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Myasoedova VA, Bertolini F, Valerio V, Moschetta D, Massaiu I, Rusconi V, De Giorgi D, Ciccarelli M, Parisi V, Poggio P. The Role of Adiponectin and Leptin in Fibro-Calcific Aortic Valve Disease: A Systematic Review and Meta-Analysis. Biomedicines 2024; 12:1977. [PMID: 39335491 PMCID: PMC11428218 DOI: 10.3390/biomedicines12091977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Fibro-calcific aortic valve disease (FCAVD) is a progressive disorder characterized by the thickening and calcification of the aortic valve, eventually leading to aortic stenosis. Adiponectin and leptin, known for their anti-inflammatory and proinflammatory properties, respectively, have been implicated in cardiovascular diseases, but their associations with FCAVD are controversial. This meta-analysis aims to evaluate the relationships between adiponectin and leptin levels and FCAVD, particularly in patients with severe aortic stenosis (AS). METHODS A systematic search was conducted across the PubMed, Scopus, and Web of Science databases to identify studies on adiponectin and leptin levels in FCAVD. The methodological quality of each study was assessed using the Newcastle-Ottawa Scale. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated, and publication bias was evaluated using Egger's test and funnel plots. RESULTS Out of 191 articles identified, 10 studies involving 2360 patients (989 with FCAVD and 1371 controls) were included. The analysis suggested trends in the associations of lower adiponectin levels (SMD = -0.143, 95% CI: -0.344, 0.057, p = 0.161) and higher leptin levels (SMD = 0.175, 95% CI: -0.045, 0.395, p = 0.119) with FCAVD. The association remained a trend for low adiponectin but showed a significant correlation with high leptin in severe AS patients (SMD = 0.29, 95% CI: 0.036, 0.543, p = 0.025). CONCLUSION This meta-analysis indicates a potential association between elevated leptin levels and severe aortic stenosis, while the relationship with adiponectin levels remains inconclusive. These findings highlight the need for further and dedicated research to clarify the roles of these adipokines in the pathogenesis of FCAVD and their potential roles as biomarkers for disease progression.
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Affiliation(s)
| | | | | | | | | | | | | | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy
| | - Valentina Parisi
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Paolo Poggio
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
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Hansén N, Ljungberg J, Bergdahl IA, Hultdin J, Näslund U, Johansson B, Söderberg S. Adipokines are possible risk markers for aortic stenosis requiring surgery. SCAND CARDIOVASC J 2023; 57:2247193. [PMID: 37592808 DOI: 10.1080/14017431.2023.2247193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/15/2023] [Accepted: 08/08/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVES Aortic stenosis (AS) is the most prevalent valvular heart disease among adults. The adipocyte-derived hormones, leptin and adiponectin, have profound metabolic actions. We examined whether these adipokines are independently associated with future aortic valve replacement (AVR). DESIGN In this longitudinal case-control study, we identified 336 cases who had undergone AVR due to AS, and who had previously participated in population-based health surveys. Two referents were matched to each case and leptin and adiponectin concentrations were analysed from stored baseline survey samples. Uni- and multivariable logistic regression analyses were used to estimate the risk of future AVR. An additional cohort was identified for validation including 106 cases with AVR and 212 matched referents. RESULTS Median age (interquartile range (IQR)) in years at survey was 59.9 (10.4) and at surgery 68.3 (12.7), and 48% were women. An elevated concentration of leptin was not associated with future AVR (odds ratio [95% confidence interval]) (1.10 [0.92-1.32]), although leptin was associated with a higher risk in patients with coronary artery disease (CAD) having more than 5 years between survey and AVR (1.41 [1.08-1.84]). Adiponectin was not associated with higher risk for future AVR (0.95 [0.82-1.11]), although after stratification for age, higher levels were associated with reduced risk for AVR in persons aged ≥60 years at surgery (0.79 [0.64-0.98]). In the validation study, leptin was associated with future AVR whereas adiponectin was not. None of the associations remained significant after adjustment for body mass index (BMI). CONCLUSIONS The adipokine leptin may promote the development of AS.
