Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Hospital del Mar Medical Research Institute (IMIM), Parc de Salut Mar, Barcelona, Spain.
J Cardiovasc Transl Res. 2022 Feb;15(1):5-14. doi: 10.1007/s12265-021-10138-4. Epub 2021 Aug 2.
The aim of this work was to study the association of potential biomarkers with fast aortic stenosis (AS) progression. Patients with moderate-to-severe AS were classified as very fast progressors (VFP) if exhibited an annualized change in peak velocity (aΔVmax) ≥0.45m/s/year and/or in aortic valve area (aΔAVA) ≥-0.2cm2/year. Respective cut-off values of ≥0.3m/s/year and ≥-0.1cm/year defined fast progressors (FP), whereas the remaining patients were non-fast progressors (non-FP). Baseline markers of lipid metabolism, inflammation, and cardiac overload were determined. Two hundred and nine patients (97 non-FP, 38 FP, and 74 VFP) were included. PCSK9 levels were significantly associated with VFP (OR 1.014 [95%CI 1.005-1.024], for every 10 ng/mL), as were active smoking (OR 3.48) and body mass index (BMI, OR 1.09), with an AUC of 0.704 for the model. PCSK9 levels, active smoking, and BMI were associated with very fast AS progression in our series, suggesting that inflammation and calcification participate in disease progression.
本研究旨在探讨潜在生物标志物与快速主动脉瓣狭窄（AS）进展的相关性。中重度 AS 患者如果峰值流速（aΔVmax）的年变化率≥0.45m/s/年和/或主动脉瓣口面积（aΔAVA）的年变化率≥-0.2cm2/年，则被归类为快速进展者（VFP）。相应的 aΔVmax≥0.3m/s/年和 aΔAVA≥-0.1cm/年的截值定义为快速进展者（FP），其余患者为非快速进展者（non-FP）。测定了基线脂质代谢、炎症和心脏负荷标志物。共纳入 209 例患者（97 例非-FP、38 例 FP 和 74 例 VFP）。PCSK9 水平与 VFP 显著相关（OR 1.014 [95%CI 1.005-1.024]，每增加 10ng/mL），与活跃吸烟（OR 3.48）和体重指数（BMI，OR 1.09）也显著相关，模型的 AUC 为 0.704。在本研究中，PCSK9 水平、活跃吸烟和 BMI 与快速 AS 进展相关，提示炎症和钙化参与了疾病的进展。
