C-reactive protein in degenerative aortic valve stenosis

Pedro L Sanchez, AnnaMaria Mazzone, Pedro L Sanchez, AnnaMaria Mazzone

Abstract

Degenerative aortic valve stenosis includes a range of disorder severity from mild leaflet thickening without valve obstruction, "aortic sclerosis", to severe calcified aortic stenosis. It is a slowly progressive active process of valve modification similar to atherosclerosis for cardiovascular risk factors, lipoprotein deposition, chronic inflammation, and calcification. Systemic signs of inflammation, as wall and serum C-reactive protein, similar to those found in atherosclerosis, are present in patients with degenerative aortic valve stenosis and may be expression of a common disease, useful in monitoring of stenosis progression.

References

    1. Mazzone A, Epistolato MC, De Caterina R, Storti S, Vittorini S, Sbrana S, Gianetti J, Bevilacqua S, Glauber M, Biagini A, Tanganelli P. Neoangiogenesis, T-lymphocyte infiltration, and heat shock protein-60 are biological hallmarks of an immunomediated inflammatory process in end-stage calcified aortic valve stenosis. J Am Coll Cardiol. 2004;43:1670–1676. doi: 10.1016/j.jacc.2003.12.041.
    1. Rajamannan NM, Gersh B, Bonow RO. Calcific aortic stenosis: from bench to the bedside – emerging clinical and cellular concepts. Heart. 2003;89:801–805. doi: 10.1136/heart.89.7.801.
    1. Freeman RV, Otto CM. Spectrum of calcific aortic valve disease: pathogenesis, disease progression, and treatment strategies. Circulation. 2005;111:3316–3326. doi: 10.1161/CIRCULATIONAHA.104.486738.
    1. O'Brien KD, Reichenbach DD, Marcovina SM, Kuusisto J, Alpers CE, Otto CM. Apolipoprotein B, (a), and E accumulate in the morphologically early lesion of degenerative valvular aortic stenosis. Arterioscler Thromb. 1996;16:523–532.
    1. Myers GL, Rifai N, Tracy RP, Roberts WL, Alexander RW, Biasucci LM, Catravas JD, Cole TG, Cooper GR, Khan BV, Kimberly MM, Stein EA, Taubert KA, Warnick GR, Waymack PP, CDC; AHA CDC/AHA: Workshop on Markers of Inflammation and Cardiovascular Disease: Application to Clinical and Public Health Practice: report from the laboratory science discussion group. Circulation. 2004;110:e545–549. doi: 10.1161/01.CIR.0000148980.87579.5E.
    1. Galante A, Pietroiusti A, Vellini M, Piccolo P, Possati G, De Bonis M, Grillo RL, Fontana C, Favalli C. C-reactive protein is increased in patients with degenerative aortic valvular stenosis. J Am Coll Cardiol. 2001;38:1078–1082. doi: 10.1016/S0735-1097(01)01484-X.
    1. Gunduz H, Akdemir R, Binak E, Tamer A, Keser N, Uyan C. Can serum lipid and CRP levels predict the "severity" of aortic valve stenosis? Acta Cardiol. 2003;58:321–326. doi: 10.2143/AC.58.4.2005289.
    1. Sanchez PL, Santos JL, Kaski JC, Cruz I, Arribas A, Villacorta E, Cascon M, Palacios IF, Martin-Luengo C, Grupo AORTICA (Grupo de Estudio de la Estenosis Aortica) Relation of circulating C-reactive protein to progression of aortic valve stenosis. Am J Cardiol. 2006;97:90–93. doi: 10.1016/j.amjcard.2005.07.113.
    1. Gerber IL, Stewart RA, Hammett CJ, Legget ME, Oxenham H, West TM, French JK, White HD. Effect of aortic valve replacement on c-reactive protein in nonrheumatic aortic stenosis. Am J Cardiol. 2003;92:1129–1132. doi: 10.1016/j.amjcard.2003.07.012.
    1. Agmon Y, Khandheria BK, Jamil Tajik A, Seward JB, Sicks JD, Fought AJ, O'Fallon WM, Smith TF, Wiebers DO, Meissner I. Inflammation, infection, and aortic valve sclerosis; Insights from the Olmsted County (Minnesota) population. Atherosclerosis. 2004;174:337–342.
    1. Warrier B, Mallipeddi R, Karla PK, Lee CH. The functional role of C-reactive protein in aortic wall calcification. Cardiology. 2005;104:57–64. doi: 10.1159/000086686.
    1. Kajbaf S, Veinot JP, Ha A, Zimmerman D. Comparison of surgically removed cardiac valves of patients with ESRD with those of the general population. Am J Kidney Dis. 2005;46:86–93. doi: 10.1053/j.ajkd.2005.03.020.
    1. Movilli E, Feliciani A, Camerini C, Brunori G, Zubani R, Scolari F, Parrinello G, Cancarini GC. A high calcium-phosphate product is associated with high C-reactive protein concentrations in hemodialysis patients. Nephron Clin Pract. 2005;101:c161–167. doi: 10.1159/000087391.
    1. Torun D, Sezer S, Baltali M, Adam FU, Erdem A, Ozdemir FN, Haberal M. Association of cardiac valve calcification and inflammation in patients on hemodialysis. Ren Fail. 2005;27:221–226.
    1. Skowasch D, Schrempf S, Preusse CJ, Likungu JA, Welz A, Luderitz B, Bauriedel G. Tissue-resident C-reactive protein within degenerative aortic valves: correlation with serum CRP levels and modification by statins. Heart. 2005, Sep 13.