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Affiliation(s)
- Nike Hansén
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Johan Ljungberg
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | | | - Johan Hultdin
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Ulf Näslund
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Bengt Johansson
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
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3
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Martín-Núñez E, Goñi-Olóriz M, Matilla L, Garaikoetxea M, Mourino-Alvarez L, Navarro A, Fernández-Celis A, Tamayo I, Gainza A, Álvarez V, Sádaba R, Barderas MG, Jover E, López-Andrés N. Influence of diabetes mellitus on the pathological profile of aortic stenosis: a sex-based approach. Cardiovasc Diabetol 2023; 22:280. [PMID: 37848892 PMCID: PMC10583330 DOI: 10.1186/s12933-023-02009-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) accelerates the progression of aortic stenosis (AS), but how their underlying molecular mechanisms interact is not clear. Moreover, whether DM contributes to clinically relevant sex-differences in AS is unknown. In this work we aim to characterize the sex-specific profile of major pathological mechanisms fundamental to aortic valve (AV) degeneration in AS patients with or without concomitant DM. METHODS 283 patients with severe AS undergoing surgical valve replacement (27.6% DM, 59.4% men) were recruited. Expression of pathological markers related to AS were thoroughly assessed in AVs and valve interstitial cells (VICs) according to sex and presence of DM. Complementary in vitro experiments in VICs in the presence of high-glucose levels (25 mM) for 24, 48 and 72 h were performed. RESULTS Oxidative stress and metabolic dysfunction markers were increased in AVs from diabetic AS patients compared to non-diabetic patients in both sexes. However, disbalanced oxidative stress and enhanced inflammation were more predominant in AVs from male AS diabetic patients. Osteogenic markers were exclusively increased in the AVs of diabetic women. Basal characterization of VICs confirmed that oxidative stress, inflammation, calcification, and metabolic alteration profiles were increased in diabetic VICs with sex-specific differences. VICs cultured in hyperglycemic-like conditions triggered inflammatory responses in men, whereas in women rapid and higher production of pro-osteogenic molecules. CONCLUSIONS DM produces sex-specific pathological phenotypes in AV of AS patients. Importantly, women with diabetes are more prone to develop AV calcification. DM should be considered as a risk factor in AS especially in women.
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Affiliation(s)
- Ernesto Martín-Núñez
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain
| | - Miriam Goñi-Olóriz
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain
| | - Lara Matilla
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain
| | - Mattie Garaikoetxea
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain
| | - Laura Mourino-Alvarez
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain
- Hospital Nacional de Paraplejicos, Servicio de Salud de Castilla-La Mancha (SESCAM), Toledo, Spain
| | - Adela Navarro
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain
| | - Amaya Fernández-Celis
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain
| | - Ibai Tamayo
- Research Methodology Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Alicia Gainza
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain
| | - Virginia Álvarez
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain
| | - Rafael Sádaba
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain
| | - María G Barderas
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain
- Hospital Nacional de Paraplejicos, Servicio de Salud de Castilla-La Mancha (SESCAM), Toledo, Spain
| | - Eva Jover
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain.
| | - Natalia López-Andrés
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), C/Irunlarrea 3, 31008, Pamplona, Spain.
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Walpot J, van Herck P, Collas V, Bossaerts L, Van de Heyning CM, Vandendriessche T, Heidbuchel H, Rodrigus I, De Block C, Small GR, Bosmans J. Adiponectin serum level is an independent and incremental predictor of all-cause mortality after transcatheter aortic valve replacement. Clin Cardiol 2022; 45:1060-1069. [PMID: 35932173 PMCID: PMC9574742 DOI: 10.1002/clc.23892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/20/2022] [Accepted: 07/12/2022] [Indexed: 11/22/2022] Open
Abstract
Background Quantifiable biomarkers may be useful for a better risk and frailty assessment of patients referred for transcatheter aortic valve implantation (TAVI). Hypothesis To determine if adiponectin serum concentration predicts all‐cause mortality in patients undergoing TAVI. Methods 77 consecutive patients, undergoing TAVI, were analyzed. The CT axial slices at the level of the fourth lumbar vertebra were used to measure the psoas muscle area, and its low‐density muscle fraction (LDM (%)). To assess the operative risk, the STS (Society of Thoracic Surgeons Predicted Risk of Mortality) score, Log. Euroscore, and Euroscore II were determined. A clinical frailty assessment was performed. ELISA kits were used to measure adiponectin serum levels. We searched for a correlation between serum adiponectin concentration and all‐cause mortality after TAVI. Results The mean age was 80.8 ± 7.4 years. All‐cause mortality occurred in 22 patients. The mean follow‐up was 1779 days (range: 1572–1825 days). Compared with patients with the lowest adiponectin level, patients in the third tertile had a hazards ratio of all‐cause mortality after TAVI of 4.155 (95% CI: 1.364–12.655) (p = .004). In the multivariable model, including STS score, vascular access of TAVI procedure, LDM (%), and adiponectin serum concentration, serum adiponectin level, and LDM(%) were independent predictors of all‐cause mortality after TAVI (p = .178, .303, .042, and .017, respectively). Adiponectin level was a predictor of all‐cause mortality in females and males (p = .012 and 0.024, respectively). Conclusion Adiponectin serum level is an independent and incremental predictor of all‐cause mortality in patients undergoing TAVI.
