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Inflammation in calcific aortic stenosis is determined by the metabolic syndrome
Author(s) -
Côté Claude,
Cartier Amélie,
Charest Allain,
Briand Martin,
Pibarot Philippe,
Després JeanPierre
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.4.a653
Subject(s) - inflammation , metabolic syndrome , medicine , triglyceride , adiponectin , cholesterol , aortic valve , infiltration (hvac) , cardiology , stenosis , fibrosis , obesity , endocrinology , insulin resistance , physics , thermodynamics
Introduction Calcific aortic stenosis (AS) is an inflammatory disease. We therefore hypothesized that metabolic syndrome (MS) might influence valve inflammatory activity during the development of AS. Methods We analyzed 35 AS valves to compare the relationship between the degree of valvular inflammation and the different atherosclerotic risk factors including the MS. Results Immunohistochemistry studies demonstrated that AS valves were heavily infiltrated by leukocytes. Age, gender, hypercholesterolemia, obesity, smoking, as well as treatment with statins had no significant effect on the extent of valve leukocytes infiltration (VLI). Factors that were associated with VLI were hypertension (36.5±7.6 leukocytes/400x field vs. 19.1±6.1 leukocytes/400x field; p=0.09) and MS (41.2±7.6 leukocytes/400x field vs. 15.3±5.2 leukocytes/400x field; p=0.0008). In multivariate analysis, MS was the only independent predictor of VLI. Lipid infiltration and deposition of apo B‐100 within the aortic valve was significantly increased in AS valves from patients with the MS and correlated with VLI (r=0.42; p=0.01). Furthermore, VLI was inversely correlated with plasma HDL cholesterol level (r=‐0.46; p=0.01), whereas it was not associated with total LDL, triglyceride, adiponectin, CRP, and Apo B100 blood level. Conclusion This is the first study to demonstrate that inflammation in calcific AS is independently associated with the MS. Reduced plasma HDL cholesterol level and enhanced lipid infiltration into the valve are among the main factors responsible for the association between the MS and the development of valvular inflammation.