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脂蛋白(a)作为二叶式主动脉瓣患者早期主动脉瓣置换的潜在预测因素。

Lipoprotein(a) As a Potential Predictive Factor for Earlier Aortic Valve Replacement in Patients with Bicuspid Aortic Valve.

作者信息

Krzesińska Aleksandra, Nowak Maria, Mickiewicz Agnieszka, Chyła-Danił Gabriela, Ćwiklińska Agnieszka, Koper-Lenkiewicz Olga M, Kamińska Joanna, Matowicka-Karna Joanna, Gruchała Marcin, Jankowski Maciej, Fijałkowski Marcin, Kuchta Agnieszka

机构信息

Department of Clinical Chemistry, Medical University of Gdańsk, 80-211 Gdańsk, Poland.

1st Department of Cardiology, Medical University of Gdańsk, 80-211 Gdańsk, Poland.

出版信息

Biomedicines. 2023 Jun 25;11(7):1823. doi: 10.3390/biomedicines11071823.


DOI:10.3390/biomedicines11071823
PMID:37509461
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10376971/
Abstract

Bicuspid aortic valve (BAV) affects 0.5-2% of the general population and constitutes the major cause of severe aortic valve stenosis (AVS) in individuals ≤70 years. The aim of the present study was to evaluate the parameters that may provide information about the risk of AVS developing in BAV patients, with particular emphasis on lipoprotein(a) (Lp(a)), which is a well-recognized risk factor for stenosis in the general population. We also analyzed the impact of autotaxin (ATX) and interleukin-6 (IL-6) as parameters potentially related to the pathomechanism of Lp(a) action. We found that high Lp(a) levels (>50 mg/dL) occurred significantly more frequently in patients with AVS than in patients without AVS, both in the group below and above 45 years of age ( = 0.036 and = 0.033, respectively). Elevated Lp(a) levels were also strictly associated with the need for aortic valve replacement (AVR) at a younger age ( = 0.016). However, the Lp(a) concentration did not differ significantly between patients with and without AVS. Similarly, we observed no differences in ATX between the analyzed patient groups, and both ATX activity and concentration correlated significantly with Lp(a) level (R = 0.465, < 0.001 and R = 0.599, < 0.001, respectively). We revealed a significantly higher concentration of IL-6 in young patients with AVS. However, this observation was not confirmed in the group of patients over 45 years of age. We also did not observe a significant correlation between IL-6 and Lp(a) or between CRP and Lp(a) in any of the analyzed groups of BAV patients. Our results demonstrate that a high level of Lp(a), greater than 50 mg/dL, may be a significant predictive factor for earlier AVR. Lp(a)-related parameters, such as ATX and IL-6, may be valuable in providing information about the additional cardiovascular risks associated with developing AVS.

摘要

二叶式主动脉瓣(BAV)影响0.5%-2%的普通人群,是70岁及以下个体严重主动脉瓣狭窄(AVS)的主要原因。本研究的目的是评估可能提供有关BAV患者发生AVS风险信息的参数,特别强调脂蛋白(a)(Lp(a)),它是普通人群中公认的狭窄风险因素。我们还分析了自分泌运动因子(ATX)和白细胞介素-6(IL-6)作为可能与Lp(a)作用发病机制相关参数的影响。我们发现,无论在45岁以下组还是45岁以上组,AVS患者中Lp(a)水平>50mg/dL的发生率均显著高于无AVS患者(分别为P=0.036和P=0.033)。Lp(a)水平升高也与较年轻时进行主动脉瓣置换术(AVR)的必要性密切相关(P=0.016)。然而,AVS患者和无AVS患者之间的Lp(a)浓度无显著差异。同样,我们在分析的患者组之间未观察到ATX的差异,且ATX活性和浓度均与Lp(a)水平显著相关(相关系数R分别为0.465,P<0.001和0.599,P<0.001)。我们发现年轻的AVS患者中IL-6浓度显著更高。然而,在45岁以上患者组中未证实这一观察结果。在任何分析的BAV患者组中,我们也未观察到IL-6与Lp(a)之间或C反应蛋白(CRP)与Lp(a)之间存在显著相关性。我们的结果表明,Lp(a)水平高于50mg/dL可能是早期AVR的重要预测因素。与Lp(a)相关的参数,如ATX和IL-6,可能有助于提供有关与发生AVS相关的额外心血管风险的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a64d/10376971/58f184af7e18/biomedicines-11-01823-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a64d/10376971/34beaa62df8a/biomedicines-11-01823-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a64d/10376971/e2e11877ec09/biomedicines-11-01823-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a64d/10376971/58f184af7e18/biomedicines-11-01823-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a64d/10376971/34beaa62df8a/biomedicines-11-01823-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a64d/10376971/e2e11877ec09/biomedicines-11-01823-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a64d/10376971/58f184af7e18/biomedicines-11-01823-g003.jpg

相似文献

[1]
Lipoprotein(a) As a Potential Predictive Factor for Earlier Aortic Valve Replacement in Patients with Bicuspid Aortic Valve.

Biomedicines. 2023-6-25

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Association of Lipoprotein(a) With Severe Degenerative Aortic Valve Stenosis.

JACC Asia. 2024-9-10

[2]
Lipoprotein (a) and lipid-lowering treatment from the perspective of a cardiac surgeon. An impact on the prognosis in patients with aortic valve replacement and after heart transplantation.

Int J Cardiol Cardiovasc Risk Prev. 2024-6-6

本文引用的文献

[1]
gene polymorphism association with calcific aortic valve stenosis and influence on serum levels of interleukin-6.

Front Cardiovasc Med. 2022-10-20

[2]
Impact of Left Ventricular Ejection Fraction on Clinical Outcomes in Bicuspid Aortic Valve Disease.

J Am Coll Cardiol. 2022-9-13

[3]
The mechanistic pathways of oxidative stress in aortic stenosis and clinical implications.

Theranostics. 2022

[4]
Lipoprotein(a) measurement issues: Are we making a mountain out of a molehill?

Atherosclerosis. 2022-5

[5]
The association of bicuspid aortic valve on long-term outcome following one-stage repair of aortic arch obstruction associated with ventricular septal defect.

Cardiol Young. 2023-2

[6]
Safety and Efficacy of Myval Implantation in Patients with Severe Bicuspid Aortic Valve Stenosis-A Multicenter Real-World Experience.

J Clin Med. 2022-1-15

[7]
Lipoprotein(a)-The Crossroads of Atherosclerosis, Atherothrombosis and Inflammation.

Biomolecules. 2021-12-24

[8]
Lipoprotein(a), venous thromboembolism and COVID-19: A pilot study.

Atherosclerosis. 2022-1

[9]
Left ventricular remodelling in bicuspid aortic valve disease.

Eur Heart J Cardiovasc Imaging. 2022-11-17

[10]
Lipoprotein(a) and aortic valve stenosis: A casual or causal association?

Nutr Metab Cardiovasc Dis. 2022-2

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