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Affiliation(s)
- Jeroen Walpot
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Department of Cardiology, ZorgSaam Hospital, Terneuzen, The Netherlands
| | - Paul van Herck
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium
| | - Valerie Collas
- Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Liene Bossaerts
- Faculty of Biomedical Sciences, University of Antwerp, Wilrijk, Belgium
| | - Caroline M Van de Heyning
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Tom Vandendriessche
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium
| | - Hein Heidbuchel
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Inez Rodrigus
- Department of Cardiac Surgery, University Hospital Antwerp, Antwerp, Edegem, Belgium
| | - Christophe De Block
- Department of Endocrinology-Diabetology and Metabolism, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Gary R Small
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Johan Bosmans
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Faculty of Biomedical Sciences, University of Antwerp, Wilrijk, Belgium
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Sasako T, Kadowaki H, Fujiwara T, Kodera S, Komuro I, Kadowaki T, Yamauchi T. Severe aortic stenosis during leptin replacement therapy in a patient with generalized lipodystrophy-associated progeroid syndrome due to a LMNA variant: a case report. J Diabetes Investig 2022; 13:1636-1638. [PMID: 35524481 PMCID: PMC9434571 DOI: 10.1111/jdi.13827] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/28/2022] [Accepted: 05/01/2022] [Indexed: 11/28/2022] Open
Abstract
Leptin replacement therapy (LRT) has drastically improved the prognosis of patients with lipodystrophy, but pro‐inflammatory properties of leptin could become evident in the long term. Here, we report a 30‐year‐old Japanese woman with generalized lipodystrophy‐associated progeroid syndrome due to a heterozygous LMNA variant (c.29C > T; p.T10I), who was diagnosed with severe aortic stenosis (AS) after more than a decade of LRT, which required transcatheter aortic valve implantation. Given her marked hypoadiponectinemia and the LMNA variant, our patient might have been susceptible to progeria‐associated disorders, including aortic stenosis, which could have been exaggerated by the prolonged ‘imbalanced adipokines’ caused by LRT between pro‐inflammatory leptin and anti‐inflammatory adiponectin. Thus, long‐term LRT could be associated with AS in patients with the LMNA variant to cause generalized lipodystrophy‐associated progeroid syndrome and hypoadiponectinemia.
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Affiliation(s)
- Takayoshi Sasako
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Takayuki Fujiwara
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Kodera
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Assmann AK, Goschmer D, Sugimura Y, Chekhoeva A, Barth M, Assmann A, Lichtenberg A, Akhyari P. A Role for Peroxisome Proliferator-Activated Receptor Gamma Agonists in Counteracting the Degeneration of Cardiovascular Grafts. J Cardiovasc Pharmacol 2021; 79:e103-e115. [PMID: 34654784 PMCID: PMC8728763 DOI: 10.1097/fjc.0000000000001150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/25/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Aortic valve replacement for severe stenosis is a standard procedure in cardiovascular medicine. However, the use of biological prostheses has limitations especially in young patients because of calcifying degeneration, resulting in implant failure. Pioglitazone, a peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonist, was shown to decrease the degeneration of native aortic valves. In this study, we aim to examine the impact of pioglitazone on inflammation and calcification of aortic valve conduits (AoC) in a rat model. Cryopreserved AoC (n = 40) were infrarenally implanted into Wistar rats treated with pioglitazone (75 mg/kg chow; n = 20, PIO) or untreated (n = 20, controls). After 4 or 12 weeks, AoC were explanted and analyzed by histology, immunohistology, and polymerase chain reaction. Pioglitazone significantly decreased the expression of inflammatory markers and reduced the macrophage-mediated inflammation in PIO compared with controls after 4 (P = 0.03) and 12 weeks (P = 0.012). Chondrogenic transformation was significantly decreased in PIO after 12 weeks (P = 0.001). Calcification of the intima and media was significantly reduced after 12 weeks in PIO versus controls (intima: P = 0.008; media: P = 0.025). Moreover, echocardiography revealed significantly better functional outcome of the AoC in PIO after 12 weeks compared with control. Interestingly, significantly increased intima hyperplasia could be observed in PIO compared with controls after 12 weeks (P = 0.017). Systemic PPAR-gamma activation prevents inflammation as well as intima and media calcification in AoC and seems to inhibit functional impairment of the implanted aortic valve. To further elucidate the therapeutic role of PPAR-gamma regulation for graft durability, translational studies and long-term follow-up data should be striven for.
