Lp-PLA2 is associated with structural valve degeneration of bioprostheses

Authors: Mahmut, AblajanMahjoub, HaïfaBoulanger, Marie-ChloéFournier, DominiqueDesprés, Jean-PierrePibarot, PhilippeMathieu, Patrick
Abstract: Objectives: In this study, we sought to determine the metabolic markers associated with structural valve degeneration (SVD). Background: Structural valve degeneration (SVD) is the major cause of bioprosthetic valve failure leading to bioprostheses (BPs) stenosis or regurgitation. We hypothesized that lipoprotein-associated phospholipase A2 (Lp-PLA2) is involved in the SVD of BPs. Methods: We included 197 patients who underwent aortic valve replacement with a bioprosthetic valve and had echocardiographic follow-up to evaluate valve function. Moreover, explanted BPs (n = 39) were analysed by immunohistochemistry for the expression of Lp-PLA2. Results: After a mean follow-up of 7·9 ±0·2 years, forty-one patients (21%) were identified as developing SVD. Patients with SVD had significantly higher plasma level of Lp-PLA2 mass (151·8 ± 9·2 ng/mL vs. 133·2 ± 3·4 ng/mL, P = 0·03) and activity (27·6 ± 0·9 nmol/min/mL vs. 25·0 ± 0·4 nmol/min/mL, P = 0·005). Multivariate analysis revealed that Lp-PLA2 activity (OR: 1·09, 95% CI: 1·01–1·18; P = 0·03) was the strongest independent predictor of SVD. Immunohistochemistry studies of explanted BP showed that 77% of explanted BPs had the expression of Lp-PLA2, which correlated with the density of macrophages (CD68), and ox-LDL levels in bioprosthetic tissues. Conclusions: Increased blood plasma activity of Lp-PLA2 is associated with higher prevalence of SVD. These findings open new avenues for the identification of patients at risk for SVD and for the development of pharmacotherapy aiming at the prevention of SVD.
Document Type: Article de recherche
Issue Date: 28 November 2013
Open Access Date: Restricted access
Document version: VoR
Permalink: http://hdl.handle.net/20.500.11794/6788
This document was published in: European journal of clinical investigation, Vol. 44 (2), 136-145 (2014)
European Society for Clinical Investigation
Alternative version: 10.1111/eci.12199
Collection:Articles publiés dans des revues avec comité de lecture

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