappa-B transcription factor activator in the calcification of aortic valve

2019 ◽  
Vol 65 (1) ◽  
pp. 57-62
Author(s):  
I.V. Voronkina ◽  
O.B. Irtyuga ◽  
L.V. Smagina ◽  
P.E. Adamova ◽  
E.V. Zhiduleva ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Aortic Dilatation ◽  
Valve Calcification ◽  
Soluble Ligand ◽  
Rank System ◽  
Group 3 ◽  
Group 2

The mechanism of valve calcification that is the main cause of aortic stenosis formation and progression is not yet clear. In recent years, the role of the OPG/RANKL/RANK system is considered as one of possible variants of pathogenesis of valve calcification. In presented work the differences in OPG and sRANKL levels involved in the calcification processes in tissues of patients with severe aortic stenosis have been examined. The study was performed using three groups of patients: group 1 – patients with aortic stenosis, group 2 – patients with aortic aneurysm, and group 3 – patients with aortic stenosis and aortic dilatation. In patients with aortic stenosis, the level of RANKL was significantly higher, and the level of RANKL was higher in valve than in tissue. The negative correlation between aortic dilatation and RANKL level indicated the lack of RANKL influence on pathogenesis of aortic dilatation. The obtained data confirm the increased expression of RANKL in patients with aortic valve calcification. The results of this study confirm importance of the OPG/RANKL/RANK system in calcification in patients with aortic stenosis. Athough patients of all groups had comparable values of OPG (including patients with aortic dilatation), the RANKL level increased only in patients with aortic stenosis. This suggest involvement of some additional mechanisms influencing the increase of RANKL expression.

Abstract 11653: The Qualitative Grading of Aortic Valve Calcification in Severe Aortic Stenosis is Weakly Associated With Aortic Valve Weight and is Gender Dependent

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Dragos Alexandru ◽  
Florentina Petillo ◽  
Simcha Pollack ◽  
Nathaniel Reichek ◽  
Eddy Barasch
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Pearson Correlation ◽  
Calcium Score ◽  
Aortic Valve Calcification ◽  
Test Analysis ◽  
Valve Calcification ◽  
Exact Test ◽  
The Difference

Background: In severe aortic stenosis (AS), qualitative estimation of aortic valve calcification (AVC) burden by echocardiography has diagnostic and prognostic value. Hypothesis: there is a weak association between a qualitative calcium score (QCS) by TEE and AV weight in severe AS. Methods: Between 2010-2014, of 719 pts who underwent surgical AVR for isolated severe AS, QCS was feasible in 483 (67%): mean age 76.7 ± 9.5 yrs, 59% males, EF 56 ±12%, AVAi 0.35 ±0.09 cm2/m2, AVW 2.45 ± 0.09 g, QCS 3.5± 0.57, 11% bicuspid valves . AVC was determined using short- and long-axis views and graded as mild (1) localized, small, nondense calcifications to severe (4) extensive thickening and calcification of all cusps. TEEs were done on the day of surgery and excised valves were weighed. Independent t-test, Fisher’s exact test, analysis of variance, and Pearson correlation were done as appropriate. Results: Intraclass correlations for intra and interobserver variability were 0.76 and 0.53 , respectively.The association between indices of AS severity and AVC burden, is stronger for AVW than for QCS (table).19 pts had QCS = 2, 183 = 3 and 280 = 4. A QCS of 2 to 4 corresponded to an AVW of 1 to 6 g. The correlation between QCS and AVW was 0.11, p=.01, and 0.09, p =.04 when controlling for age, sex and BSA. QCS-AVW association was gender dependent : for females (196), who had a lower severity of stenosis, r=0.23, p=0.001, for males (286), r=0.02, p=.68 with p =.02 for the difference. Conclusions: 1. In severe AS, QCS by TEE has limited reliability with no relationship with AVW in males and a weak one in females. 2. The utilization of QCS in severe AS even when employing TEE is weakly associated with total AVC burden and should probably be replaced by quantitative objective non- echocardiographic methods.

scholarly journals PATHOGENESIS OF AORTIC STENOSIS IN HYPERTENSIVE PATIENTS

2013 ◽  
Vol 19 (6) ◽  
pp. 495-501
Author(s):  
O. B. Irtyuga ◽  
E. V. Zhiduleva ◽  
E. E. Kazakova ◽  
O. M. Moiseeva
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Heart Diseases ◽  
Serum Levels ◽  
Systemic Hypertension ◽  
Control Group ◽  
Reactive Protein ◽  
Soluble Ligand ◽  
Rank System ◽  
Design And Methods