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Affiliation(s)
- Anna Kathrin Assmann
- Department of Cardiac Surgery and Research Group for Experimental Surgery, Heinrich Heine University, Medical Faculty, Duesseldorf, Germany.
| | - Daniel Goschmer
- Department of Cardiac Surgery and Research Group for Experimental Surgery, Heinrich Heine University, Medical Faculty, Duesseldorf, Germany.
| | - Yukiharu Sugimura
- Department of Cardiac Surgery and Research Group for Experimental Surgery, Heinrich Heine University, Medical Faculty, Duesseldorf, Germany.
| | - Agunda Chekhoeva
- Department of Cardiac Surgery and Research Group for Experimental Surgery, Heinrich Heine University, Medical Faculty, Duesseldorf, Germany.
| | - Mareike Barth
- Department of Cardiac Surgery and Research Group for Experimental Surgery, Heinrich Heine University, Medical Faculty, Duesseldorf, Germany.
| | - Alexander Assmann
- Department of Cardiac Surgery and Research Group for Experimental Surgery, Heinrich Heine University, Medical Faculty, Duesseldorf, Germany.
| | - Artur Lichtenberg
- Department of Cardiac Surgery and Research Group for Experimental Surgery, Heinrich Heine University, Medical Faculty, Duesseldorf, Germany.
| | - Payam Akhyari
- Department of Cardiac Surgery and Research Group for Experimental Surgery, Heinrich Heine University, Medical Faculty, Duesseldorf, Germany.
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Adipokines and Inflammation: Focus on Cardiovascular Diseases. Int J Mol Sci 2020; 21:ijms21207711. [PMID: 33081064 PMCID: PMC7589803 DOI: 10.3390/ijms21207711] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 02/08/2023] Open
Abstract
It is well established that adipose tissue, apart from its energy storage function, acts as an endocrine organ that produces and secretes a number of bioactive substances, including hormones commonly known as adipokines. Obesity is a major risk factor for the development of cardiovascular diseases, mainly due to a low grade of inflammation and the excessive fat accumulation produced in this state. The adipose tissue dysfunction in obesity leads to an aberrant release of adipokines, some of them with direct cardiovascular and inflammatory regulatory functions. Inflammation is a common link between obesity and cardiovascular diseases, so this review will summarise the role of the main adipokines implicated in the regulation of the inflammatory processes occurring under the scenario of cardiovascular diseases.
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Mizia-Stec K, Bochenek T, Kusz B, Mizia-Szubryt M, Sikora-Puz A, Gieszczyk-Strózik K. Severe degenerative aortic stenosis with preserved ejection fraction does not change adipokines serum levels. Cardiol J 2017; 26:483-492. [PMID: 29168539 DOI: 10.5603/cj.a2017.0135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 11/17/2017] [Accepted: 04/13/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The role of the adipokines in the pathogenesis of aortic stenosis (AS) is not well established. The aim was to evaluate the relationship between adipokines and clinical characteristics as well as echocardiographic indices and noninvasive markers of vascular remodeling in patients with severe AS with preserved ejection fraction (EF). METHODS Sixty-five patients (F/M: 38/27; age: 68.3 ± 9.0 years; body mass index [BMI]: 29.6 ± 4.3 kg/m2) with severe AS with preserved EF: 33 patients with paradoxical low-flow low-gradient AS (PLFLG AS) and 32 patients with normal flow high-gradient AS (NFHG AS) were prospectively enrolled into the study. Twenty-four subjects (F/M: 14/10; age: 65.4 ± 8.7 years; BMI: 29.6 ± 4.3 kg/m2) who matched as to age, sex, BMI and coronary artery disease (CAD) constituted the control group (CG). Clinical data and markers of vascular remodeling were related to the serum adipokines. RESULTS There were no differences in the adipokines concentrations in the AS/CG. Patients with AS and coexisting CAD were characterized by decreased serum adiponectin (9.9 ± 5.5 vs. 12.7 ± 5.8 μg/mL, p = 0.040) and leptin (8.3 ± 7.8 vs. 21.6 ± 17.1 ng/mL, p < 0.001) levels compared to subjects without CAD. There were no differences in the serum adipokines concentrations between patients with PLFLG AS and NFHG AS. Systemic hypertension, diabetes, hyperlipidemia or markers of vascular remodeling did not discriminate adipokines concentrations. Multivariate regression analysis indicated that age (F = 3.02; p = 0.015) and E/E' index (F = 0.87, p = 0.032) were independent predictors of the adiponectin level in the AS group. CONCLUSIONS The presence of AS with preserved EF did not change the adipokine serum profile. Adipokines levels were modified by coexisting atherosclerosis but not the typical cardiovascular risk factors or the hemodynamic type of AS.
