Inflammatory Characteristics of Stenotic Aortic Valves: A Comparison between Rheumatic and Nonrheumatic Aortic Stenosis

Abstract

Background. Although our comprehension of nonrheumatic aortic stenosis (NRAS) has increased substantially during the last decade, less is known about the histopathology of rheumatic aortic stenosis (RAS). The aim of this study was to investigate rheumatic aortic stenosis by means of analyses previously used in nonrheumatic stenosis. Material and Methods. Valve specimens were obtained from 39 patients referred to hospital due to significant aortic stenosis. According to established macroscopic criteria the valves were divided into two groups consisting of 29 NRAS and 10 RAS valves. Mononuclear inflammatory cells and apolipoproteins were investigated using immunohistochemical analyses. Results. The localisation of calcification differed in tricuspid nonrheumatic valves when compared to bicuspid nonrheumatic and rheumatic valves. The RAS valves revealed a lower degree of T lymphocyte infiltration compared with the NRAS valves. Infiltration of macrophages was seen in all valves and there were no differences regarding deposition of apolipoprotein. Conclusion. Rheumatic and nonrheumatic aortic stenotic valves show a similar and significant chronic inflammation. The similarities regarding the localisation of calcification indicate that the valve anomaly/morphology can influence the pathogenesis of aortic stenosis. Finally, our findings highlight the question of a postinflammatory valvular disease of other causes than rheumatic fever.

Different Calcification Stage in Each Cusp of a Calcified Tricuspid Aortic Valve

“…5, 6 The advanced calcification in the present AS patient might be possibly due to the thickening of collagen tissue, destruction of the normal layered architecture, foci of calcification and even ossification, and/or infiltration of chronic inflammatory cells, resulting in a worsening of AS and heart failure. 7 To our knowledge, this is the first study to show a simultaneous difference in calcification growth in each respective cusp of a TAV in a patient with calcific AS. In addition, cis-and/or trans-unsaturated lipids and their conversion products were also identified in each cusp, in different ratios depending on the stage of calcification.…”

In vitro models of aortic valve calcification: solidifying a system

“…Early stages of CAVD develop lesions similar to atherosclerotic lesions, which suggests a role for inflammatory cells and biochemical signals [29, 30]. Elevated levels of macrophages and T-lymphocytes have been found in human calcified aortic valves [21, 31–33]. These cell populations all contribute to CAVD progression, but it is likely that it is through secretion of factors that influence AVIC behavior.…”

Levels of sP-selectin and hs-CRP Decrease with Dietary Intervention with Selenium and Coenzyme Q10 Combined: A Secondary Analysis of a Randomized Clinical Trial

“…Inflammation is part of the atherosclerotic process in the body[ 1 ], but also in other processes, including different disease states such as e.g. cardiometabolic syndrome, acute coronary syndromes [ 2 , 3 ], heart failure with preserved ejection fraction [ 4 , 5 ] as well as heart failure with reduced ejection fraction [ 6 , 7 ] and also in aortic stenosis [ 8 ] and rheumatoid inflammations that may predispose a patient to cardiovascular disease. Aging itself is also associated with an increased inflammatory response [ 9 ].…”