    1. Lagrand WK, Visser CA, Hermens WT, Niessen HW, Verheugt FW, Wolbink GJ, Hack CE. C-reactive protein as a cardiovascular risk factor: more than an epiphenomenon? Circulation. 1999;100:96–102.
    1. Venugopal SK, Devaraj S, Yuhanna I, Shaul P, Jialal I. Demonstration that C-reactive protein decreases eNOS expression and bioactivity in human aortic endothelial cells. Circulation. 2002;106:1439–1441. doi: 10.1161/01.CIR.0000033116.22237.F9.
    1. Venugopal SK, Devaraj S, Jialal I. C-reactive protein decreases prostacyclin release from human aortic endothelial cells. Circulation. 2003;108:1676–1678. doi: 10.1161/01.CIR.0000094736.10595.A1.
    1. Palta S, Pai AM, Gill KS, Pai RG. New insights into the progression of aortic stenosis: implications for secondary prevention. Circulation. 2000;101:2497–2502.
    1. Otto CM, Burwash IG, Legget ME, Munt BI, Fujioka M, Healy NL, Kraft CD, Miyake-Hull CY, Schwaegler RG. A prospective study of asymptomatic valvular aortic stenosis: Clinical, echocardiographic, and exercise predictors of outcome. Circulation. 1997;95:2262–2270.
    1. Chandra HR, Goldstein JA, Choudhary N, O'Neill CS, George PB, Gangasani SR, Cronin L, Marcovitz PA, Hauser AM, O'Neill WW. Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation. J Am Coll Cardiol. 2004;43:169–175. doi: 10.1016/j.jacc.2003.08.036.
    1. Rajamannan NM, Subramaniam M, Springett M, Sebo TC, Niekrasz M, McConnell JP, Singh RJ, Stone NJ, Bonow RO, Spelsberg TC. Atorvastatin inhibits hypercholesterolemia-induced cellular proliferation and bone matrix production in the rabbit aortic valve. Circulation. 2002;105:2660–2665. doi: 10.1161/01.CIR.0000017435.87463.72.
    1. Rajamannan NM, Subramaniam M, Stock SR, Stone NJ, Springett M, Ignatiev KI, McConnell JP, Singh RJ, Bonow RO, Spelsberg TC. Atorvastatin inhibits calcification and enhances nitric oxide synthase production in the hypercholesterolaemic aortic valve. Heart. 2005;91:806–810. doi: 10.1136/hrt.2003.029785.
    1. Rajamannan NM, Subramaniam M, Caira F, Stock SR, Spelsberg TC. Atorvastatin inhibits hypercholesterolemia-induced calcification in the aortic valves via the Lrp5 receptor pathway. Circulation. 2005;112:I229–234.
    1. Aronow WS, Ahn C, Kronzon I, Goldman ME. Association of coronary risk factors and use of statins with progression of mild valvular aortic stenosis in older persons. Am J Cardiol. 2001;88:693–695. doi: 10.1016/S0002-9149(01)01821-5.
    1. Novaro GM, Tiong IY, Pearce GL, Lauer MS, Sprecher DL, Griffin BP. Effect of hydroxymethylglutaryl coenzyme A reductase inhibitors on the progression of calcific aortic stenosis. Circulation. 2001;104:2205–2209.
    1. Shavelle DM, Takasu J, Budoff MJ, Mao S, Zhao XQ, O'Brien KD. HMG CoA reductase inhibitor (statin) and aortic valve calcium. Lancet. 2002;359:1125–1126. doi: 10.1016/S0140-6736(02)08161-8.
    1. Bellamy MF, Pellikka PA, Klarich KW, Tajik AJ, Enriquez-Sarano M. Association of cholesterol levels, hydroxymethylglutaryl conezyme-A reductase treatment, and progression of aortic stenosis in the community. J Am Coll Cardiol. 2002;40:1723–1730. doi: 10.1016/S0735-1097(02)02496-8.
    1. Rosenhek R, Rader F, Loho N, Gabriel H, Heger M, Klaar U, Schemper M, Binder T, Maurer G, Baumgartner H. Statins but not angiotensinconverting enzyme inhibitors delay progression of aortic stenosis. Circulation. 2004;110:1291–1295. doi: 10.1161/01.CIR.0000140723.15274.53.
    1. Cowell SJ, Newby DE, Prescott RJ, Bloomfield P, Reid J, Northridge DB, Boon NA, Scottish Aortic Stenosis and Lipid Lowering Trial, Impact on Regression (SALTIRE) Investigators A randomized trial of intensive lipid-lowering therapy in calcific aortic stenosis. N Engl J Med. 2005;352:2389–2397. doi: 10.1056/NEJMoa043876.
    1. Rosenhek R. Statins for aortic stenosis. N Engl J Med. 2005;352:2441–2443. doi: 10.1056/NEJMe058070.
    1. Black S, Kushner I, Samols D. C-reactive protein. J Biologic Chem. 2004;279:48487–48490. doi: 10.1074/jbc.R400025200.
    1. Ledue TB, Rifai N. Preanalytic and analytic sources of variations in C-reactive protein measurement: implications for cardiovascular disease risk assessment. Clin Chem. 2003;49:1258–1271. doi: 10.1373/49.8.1258.
    1. Albert MA, Glynn RJ, Ridker PM. Plasma concentration of C-reactive protein and the calculated Framingham Coronary heart disease Risk Score. Circulation. 2003;108:161–165. doi: 10.1161/.

Source: PubMed

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