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Affiliation(s)
- Katarzyna Mizia-Stec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice Poland
| | - Tomasz Bochenek
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice Poland.
| | - Błażej Kusz
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice Poland
| | - Magdalena Mizia-Szubryt
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice Poland
| | - Agnieszka Sikora-Puz
- Second Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice Poland
| | - Klaudia Gieszczyk-Strózik
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice Poland
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9
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Affiliation(s)
- Patrick Mathieu
- Laboratory of Cardiovascular Pathobiology, Quebec Heart and Lung Institute/Research Center, Department of Surgery, Laval University, Quebec, Canada
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10
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Çabuk G, Guray U, Kafes H, Guray Y, Cabuk AK, Bayir PT, Asarcikli LD. Aortic valve sclerosis is associated with lower serum adiponectin levels. J Cardiovasc Med (Hagerstown) 2016; 16:451-5. [PMID: 25010503 DOI: 10.2459/jcm.0000000000000137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
AIMS The sclerotic lesions of the aortic valve share common features with atherosclerosis. An anti-inflammatory protein, adiponectin, seems to have a protective effect on the cardiovascular system. The goal of our study is to determine adiponectin levels in patients with aortic sclerosis and to compare these values with the control group with similar age and cardiovascular risk profile. METHODS Sixty-eight patients with aortic sclerosis and 40 controls were included. Serum adiponectin levels were measured by solid-phase enzyme-linked immunosorbent assay. RESULTS There were no significant differences regarding age, sex and other cardiovascular risk factors between groups. Also, mean body mass index values were similar. The rate of mitral annular calcification and left ventricular hypertrophy were significantly higher in patients with aortic sclerosis. Among laboratory variables, high-sensitive C-reactive protein (hsCRP) levels were significantly higher in patients with aortic sclerosis than in those without (4.0 ± 2.9 vs. 2.9 ± 2.3 mg/dl, P = 0.04). Adiponectin levels were found to be significantly lower in aortic sclerosis group than in controls (9.7 ± 4.4 vs. 11.7 ± 4.9 μg/ml, P = 0.034). In the whole group, adiponectin levels were significantly correlated with BMI (r = -0.22, P = 0.02), white blood cell count (r = -0.2, P = 0.03), hsCRP (r = -0.25, P = 0.008), total cholesterol (r = -0.18, P = 0.05), high-density lipoprotein (HDL) cholesterol (r = 0.31, P = 0.001) and triglyceride (r = -0.36, P < 0.001). CONCLUSION In patients with aortic sclerosis, serum adiponectin levels were significantly lower compared with those with normal aortic valves. Our findings suggested that adiponectin might play a role in the progression of degenerative aortic valve disease.
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Affiliation(s)
- Gizem Çabuk
- Department of Cardiology, Turkey Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
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11
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Markus MRP, Lieb W, Stritzke J, Siewert U, Troitzsch P, Koch M, Dörr M, Felix SB, Völzke H, Schunkert H, Baumeister SE. Light to Moderate Alcohol Consumption Is Associated With Lower Risk of Aortic Valve Sclerosis: The Study of Health in Pomerania (SHIP). Arterioscler Thromb Vasc Biol 2015; 35:1265-70. [PMID: 25767276 DOI: 10.1161/atvbaha.114.304831] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 02/22/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE In developed countries, sclerotic and calcific degeneration of the aortic valve is a common disorder showing pathophysiologic similarities with atherothrombotic coronary disease. Light to moderate alcohol consumption has been associated with a lower risk for atherothrombotic coronary disease and mortality. Whether alcohol consumption affects the development of aortic valve sclerosis (AVS) is not well known. In the present study, we aim to analyze the cross-sectional association between average daily alcohol consumption and AVS in the general population. APPROACH AND RESULTS We analyzed cross-sectional data from 2022 men and women, aged 45 to 81 years, from the population-based Study of Health in Pomerania. We used a computer-assisted interview that included beverage-specific questions about quantity and frequency of alcohol over the last 30 days to calculate the average quantity of alcohol consumption (in grams of ethanol per day). AVS was ascertained by echocardiography. The prevalence of AVS was 32.3%. Average daily alcohol intake displayed a J-type relation with AVS (fully adjusted P value: 0.005). Compared with individuals with an average consumption of 10 g of alcohol per day, multivariable-adjusted odds ratios were 1.60 (95% confidence interval, 1.19-2.14) among current abstainers and 1.56 (95% confidence interval, 1.01-2.41) among individuals with an average consumption of 60 g per day. CONCLUSIONS Our findings indicate that light to moderate alcohol consumption was associated with a lower odd of having AVS. Prospective data need to address whether alcohol consumption and related changes over time in several biological markers affect the progression of AVS.
