Osteoprotegerin in patients with degenerative aortic stenosis and preserved left-ventricular ejection fraction

Abstract

Objectives The aim of the present study was to evaluate value of osteoprotegerin (OPG) in patients with degenerative aortic stenosis and preserved left-ventricular ejection fraction.Methods We have prospectively followed 70 patients with aortic stenosis (mean aortic gradient > -15 mmHg) and preserved left-ventricular ejection fraction for 1 year. In all patients, echocardiography and blood tests (OPG, lipids, high-sensitivity C-reactive protein) were performed at baseline and after 1 year of follow-up. Detailed medical history including atherosclerotic risk factors was obtained. The control group consisted of 20 healthy individuals with normal echocardiographic findings. Rapid progression of aortic stenosis was defined as more than 7 mmHg increase in mean aortic gradient per year.Results Osteoprotegerin concentrations were significantly higher in patients with aortic stenosis (P < 0.0001) and correlated with the degree of aortic stenosis. In multivariable regression model analysis, age (b U 0.015, P < 0.0001), mean aortic gradient (b U 0.04, P U 0.0078) and presence of coronary artery disease (b U 0.111, P U 0.0408) were the only independent determinants of plasma OPG concentrations. There was no association between OPG concentrations and coronary artery disease risk factors: male sex, smoking, hypertension and hypercholesterolemia. Concentrations of high-sensitivity C-reactive protein correlated positively with OPG levels only in nonsurgical patients (with lower degree of stenosis) (r U 0.34, P U 0.01). Aortic stenosis progression was related to body mass, diabetes, triglyceride concentrations, metabolic syndrome and left-ventricular systolic volume. In multivariate analysis, only metabolic syndrome was an independent predictor of aortic stenosis progression.Conclusion Osteoprotegerin concentrations are linked to the presence and severity of aortic stenosis. Metabolic syndrome was the only independent predictor of degenerative aortic stenosis progression. J Cardiovasc Med 2013, 15:000-000

Identification of pyroptosis-associated genes with diagnostic value in calcific aortic valve disease

“…TNFRSF11B levels increased in CAVD patients with NOTCH1 mutations ( 36 ). Consistent with previous studies ( 37 ), our results demonstrated overexpression of TNFRSF11B in the calcified valves compared with the normal valves. However, the role of TNFRSF11B in CAVD still needs further investigation.…”

Patient Management in Aortic Stenosis: Towards Precision Medicine through Protein Analysis, Imaging and Diagnostic Tests

“…Given the nature of the disease, biomarkers belonging to multiple biological pathways such as endothelial dysfunction, oxidative stress, inflammation, or mineral, and lipid metabolism have been studied, although only a few have proved promising [31,43]. For example, proteins involved in bone formation, such as fetuin-A, osteopontin, and osteoprotegerin, have a strong association with AS [44][45][46], but it is not clear whether or not they are related to disease progression. Indeed, in a study of 88 patients with different degrees of calcification and concomitant coronary artery disease, fetuin-A levels were not significantly different between patients with no AS, moderate AS, ands severe AS [47].…”