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Inflammation Is Associated with the Remodeling of Calcific Aortic Valve Disease

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Abstract

Calcific aortic valve disease (CAVD) is the most frequent heart valve disorder. Studies indicate that mineralization of the aortic valve may be related to the inflammatory process. However, no clear evidence has been given regarding clinical evolution of aortic stenosis and the inflammatory process within the aortic valve. Aortic valves excised from 285 patients with CAVD undergoing aortic valve replacement were analyzed for the presence of chronic inflammatory infiltrates, and those findings were related to the hemodynamic severity of aortic stenosis. In a subset of 57 patients, in whom additional valvular tissue and the clinical progression rate of aortic stenosis were available, the density of leukocytes was determined as well as the number of TNF-α transcripts. Histological analyses revealed that in 81 (28.4 %) patients, the presence of chronic inflammatory infiltrates was documented within CAVD tissue, which was characterized by the existence of a cluster of cells as well as the presence of neovascularisation and osseous metaplasia. The presence of an inflammatory process within the CAVD tissue was independently related to the remodeling process and the peak transaortic gradient. In addition, the density of leukocytes within CAVD tended to correlate (r = 0.25, p = 0.05) with the progression rate of aortic stenosis. Dense inflammatory infiltrate within CAVD is associated with an active remodeling process, the severity of aortic stenosis, and the hemodynamic progression rate.

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Acknowledgments

This study was supported by CIHR grants MOP114893 and MOP79342 and the Heart and Stroke Foundation of Canada (HSFC). N. Coté is a recipient of a doctoral research award from the Fonds de Recherche du Québec–Santé (FRQS). Y. Bossé is a research scholar from the HSFC. P. Pibarot holds the Canada Research Chair in Valvular Heart Diseases. P. Mathieu is a research scholar from the FRQS.

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Authors and Affiliations

  1. Laboratoire d’Études Moléculaires des Valvulopathies (LEMV), Groupe de Recherche en Valvulopathies (GRV), Quebec Heart and Lung Institute/Research Center, Department of Surgery, Laval University, Quebec, Canada

    Nancy Coté, Ablajan Mahmut, Marie-Chloé Boulanger, Dominique Fournier & Patrick Mathieu

  2. Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, 2725 Chemin Ste-Foy, Québec, QC, Canada, G1V 4G5

    Yohan Bosse, Christian Couture, Sylvain Pagé, Sylvain Trahan, Philippe Pibarot & Patrick Mathieu

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  1. Nancy Coté
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  2. Ablajan Mahmut
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  3. Yohan Bosse
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  4. Christian Couture
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  5. Sylvain Pagé
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  7. Marie-Chloé Boulanger
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  8. Dominique Fournier
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  9. Philippe Pibarot
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  10. Patrick Mathieu
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Correspondence to Patrick Mathieu.

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Coté, N., Mahmut, A., Bosse, Y. et al. Inflammation Is Associated with the Remodeling of Calcific Aortic Valve Disease. Inflammation 36, 573–581 (2013). https://doi.org/10.1007/s10753-012-9579-6

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  • DOI: https://doi.org/10.1007/s10753-012-9579-6

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