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Affiliation(s)
- Marcello Ricardo Paulista Markus
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.).
| | - Wolfgang Lieb
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.)
| | - Jan Stritzke
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.)
| | - Ulrike Siewert
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.)
| | - Paulina Troitzsch
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.)
| | - Manja Koch
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.)
| | - Marcus Dörr
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.)
| | - Stephan Burkhard Felix
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.)
| | - Henry Völzke
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.)
| | - Heribert Schunkert
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.)
| | - Sebastian Edgar Baumeister
- From the Department of Internal Medicine B (M.R.P.M., M.D., S.B.F.), Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine (M.R.P.M., P.T., H.V., S.E.B.), and Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine (U.S.), University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany (M.R.P.M., M.D., S.B.F., H.V.); Institute of Epidemiology, Christian-Albrechts-University Kiel, Kiel, Germany (W.L., M.K.); Department of Cardiology, Asklepios North Sea Clinic, Westerland/Sylt, Germany (J.S.); Department of Cardiovascular Diseases, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (H.S.); DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (H.S.); and Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany (S.E.B.)
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12
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Šram M, Vrselja Z, Lekšan I, Ćurić G, Selthofer-Relatić K, Radić R. Epicardial Adipose Tissue Is Nonlinearly Related to Anthropometric Measures and Subcutaneous Adipose Tissue. Int J Endocrinol 2015; 2015:456293. [PMID: 26124828 PMCID: PMC4466489 DOI: 10.1155/2015/456293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 04/06/2015] [Indexed: 12/28/2022] Open
Abstract
Introduction. Adipose tissue is the largest endocrine organ, composed of subcutaneous (SAT) and visceral adipose tissue (VAT), the latter being highly associated with coronary artery disease (CAD). Expansion of epicardial adipose tissue (EAT) is linked to CAD. One way of assessing the CAD risk is with low-cost anthropometric measures, although they are inaccurate and cannot discriminate between VAT and SAT. The aim of this study is to evaluate (1) the relationship between EAT thickness, SAT thickness and anthropometric measures in a cohort of patients assessed at the cardiology unit and (2) determine predictive power of anthropometric measures and EAT and SAT thickness in establishment of CAD. Methods. Anthropometric measures were obtained from 53 CAD and 42 non-CAD patients. Vascular and structural statuses were obtained with coronarography and echocardiography, as well as measurements of the EAT and SAT thickness. Results. Anthropometric measures showed moderate positive correlation with EAT and SAT thickness. Anthropometric measures and SAT follow nonlinear S curve relationship with EAT. Strong nonlinear power curve relationship was observed between EAT and SAT thinner than 10 mm. Anthropometric measures and EAT and SAT were poor predictors of CAD. Conclusion. Anthropometric measures and SAT have nonlinear relationship with EAT. EAT thickness and anthropometric measures have similar CAD predictive value.
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Affiliation(s)
- Miroslav Šram
- Department of Cardiology, Clinic of Internal Medicine, Osijek University Hospital Centre, 31000 Osijek, Croatia
| | - Zvonimir Vrselja
- Department of Anatomy and Neuroscience, Faculty of Medicine, University of J.J. Strossmayer in Osijek, 31000 Osijek, Croatia
| | - Igor Lekšan
- Department of Cardiac Surgery, Clinic of Surgery, Osijek University Hospital, 31000 Osijek, Croatia
| | - Goran Ćurić
- DNA Laboratory, Department of Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, University of J.J. Strossmayer in Osijek, 31000 Osijek, Croatia
| | - Kristina Selthofer-Relatić
- Department of Cardiology, Clinic of Internal Medicine, Osijek University Hospital Centre, 31000 Osijek, Croatia
- Department of Internal Medicine, Faculty of Medicine, University of J.J. Strossmayer in Osijek, 31000 Osijek, Croatia
- *Kristina Selthofer-Relatić:
| | - Radivoje Radić
- Department of Anatomy and Neuroscience, Faculty of Medicine, University of J.J. Strossmayer in Osijek, 31000 Osijek, Croatia
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13
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Capoulade R, Mahmut A, Tastet L, Arsenault M, Bédard É, Dumesnil JG, Després JP, Larose É, Arsenault BJ, Bossé Y, Mathieu P, Pibarot P. Impact of Plasma Lp-PLA2 Activity on the Progression of Aortic Stenosis. JACC Cardiovasc Imaging 2015; 8:26-33. [DOI: 10.1016/j.jcmg.2014.09.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/12/2014] [Accepted: 09/22/2014] [Indexed: 02/05/2023]
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14
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Mathieu P, Boulanger MC, Després JP. Ectopic visceral fat: a clinical and molecular perspective on the cardiometabolic risk. Rev Endocr Metab Disord 2014; 15:289-98. [PMID: 25326657 DOI: 10.1007/s11154-014-9299-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Worldwide, cardiovascular diseases (CVDs) are a leading cause of mortality. While in many westernized societies there has been a decrease prevalence of smoking and that a special emphasis has been put on the urgency to control the, so called, classical risk factors, it is more and more recognized that there remains a residual risk, which contributes to the development of CVDs. Imaging studies conducted over two decades have highlighted that the accumulation of ectopic visceral fat is associated with a plethora of metabolic dysfunctions, which have complex and intertwined interactions and participate to the development/progression/events of many cardiovascular disorders. The contribution of visceral ectopic fat to the development of coronary artery disease (CAD) is now well established, while in the last several years emerging evidence has pointed out that accumulation of harmful ectopic fat is associated with other cardiovascular disorders such as calcific aortic valve disease (CAVD), atrial fibrillation and left ventricular dysfunction. We review herein the key molecular processes linking the accumulation of ectopic fat to the development of CVDs. We have attempted, whenever possible, to use a translational approach whereby the pathobiology processes are linked to clinical observations.
