TY - JOUR
T1 - Role of lipoprotein (a) and LPA KIV2 repeat polymorphism in bicuspid aortic valve stenosis and calcification
T2 - a proof of concept study
AU - Sticchi, Elena
AU - Giusti, Betti
AU - Cordisco, Antonella
AU - Gori, Anna Maria
AU - Sereni, Alice
AU - Sofi, Francesco
AU - Mori, Fabio
AU - Colonna, Stefania
AU - Fugazzaro, Maria Pia
AU - Pepe, Guglielmina
AU - Nistri, Stefano
AU - Marcucci, Rossella
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Hemodynamic valvular impairment is a frequent determinant of the natural history of bicuspid aortic valve (BAV). The role of elevated Lp(a) levels and LPA Kringle IV type 2 (KIV-2) size polymorphism in influencing aortic valve calcification and stenosis development in patients with tricuspid aortic valve was recognized. In this study, we investigate the association between Lp(a) and LPA KIV-2 repeat number, and the presence of calcification and stenosis in BAV patients. Sixty-nine patients [79.7% males; median age 45(30–53) yrs], consecutively referred to Center for Cardiovascular Diagnosis or Referral Center for Marfan syndrome or related disorders, AOU Careggi, from June to November 2014, were investigated. For each patient, clinical (ECG and echocardiography) and laboratory [Lp(a) (Immunoturbidimetric assay) and LPA KIV-2 repeat number (real-time PCR)] evaluation were performed. Patients were compared with 69 control subjects. No significant association between Lp(a) circulating levels and LPA KIV-2 repeat number and BAV was evidenced. Among BAV patients, significantly higher Lp(a) levels according to calcification degree were found [no calcifications:78(42–159) mg/L, mild/moderate: 134(69–189) mg/L; severe: 560(286–1511) mg/L, p = 0.008]. Conversely, lower LPA KIV-2 repeat numbers in subjects with more severe calcification degree were observed. Furthermore, higher Lp(a) levels in patients with aortic stenosis [214(67–501) mg/L vs 104(56–169) mg/L, p = 0.043] were also found. In conclusion, present data suggest the potential role for Lp(a) as a possible risk marker useful to stratify, among BAV patients, those with a higher chance to develop valvular calcifications and aortic stenosis.
AB - Hemodynamic valvular impairment is a frequent determinant of the natural history of bicuspid aortic valve (BAV). The role of elevated Lp(a) levels and LPA Kringle IV type 2 (KIV-2) size polymorphism in influencing aortic valve calcification and stenosis development in patients with tricuspid aortic valve was recognized. In this study, we investigate the association between Lp(a) and LPA KIV-2 repeat number, and the presence of calcification and stenosis in BAV patients. Sixty-nine patients [79.7% males; median age 45(30–53) yrs], consecutively referred to Center for Cardiovascular Diagnosis or Referral Center for Marfan syndrome or related disorders, AOU Careggi, from June to November 2014, were investigated. For each patient, clinical (ECG and echocardiography) and laboratory [Lp(a) (Immunoturbidimetric assay) and LPA KIV-2 repeat number (real-time PCR)] evaluation were performed. Patients were compared with 69 control subjects. No significant association between Lp(a) circulating levels and LPA KIV-2 repeat number and BAV was evidenced. Among BAV patients, significantly higher Lp(a) levels according to calcification degree were found [no calcifications:78(42–159) mg/L, mild/moderate: 134(69–189) mg/L; severe: 560(286–1511) mg/L, p = 0.008]. Conversely, lower LPA KIV-2 repeat numbers in subjects with more severe calcification degree were observed. Furthermore, higher Lp(a) levels in patients with aortic stenosis [214(67–501) mg/L vs 104(56–169) mg/L, p = 0.043] were also found. In conclusion, present data suggest the potential role for Lp(a) as a possible risk marker useful to stratify, among BAV patients, those with a higher chance to develop valvular calcifications and aortic stenosis.
KW - Bicuspid aortic valve
KW - Calcification
KW - Kringle IV type 2
KW - Lipoprotein (a)
KW - Stenosis
UR - http://www.scopus.com/inward/record.url?scp=85051244452&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85051244452&partnerID=8YFLogxK
U2 - 10.1007/s11739-018-1925-8
DO - 10.1007/s11739-018-1925-8
M3 - Article
AN - SCOPUS:85051244452
JO - Internal and Emergency Medicine
JF - Internal and Emergency Medicine
SN - 1828-0447
ER -