Abstract
Objectives: It was the aim of this study to assess the pathophysiological, prognostic role of aortic regurgitation (AR) in the 'mixed pictures' of degenerative aortic valve stenoinsufficiency (ASI) by a multimarker clinical approach. Methods: We enrolled 112 consecutive surgical patients: 19 with pure valve stenosis (PAS), 39 with mild regurgitation, 29 with severe regurgitation, and 25 controls with annulo-ectatic AR. All underwent complete echocardiography, carotid ultrasound and aortic/coronary multislice computed tomography calcium score evaluation. We determined tissue semiquantitative osteopontin, metalloproteinases (MMPs), tissue inhibitors of MMPs (TIMPs) and circulating brain natriuretic peptide. We evaluated major adverse cardiac events and cardiovascular early, long-term mortality after bioprosthetic valve implantation. Results: Tissue calcification, carotid and coronary atherosclerotic disease were prevalent in PAS versus ASI and AR patients. The multislice computed tomography calcium score (Agatston) was comparable between PAS and ASI (PAS 3,507.3 + 2,442.6; mild AR 4,270.7 + 2,213.5; severe AR 3,568.5 + 1,823.4), but much lower in AR (1,247.8 + 2,708.6). In ASI, a plasma/tissue 'profibrotic' MMP/TIMP balance prevailed, with circulating and echocardiographic indices of myocardial dysfunction. Percentages of major adverse cardiac events and early, long-term mortality were higher in ASI. Conclusions: In ASI, different, still unknown, genetic and dysplastic factors could work synergically with cardiovascular risk factors, determining a much more adverse myocardial and valve remodeling, resulting in worse clinical outcome.
| Original language | English |
|---|---|
| Pages (from-to) | 126-137 |
| Number of pages | 12 |
| Journal | Cardiology |
| Volume | 124 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Mar 2013 |
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Keywords
- Atherosclerosis
- Clinical outcome
- Degenerative aortic valve disease
- Stenoinsufficiency
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Pharmacology (medical)
Cite this
A multimarker study of degenerative aortic valve disease : Stenoinsufficiency shows more indices of bad prognosis. / Vianello, Annamaria; Perlini, Stefano; Cappelli, Stefania; Palladini, Giuseppina; Epistolato, Maria Carmela; Della Latta, Daniele; Cerillo, Alfredo; Berti, Sergio; Chiappino, Dante; Tanganelli, Piero; Glauber, Mattia; Mazzone, Annamaria.
In: Cardiology, Vol. 124, No. 2, 03.2013, p. 126-137.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A multimarker study of degenerative aortic valve disease
T2 - Stenoinsufficiency shows more indices of bad prognosis
AU - Vianello, Annamaria
AU - Perlini, Stefano
AU - Cappelli, Stefania
AU - Palladini, Giuseppina
AU - Epistolato, Maria Carmela
AU - Della Latta, Daniele
AU - Cerillo, Alfredo
AU - Berti, Sergio
AU - Chiappino, Dante
AU - Tanganelli, Piero
AU - Glauber, Mattia
AU - Mazzone, Annamaria
PY - 2013/3
Y1 - 2013/3
N2 - Objectives: It was the aim of this study to assess the pathophysiological, prognostic role of aortic regurgitation (AR) in the 'mixed pictures' of degenerative aortic valve stenoinsufficiency (ASI) by a multimarker clinical approach. Methods: We enrolled 112 consecutive surgical patients: 19 with pure valve stenosis (PAS), 39 with mild regurgitation, 29 with severe regurgitation, and 25 controls with annulo-ectatic AR. All underwent complete echocardiography, carotid ultrasound and aortic/coronary multislice computed tomography calcium score evaluation. We determined tissue semiquantitative osteopontin, metalloproteinases (MMPs), tissue inhibitors of MMPs (TIMPs) and circulating brain natriuretic peptide. We evaluated major adverse cardiac events and cardiovascular early, long-term mortality after bioprosthetic valve implantation. Results: Tissue calcification, carotid and coronary atherosclerotic disease were prevalent in PAS versus ASI and AR patients. The multislice computed tomography calcium score (Agatston) was comparable between PAS and ASI (PAS 3,507.3 + 2,442.6; mild AR 4,270.7 + 2,213.5; severe AR 3,568.5 + 1,823.4), but much lower in AR (1,247.8 + 2,708.6). In ASI, a plasma/tissue 'profibrotic' MMP/TIMP balance prevailed, with circulating and echocardiographic indices of myocardial dysfunction. Percentages of major adverse cardiac events and early, long-term mortality were higher in ASI. Conclusions: In ASI, different, still unknown, genetic and dysplastic factors could work synergically with cardiovascular risk factors, determining a much more adverse myocardial and valve remodeling, resulting in worse clinical outcome.
AB - Objectives: It was the aim of this study to assess the pathophysiological, prognostic role of aortic regurgitation (AR) in the 'mixed pictures' of degenerative aortic valve stenoinsufficiency (ASI) by a multimarker clinical approach. Methods: We enrolled 112 consecutive surgical patients: 19 with pure valve stenosis (PAS), 39 with mild regurgitation, 29 with severe regurgitation, and 25 controls with annulo-ectatic AR. All underwent complete echocardiography, carotid ultrasound and aortic/coronary multislice computed tomography calcium score evaluation. We determined tissue semiquantitative osteopontin, metalloproteinases (MMPs), tissue inhibitors of MMPs (TIMPs) and circulating brain natriuretic peptide. We evaluated major adverse cardiac events and cardiovascular early, long-term mortality after bioprosthetic valve implantation. Results: Tissue calcification, carotid and coronary atherosclerotic disease were prevalent in PAS versus ASI and AR patients. The multislice computed tomography calcium score (Agatston) was comparable between PAS and ASI (PAS 3,507.3 + 2,442.6; mild AR 4,270.7 + 2,213.5; severe AR 3,568.5 + 1,823.4), but much lower in AR (1,247.8 + 2,708.6). In ASI, a plasma/tissue 'profibrotic' MMP/TIMP balance prevailed, with circulating and echocardiographic indices of myocardial dysfunction. Percentages of major adverse cardiac events and early, long-term mortality were higher in ASI. Conclusions: In ASI, different, still unknown, genetic and dysplastic factors could work synergically with cardiovascular risk factors, determining a much more adverse myocardial and valve remodeling, resulting in worse clinical outcome.
KW - Atherosclerosis
KW - Clinical outcome
KW - Degenerative aortic valve disease
KW - Stenoinsufficiency
UR - http://www.scopus.com/inward/record.url?scp=84874009183&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874009183&partnerID=8YFLogxK
U2 - 10.1159/000346396
DO - 10.1159/000346396
M3 - Article
C2 - 23428667
AN - SCOPUS:84874009183
VL - 124
SP - 126
EP - 137
JO - Cardiology
JF - Cardiology
SN - 0008-6312
IS - 2
ER -