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Affiliation(s)
- Patrick Mathieu
- Institut de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, 2725 Chemin Ste-Foy, Québec, QC, G1V-4G5, Canada,
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15
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Capoulade R, Côté N, Mathieu P, Chan KL, Clavel MA, Dumesnil JG, Teo KK, Tam JW, Fournier D, Després JP, Pibarot P. Circulating levels of matrix gla protein and progression of aortic stenosis: a substudy of the Aortic Stenosis Progression Observation: Measuring Effects of rosuvastatin (ASTRONOMER) trial. Can J Cardiol 2014; 30:1088-95. [PMID: 25015689 DOI: 10.1016/j.cjca.2014.03.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 03/03/2014] [Accepted: 03/16/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Matrix γ-carboxyglutamate protein is an inhibitor of cardiovascular calcification. The objective of this substudy of the Aortic Stenosis Progression Observation: Measuring Effects of Rosuvastatin (ASTRONOMER) trial was to examine the relationship between total (ie, carboxylated [active] form + uncarboxylated [inactive] form) circulating desphosphorylated matrix γ-carboxyglutamate protein (dpMGP) level and the progression rate of aortic stenosis (AS). METHODS Among the patients included in the ASTRONOMER trial, 215 patients had measures of baseline circulating total dpMGP level and an echocardiographic follow-up (mean follow-up: 3.5 ± 1.3 years). Progression of AS was assessed according to the measurement of the annualized increase in peak aortic jet velocity. RESULTS In the whole cohort, baseline dpMGP level was associated with faster progression rate of peak aortic jet velocity (r = 0.16; P = 0.02) in individual analysis but not in multivariable analysis (P = 0.40). However, there was a significant interaction (P = 0.03) between dpMGP level and age, with respect to the effect on AS progression. After dichotomization according to median value of age (ie, 57 years old), total dpMGP level was associated with faster AS progression rate (r = 0.24; P = 0.008) in the younger patients, and this association remained significant in multivariable analysis (P = 0.04), but not in the older ones. The independent correlates of dpMGP level were fasting glucose (P = 0.009) and oxidized low-density lipoprotein (P = 0.01). CONCLUSIONS This is the first prospective study to demonstrate a relationship between increased circulating levels of total dpMGP and faster progression rate of AS in younger individuals. Future studies are needed to determine if dpMGP is simply a marker or a contributing factor to ectopic mineralization of aortic valve.
