Mohty D, Pibarot P, Côté N, Cartier A, Audet A, Després J P, Mathieu P
Laboratoire d'Études Moléculaires des Valvulopathies, Groupe de Recherche en Valvulopathies, Laval Hospital Research Center/Quebec Heart Institute, Department of Surgery, Laval University, Québec City, Qué., Canada.
Cardiology. 2011;118(2):140-6. doi: 10.1159/000327588. Epub 2011 May 19.
Adiponectin is a protein secreted by adipocytes which has anti-inflammatory properties. The objective of this study was to examine the relationship between adiponectinemia and the hemodynamic progression of aortic stenosis (AS) as well as the degree of inflammation in the valve explanted at the time of aortic valve replacement (AVR).
The plasma level of adiponectin was measured in 122 patients undergoing AVR. The explanted aortic valves were analyzed and the density of leukocytes (CD45+), T cells (CD3+) and blood vessels (von Willebrand factor positive; vWF+) was documented. Also, a subset of patients (n = 67) had ≥2 echocardiographic studies separated by at least 6 months, thereby allowing assessment of the rate of progression of stenosis during the preoperative period.
Patients with lower plasma levels of adiponectin (<5.4 μg/ml) had a faster progression rate of the mean transvalvular gradient before surgery than those with higher levels (9 ± 1 vs. 4 ± 1 mm Hg/year; p = 0.008). Moreover, these patients with hypoadiponectinemia had significantly more leukocytes (CD45+), T cells and blood vessels (vWF+) in their explanted valves compared to those with higher adiponectin levels.
These findings support the concept that adiponectin may play a protective role against the inflammatory process and progression of calcific AS.
脂联素是一种由脂肪细胞分泌的具有抗炎特性的蛋白质。本研究的目的是探讨脂联素血症与主动脉瓣狭窄（AS）血流动力学进展以及主动脉瓣置换术（AVR）时切除瓣膜的炎症程度之间的关系。
对122例接受AVR的患者测定血浆脂联素水平。对切除的主动脉瓣进行分析，并记录白细胞（CD45+）、T细胞（CD3+）和血管（血管性血友病因子阳性；vWF+）的密度。此外，一部分患者（n = 67）进行了至少间隔6个月的≥2次超声心动图检查，从而能够评估术前狭窄的进展速度。
血浆脂联素水平较低（<5.4μg/ml）的患者术前平均跨瓣压差的进展速度比水平较高的患者更快（9±1 vs. 4±1 mmHg/年；p = 0.008）。此外，与脂联素水平较高的患者相比，这些低脂联素血症患者切除的瓣膜中白细胞（CD45+）、T细胞和血管（vWF+）明显更多。
这些发现支持脂联素可能对钙化性AS的炎症过程和进展起保护作用这一概念。
