PMID- 23428667
OWN - NLM
STAT- MEDLINE
DCOM- 20130819
LR  - 20151119
IS  - 1421-9751 (Electronic)
IS  - 0008-6312 (Linking)
VI  - 124
IP  - 2
DP  - 2013
TI  - A multimarker study of degenerative aortic valve disease: stenoinsufficiency 
      shows more indices of bad prognosis.
PG  - 126-37
LID - 10.1159/000346396 [doi]
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.
CI  - Copyright (c) 2013 S. Karger AG, Basel.
FAU - Vianello, Annamaria
AU  - Vianello A
AD  - Department of Human Morphology and Applied Biology, University of Pisa, Pisa, 
      Italy.
FAU - Perlini, Stefano
AU  - Perlini S
FAU - Cappelli, Stefania
AU  - Cappelli S
FAU - Palladini, Giuseppina
AU  - Palladini G
FAU - Epistolato, Maria Carmela
AU  - Epistolato MC
FAU - Della Latta, Daniele
AU  - Della Latta D
FAU - Cerillo, Alfredo
AU  - Cerillo A
FAU - Berti, Sergio
AU  - Berti S
FAU - Chiappino, Dante
AU  - Chiappino D
FAU - Tanganelli, Piero
AU  - Tanganelli P
FAU - Glauber, Mattia
AU  - Glauber M
FAU - Mazzone, Annamaria
AU  - Mazzone A
LA  - eng
PT  - Journal Article
DEP - 20130221
PL  - Switzerland
TA  - Cardiology
JT  - Cardiology
JID - 1266406
RN  - 0 (Biomarkers)
RN  - 0 (Tissue Inhibitor of Metalloproteinases)
RN  - 106441-73-0 (Osteopontin)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - EC 3.4.- (Metalloproteases)
SB  - IM
MH  - Aged
MH  - Aortic Valve Insufficiency/*mortality/pathology/surgery
MH  - Aortic Valve Stenosis/*mortality/pathology
MH  - Atherosclerosis/mortality/pathology
MH  - Biomarkers/*metabolism
MH  - Bioprosthesis/adverse effects
MH  - Carotid Stenosis/mortality/pathology
MH  - Case-Control Studies
MH  - Female
MH  - Heart Valve Prosthesis Implantation/adverse effects
MH  - Humans
MH  - Male
MH  - Metalloproteases/metabolism
MH  - Natriuretic Peptide, Brain/metabolism
MH  - Osteopontin/metabolism
MH  - Prognosis
MH  - Prospective Studies
MH  - Tissue Inhibitor of Metalloproteinases/metabolism
MH  - Vascular Calcification/mortality/pathology
EDAT- 2013/02/23 06:00
MHDA- 2013/08/21 06:00
CRDT- 2013/02/23 06:00
PHST- 2012/05/30 00:00 [received]
PHST- 2012/11/27 00:00 [accepted]
PHST- 2013/02/23 06:00 [entrez]
PHST- 2013/02/23 06:00 [pubmed]
PHST- 2013/08/21 06:00 [medline]
AID - 000346396 [pii]
AID - 10.1159/000346396 [doi]
PST - ppublish
SO  - Cardiology. 2013;124(2):126-37. doi: 10.1159/000346396. Epub 2013 Feb 21.