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Affiliation(s)
- Romain Capoulade
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Nancy Côté
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Patrick Mathieu
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Kwan L Chan
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Jean G Dumesnil
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Koon K Teo
- McMaster University, Hamilton, Ontario, Canada
| | - James W Tam
- St Boniface General Hospital, Winnipeg, Manitoba, Canada
| | - Dominique Fournier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Jean-Pierre Després
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
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Arsenault BJ, Boekholdt SM, Mora S, DeMicco DA, Bao W, Tardif JC, Amarenco P, Pedersen T, Barter P, Waters DD. Impact of high-dose atorvastatin therapy and clinical risk factors on incident aortic valve stenosis in patients with cardiovascular disease (from TNT, IDEAL, and SPARCL). Am J Cardiol 2014; 113:1378-82. [PMID: 24582532 DOI: 10.1016/j.amjcard.2014.01.414] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 01/03/2014] [Accepted: 01/03/2014] [Indexed: 02/04/2023]
Abstract
Clinical trials have not provided evidence for a role of statin therapy in reducing aortic valve stenosis (AVS) severity in patients with documented AVS. However, whether statin therapy could prevent the onset of AVS is unknown. Our objectives were (1) to compare the incidence rates of AVS among patients treated with high-dose versus usual-dose statin or placebo and (2) to identify clinical risk factors associated with the development of AVS. We conducted post hoc analyses in 23,508 participants from 3 large-scale multicenter atorvastatin randomized blinded clinical trials: Treating to New Targets, the Incremental Decrease in End Points Through Aggressive Lipid Lowering, and the Stroke Prevention by Aggressive Reduction in Cholesterol Levels. The main outcome measure was the incidence of clinical AVS over a median follow-up of 4.9 years (82 cases). Among patients who developed AVS, 39 (47.6%) were treated with atorvastatin 80 mg and 43 (52.4%) were treated with lower dose statin (atorvastatin 10 mg in Treating to New Targets, simvastatin 20 to 40 mg in Incremental Decrease in End Points Through Aggressive Lipid Lowering, or placebo in Stroke Prevention by Aggressive Reduction in Cholesterol Levels; hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.59 to 1.41, p=0.67). In multivariate analyses forcing treatment, sex, and race into the model, factors that were significantly associated with AVS included age (HR 2.17, 95% CI 1.61 to 2.93, p<0.0001 per 1-SD increment), diabetes (HR 1.67, 95% CI 1.00 to 2.80, p=0.05), vitamin K antagonist use (HR 3.25, 95% CI 2.06 to 5.16, p<0.0001), and previous statin use (HR 2.65, 95% CI 1.54 to 4.60, p=0.0008). In conclusion, random allocation to high-dose versus usual-dose statin therapy or placebo did not impact the incidence of AVS among patients without known AVS. Age, diabetes, vitamin K antagonists, and previous statin use were significant predictors of incident AVS in these high-risk patients.
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Affiliation(s)
- Benoit J Arsenault
- Montreal Heart Institute Research Center, Université de Montréal, Montreal, Canada
| | - S Matthijs Boekholdt
- Department of Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Samia Mora
- Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Jean-Claude Tardif
- Montreal Heart Institute Research Center, Université de Montréal, Montreal, Canada
| | - Pierre Amarenco
- Department of Neurology and Stroke Center, Bichat University Hospital, Paris, France
| | - Terje Pedersen
- Department of Biostatistics, Epidemiology and Health Economics, Oslo University Hospital, Ulleval, Oslo, Norway
| | - Philip Barter
- Centre for Vascular Biology, University of New South Wales, Sydney, Australia
| | - David D Waters
- San Francisco General Hospital, San Francisco, California.
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Kohen Avramoglu R, Laplante MA, Le Quang K, Deshaies Y, Després JP, Larose E, Mathieu P, Poirier P, Pérusse L, Vohl MC, Sweeney G, Ylä-Herttuala S, Laakso M, Uusitupa M, Marette A. The Genetic and Metabolic Determinants of Cardiovascular Complications in Type 2 Diabetes: Recent Insights from Animal Models and Clinical Investigations. Can J Diabetes 2013; 37:351-8. [PMID: 24500564 DOI: 10.1016/j.jcjd.2013.08.262] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 08/09/2013] [Accepted: 08/12/2013] [Indexed: 01/19/2023]
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18
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Zamorano JL, Gonçalves A. Adiponectin: A Novel Target for Aortic Stenosis Medical Treatment? Cardiology 2011; 118:248-50. [DOI: 10.1159/000329827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2011] [Indexed: 11/19/2022]
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19
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Mathieu P, Després JP, Pibarot P. The 'valvulo-metabolic' risk in calcific aortic valve disease. Can J Cardiol 2009; 23 Suppl B:32B-39B. [PMID: 17932585 DOI: 10.1016/s0828-282x(07)71008-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Calcific aortic stenosis (AS) has been considered a degenerative and unmodifiable process resulting from aging and 'wear and tear' of the aortic valve. Over the past decade, studies in the field of epidemiology, molecular biology and lipid metabolism have highlighted similarities between vascular atherosclerosis and calcific AS. In particular, work from the Quebec Heart Institute and from that of others has documented evidence of valvular infiltration by oxidized low-density lipoproteins and the presence of inflammatory cells, along with important tissue remodelling in valves explanted from patients with AS. Recent studies have also emphasized the role of visceral obesity in the development and progression of AS. In addition, visceral obesity, with its attendant metabolic complications, commonly referred to as the metabolic syndrome, has been associated with degenerative changes in bioprosthetic heart valves. The purpose of the present review is to introduce the concept of 'valvulo-metabolic risk' and to provide an update on the recent and important discoveries regarding the pathogenesis of heart valve diseases in relation to obesity, and to discuss how these novel mechanisms might translate into clinical practice.
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Affiliation(s)
- Patrick Mathieu
- Laboratoire d'Etudes Moléculaires des Valvulopathies, Groupe de Recherche en Valvulopathies, Laval Hospital Research Center/Quebec Heart Institute, Department of Surgery, Québec, Quebec.
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