Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Immunology, Laboratory Medical Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Cardiol. 2020 Sep;76(3):287-294. doi: 10.1016/j.jjcc.2020.02.023. Epub 2020 Apr 4.
Patients with a bicuspid aortic valve (BAV) are at risk of developing valve deterioration and aortic dilatation. We aimed to investigate whether blood biomarkers are associated with disease stage in patients with BAV.
Serum levels of high sensitivity C-reactive protein (hsCRP), high sensitivity troponin T (hsTnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and total transforming growth factor-beta 1 (TGF-ß1) were measured in adult BAV patients with valve dysfunction or aortic pathology. Age-matched general population controls were included for TGFß-1 measurements. Correlation analyses and multivariable linear regression were used to determine the association between (2log-transformed) biomarker levels and aortic valve regurgitation, aortic valve stenosis, aortic dilatation, or left ventricular function.
hsCRP and hsTnT were measured in the total group of 183 patients (median age 34 years, 25th-75th percentile 23-46), NT-proBNP in 162 patients, and TGF-ß1 beta in 108 patients. Elevated levels of NT-proBNP were found in 20% of the BAV patients, elevated hsTnT in 6%, and elevated hsCRP in 7%. Higher hsTnT levels were independently associated with aortic regurgitation [odds ratio per doubling (OR) 1.34, 95% CI 1.01;1.76] and higher NT-proBNP levels with aortic valve maximal velocity (ß 0.17, 95%CI 0.07;0.28) and aortic regurgitation (OR 1.41, 95%CI 1.11;1.79). Both BAV patients with (9.9 ± 2.7 ng/mL) and without aortic dilatation (10.4 ± 2.9 ng/mL) showed lower TGF-ß1 levels compared to general population controls (n = 85, 11.8 ± 3.2 ng/mL).
Higher NT-proBNP and hsTNT levels were associated with aortic valve disease in BAV patients. TGF-ß1 levels were lower in BAV patients than in the general population, and not related to aortic dilatation. Longitudinal data are needed to further investigate the prognostic value of biomarkers in these patients.
二叶式主动脉瓣（BAV）患者存在瓣叶恶化和主动脉扩张的风险。本研究旨在探讨血液生物标志物与 BAV 患者疾病阶段的相关性。
检测了患有瓣膜功能障碍或主动脉病变的成年 BAV 患者的高敏 C 反应蛋白（hsCRP）、高敏肌钙蛋白 T（hsTnT）、氨基末端 pro-B 型利钠肽前体（NT-proBNP）和总转化生长因子-β1（TGF-ß1）的血清水平。为了测量 TGFß-1，还纳入了年龄匹配的一般人群对照。采用相关分析和多元线性回归来确定（2 对数转换）生物标志物水平与主动脉瓣反流、主动脉瓣狭窄、主动脉扩张或左心室功能之间的相关性。
共检测了 183 例患者（中位数年龄 34 岁，25-75 百分位数 23-46）的 hsCRP 和 hsTnT，162 例患者的 NT-proBNP 和 108 例患者的 TGF-ß1β。20%的 BAV 患者 NT-proBNP 升高，6%的 hsTnT 升高，7%的 hsCRP 升高。更高的 hsTnT 水平与主动脉瓣反流独立相关[每倍增的优势比（OR）1.34，95%CI 1.01；1.76]，更高的 NT-proBNP 水平与主动脉瓣最大速度（ß 0.17，95%CI 0.07；0.28）和主动脉瓣反流（OR 1.41，95%CI 1.11；1.79）相关。有（9.9±2.7ng/mL）和无主动脉扩张（10.4±2.9ng/mL）的 BAV 患者的 TGF-ß1 水平均低于一般人群对照（n=85，11.8±3.2ng/mL）。
更高的 NT-proBNP 和 hsTnT 水平与 BAV 患者的主动脉瓣疾病相关。与一般人群相比，BAV 患者的 TGF-ß1 水平较低，且与主动脉扩张无关。需要进行纵向数据研究以进一步探讨这些患者的生物标志物的预后价值。
