Altug Cakmak Huseyin, Aslan Serkan, Erturk Mehmet, Ornek Vesile, Rodi Tosu Aydin, Kemal Kalkan Ali, Ozturk Derya, Tasbulak Omer, Avci Yalcin, Gul Mehmet
Rize Kackar Government Hospital, Department of Cardiology, Rize.
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul.
J Heart Valve Dis. 2015 Nov;24(6):699-706.
Vascular adhesion protein-1 (VAP-1), a dual-function glycoprotein, is secreted by endothelial cells, adipocytes, and kidney and vascular smooth muscle cells. It has been reported to participate in the development of atherosclerosis as an adhesion molecule and a pro-inflammatory enzyme. Increased VAP-1 levels are related to type 2 diabetes mellitus, atherosclerosis, stroke and chronic renal failure. The study aim was to investigate serum VAP-1 levels in patients with calcific aortic stenosis (AS) and the possible relationship between VAP-1 and severity of calcific AS.
A total of 168 patients was categorized as having mild (n = 54), moderate (n = 58), or severe (n = 56) AS. Serum VAP-1 levels were measured using an enzyme-linked immunosorbent assay.
The mean serum VAP-1 level was significantly higher in patients with AS compared to healthy controls (244.3 ± 50.1 ng/ml versus 149.8 ± 27.5 ng/ml, p <0.001), and in the severe AS group compared to the moderate and mild AS groups (288.3 ± 30.1 ng/ml, 243.1 ± 31.8 ng/ml, and 200.8 ± 43.2 ng/ml, respectively, p <0.001). The VAP-1 level was positively related to the maximum aortic gradient, mean aortic gradient, and maximum aortic jet velocity (r = 0.649, p <0.001; r = 0.660, p <0.001; r = 0.655, p <0.001, respectively) and negatively related to the aortic valve area (r = -0.683, p <0.001).
The present study was the first to demonstrate a significant relationship between increased serum VAP-1 levels and the severity of calcific AS. VAP-1 might be a useful biomarker for the evaluation of AS and the follow up of its severity.
血管黏附蛋白-1（VAP-1）是一种具有双重功能的糖蛋白，由内皮细胞、脂肪细胞、肾及血管平滑肌细胞分泌。据报道，它作为一种黏附分子和促炎酶参与动脉粥样硬化的发展。VAP-1水平升高与2型糖尿病、动脉粥样硬化、中风及慢性肾衰竭有关。本研究旨在调查钙化性主动脉瓣狭窄（AS）患者的血清VAP-1水平，以及VAP-1与钙化性AS严重程度之间的可能关系。
168例患者被分为轻度（n = 54）、中度（n = 58）或重度（n = 56）AS。采用酶联免疫吸附测定法测量血清VAP-1水平。
与健康对照组相比，AS患者的平均血清VAP-1水平显著更高（分别为244.3±50.1 ng/ml和149.8±27.5 ng/ml）；与中度和轻度AS组相比，重度AS组的平均血清VAP-1水平更高（分别为288.3±30.1 ng/ml、243.1±31.8 ng/ml和200.8±43.2 ng/ml）（均p<0.001）。VAP-1水平与最大主动脉梯度、平均主动脉梯度及最大主动脉射流速度呈正相关（r分别为0.649，p<0.001；r为0.660，p<0.001；r为0.655，p<0.001），与主动脉瓣面积呈负相关（r = -0.683，p<0.001）。
本研究首次证明血清VAP-1水平升高与钙化性AS的严重程度之间存在显著关系。VAP-1可能是评估AS及其严重程度随访的有用生物标志物。
