Kocyigit Duygu, Zimetti Francesca, Gurses Kadri M, Zanotti Ilaria, Marchi Cinzia, Ståhlman Marcus, Borén Jan, Canpinar Hande, Soyal Mehmet F T, Guc Dicle, Hazirolan Tuncay, Ozer Necla, Tokgozoglu Lale
Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Food and Drug, University of Parma, Parma, Italy.
Atheroscler Plus. 2021 Aug 11;44:18-24. doi: 10.1016/j.athplu.2021.08.002. eCollection 2021 Oct.
Cholesterol efflux capacity is a functional property of high-density lipoproteins (HDL) reflecting the efficiency of the atheroprotective reverse cholesterol transport process in humans. Its relationship with calcific aortic valve stenosis (CAVS) has not been fully assessed yet.
We evaluated HDL-CEC in a patient population with varying degrees of aortic valvular calcific disease, assessed using echocardiography and cardiac computed tomography. Measurement of biomarkers that reflect osteogenic and tissue remodeling, along with dietary and gut microbiota-derived metabolites were performed.
Patients with moderate-severe CAVS had significantly lower HDL-CEC compared to both control and aortic sclerosis subjects (mean: 6.09%, 7.32% and 7.26%, respectively). HDL-CEC displayed negative correlations with peak aortic jet velocity and aortic valve calcium score, indexes of CAVS severity (ρ = -0.298, p = 0.002 and ρ = -0.358, p = 0.005, respectively). In multivariable regression model, HDL-CEC had independent association with aortic valve calcium score (B: -0.053, SE: 0.014, p < 0.001), GFR (B: -0.034, SE: 0.012, p = 0.007), as well as with levels of total cholesterol (B: 0.018, SE: 0.005, p = 0.002).
These results indicate an impairment of HDL-CEC in moderate-severe CAVS and may contribute to identify potential novel targets for CAVS management.
胆固醇流出能力是高密度脂蛋白（HDL）的一种功能特性，反映了人体动脉粥样硬化保护逆向胆固醇转运过程的效率。其与钙化性主动脉瓣狭窄（CAVS）的关系尚未得到充分评估。
我们在一组使用超声心动图和心脏计算机断层扫描评估的不同程度主动脉瓣钙化疾病患者中评估了HDL-CEC。测量了反映成骨和组织重塑的生物标志物，以及饮食和肠道微生物群衍生的代谢物。
与对照组和主动脉硬化患者相比，中重度CAVS患者的HDL-CEC显著降低（平均值分别为：6.09%、7.32%和7.26%）。HDL-CEC与主动脉峰值射流速度和主动脉瓣钙评分呈负相关，这两个指标是CAVS严重程度的指标（分别为ρ = -0.298，p = 0.002和ρ = -0.358，p = 0.005）。在多变量回归模型中，HDL-CEC与主动脉瓣钙评分（B：-0.053，SE：0.014，p < 0.001）、肾小球滤过率（GFR）（B：-0.034，SE：0.012，p = 0.007）以及总胆固醇水平（B：0.018，SE：0.005，p = 0.002）具有独立相关性。
这些结果表明中重度CAVS患者存在HDL-CEC受损，可能有助于确定CAVS管理的潜在新靶点。