Objective. To assess osteoprotegerin (OPG) and soluble ligand receptor activator of transcription factor kappa-B (RANKL) levels in patients with  aortic stenosis and systemic hypertension.Design and methods. Sixty-one patients with aortic valve stenosis (AVS) [31 patients with bicuspid aortic valve (BAV) and 30 patients with tricuspid aortic valve (TAV)] were examined. Thirty-two patients without heart diseases formed the control group. Serum levels of C-reactive protein, ОPG, sRANKL and lipid profile were assessed in all patients.Results. Elevated blood pressure (BP) was found in 93 % patients with TAV and in 71 % patients with BAV. Serum concentration of OPG was increased in patients with TAV and BAV vs control group. OPG concentration was negatively correlated with BP level only in patients with TAV. sRANKL level was increased only in patients with BAV. At the same time sRANKL level positively correlated with BP in patients with TAV. Conclusion. Systemic hypertension is the key risk factor for OPG/RANKL/RANK system activation in patients without congenital heart disease.

scholarly journals Calcification Characteristics of Low-Flow Low-Gradient Severe Aortic Stenosis in Patients Undergoing Transcatheter Aortic Valve Replacement

2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
Barbara E. Stähli ◽  
Thi Dan Linh Nguyen-Kim ◽  
Cathérine Gebhard ◽  
Thomas Frauenfelder ◽  
Felix C. Tanner ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Low Flow ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Transcatheter Aortic Valve

Low-flow low-gradient severe aortic stenosis (LFLGAS) is associated with worse outcomes. Aortic valve calcification patterns of LFLGAS as compared to non-LFLGAS have not yet been thoroughly assessed. 137 patients undergoing transcatheter aortic valve replacement (TAVR) with preprocedural multidetector computed tomography (MDCT) and postprocedural transthoracic echocardiography were enrolled. Calcification characteristics were assessed by MDCT both for the total aortic valve and separately for each leaflet. 34 patients had LFLGAS and 103 non-LFLGAS. Total aortic valve calcification volume (p<0.001), mass (p<0.001), and density (p=0.004) were lower in LFLGAS as compared to non-LFLGAS patients. At 30-day follow-up, mean transaortic pressure gradients and more than mild paravalvular regurgitation did not differ between groups. In conclusion, LFLGAS and non-LFLGAS express different calcification patterns which, however, did not impact on device success after TAVR.

scholarly journals Comparative Evaluation of Aortic Valve Replacement Methods in Patients Over 70 with Aortic Stenosis

2018 ◽  
Vol 7 (3) ◽  
pp. 227-233 ◽  
Author(s):  
V. V. Sokolov ◽  
M. V. Parkhomenko ◽  
A. I. Kovalyov ◽  
V. V. Vladimirov ◽  
O. L. Shiryayeva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Hospital Mortality ◽  
Heart Diseases ◽  
Surgical Techniques ◽  
Results Of Treatment ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

BackgroundAs life expectancy and quality of health improve, more and more people reach old age, and so does the number of heart diseases. One of the most urgent problems among elderly patients is degenerative stenosis of the aortic valve (AV). The conservative treatment of symptoms of chronic heart failure with AV stenosis improves the patient’s condition only for a while, whereas surgical treatment such as replacement of AV is recognized as the main effective method of treating a defect. Recently, alternative technologies for prosthetic AV have been developed, aimed at reducing adverse effects of artificial circulation (AC) in high-risk patients and minimizing the scope of surgical intervention.Aim of studyThe aim of the study was to evaluate the immediate results of surgical treatment of aortic stenosis using different methods in patients over 70.Material and methodsThe article presents the results of treatment of 64 patients over 70 with isolated AV stenosis, operated with different surgical techniques from July, 2016 to January, 2018. All patients were divided into three groups, differing in the severity of the initial condition and the method treatment. Group 1 (transcatheter implantation of the prosthetic AV, EuroSCORE II — 21.81%) consisted of 19 patients, Group 2 (non-suture implantation of a Perceval prosthetic valce under the AC, EuroSCORE II — 13.81%) consisted of 13 patients and Group 3 (“standard” prosthetics, EuroSCORE II — 9.89%) consisted of 32 patients.ResultsIn Group 1, two patients died, the hospital mortality was 10.5%. In Group 2 and Group 3, one patient died, the hospital mortality was 7.6 and 3.1%, respectively. Implantation of a permanent pacemaker was required in three patients (15.7%) from the TAVI group after installation of Medtronic Core Valve and two patients (15.3%) from the Perceval group.ConclusionThe obtained results of AV replacement by various methods allowed to expand indications for the management of AV stenosis in patients of the older age group with a high surgical risk of operation under AC conditions who had not previously been considered candidates for surgical treatment of aortic malformation due to the age and severity of the concomitant pathology.

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