Metals and Trace Elements in Calcified Valves in Patients with Acquired Severe Aortic Valve Stenosis: Is There a Connection with the Degeneration Process?

Identification of Circulating Inflammatory Proteins Associated with Calcific Aortic Valve Stenosis by Multiplex Analysis

Calcific aortic valve stenosis (CAVS) is characterized by increasing inflammation and progressive calcification in the aortic valve leaflets and is a major cause of death in the aging population. This study aimed to identify the inflammatory proteins involved in CAVS and provide potential therapeutic targets. We investigated the observational and causal associations of 92 inflammatory proteins, which were measured using affinity-based proteomic assays. Firstly, the case-control cohort identified differential proteins associated with the occurrence and progression of CAVS. Subsequently, we delved into exploring the causal impacts of these associated proteins through Mendelian randomization. This involved utilizing genetic instruments derived from cis-protein quantitative loci identified in genome-wide association studies, encompassing a cohort of over 400,000 individuals. Finally, we investigated the gene transcription and protein expression levels of inflammatory proteins by single-cell and immunohistochemistry analysis. Multivariate logistic regression and spearman's correlation analysis showed that five proteins showed a significant positive correlation with disease severity. Mendelian randomization showed that elevated levels of two proteins, namely, matrix metallopeptidase-1 (MMP1) and sirtuin 2 (SIRT2), were associated with an increased risk of CAVS. Immunohistochemistry and single-cell transcriptomes showed that expression levels of MMP1 and SIRT2 at the tissue and cell levels were significantly higher in calcified valves than in non-calcified control valves. These findings indicate that MMP1 and SIRT2 are causally related to CAVS and open up the possibility for identifying novel therapeutic targets.

The Role of Trace Elements in Cardiovascular Diseases

Essential trace elements play an important role in human physiology and are associated with various functions regulating cellular metabolism. Non-essential trace elements, on the other hand, often have well-documented toxicities that are dangerous for the initiation and development of diseases due to their widespread occurrence in the environment and their accumulation in living organisms. Non-essential trace elements are therefore regarded as serious environmental hazards that are harmful to health even in low concentrations. Many representatives of these elements are present as pollutants in our environment, and many people may be exposed to significant amounts of these substances over the course of their lives. Among the most common non-essential trace elements are heavy metals, which are also associated with acute poisoning in humans. When these elements accumulate in the body over years of chronic exposure, they often cause severe health damage in a variety of tissues and organs. In this review article, the role of selected essential and non-essential trace elements and their role in the development of exemplary pathophysiological processes in the cardiovascular system will be examined in more detail.

The Diagnostic Value of Trace Metal Concentrations in Hair in Carotid Artery Disease

Several studies showed the role of trace elements in the increase in human susceptibility to cardiovascular diseases. Carotid artery stenosis is a leading cause of ischemic neurological events. We aimed to analyze the potential role of trace elements in hair as biomarkers of atherosclerotic carotid artery disease. Materials and Methods: Fifty-seven (n = 31 (54%) men and n = 26 (46%) women) individuals with a mean age of 67.7 ± 7.7 years who were white, European, non-Hispanic, and non-Latino were diagnosed and treated in hypertensiology/internal medicine and surgical departments over three consecutive months. Of these patients, forty were diagnosed with advanced carotid artery disease, and seventeen comprised a group of healthy controls. Inflammatory and oncological diseases were exclusion criteria. Hair samples were collected, and 14 trace elements were analyzed. Clinical and laboratory data were compared and revealed differences in the co-existence of diabetes (p = 0.036) and smoking history (p = 0.041). In the multivariable analysis, zinc, chrome, and copper revealed predictive value for the occurrence of carotid artery disease, and their combined receiver operating curve showed area under the curve of 0.935, with a sensitivity of 95% and a specificity of 82.4%. Conclusion: Our report shows the significance of trace elements analyses in patients with advanced carotid artery disease. We revealed that zinc, copper, and chrome concentrations are of particular importance in differentiating atherosclerotic disease and may serve as biomarkers of carotid atherosclerosis. Hair samples represent an easily obtained and beneficial biomatrix for the assessment of biomarkers.