Lipoprotein(a), Oxidized Phospholipids, and Aortic Valve Microcalcification Assessed by 18F-Sodium Fluoride Positron Emission Tomography and Computed Tomography
Year: 2019
Type: article
Study design: Observational Study
Abstract: Background Lipoprotein(a) (Lp[a]) is the preferential lipoprotein carrier of oxidized phospholipids (OxPLs) and a well-established genetic risk factor for calcific aortic valve stenosis (CAVS). Whether Lp(a) predicts aortic valve microcalcification in individuals without CAVS is unknown. Our objective was to estimate the prevalence of elevated Lp(a) and OxPL levels in patients with CAVS and to determine if individuals with elevated Lp(a) but without CAVS have higher aortic valve microcalcification. Methods We recruited 214 patients with CAVS from Montreal and 174 patients with CAVS and 108 controls from Québec City, Canada. In a second group of individuals with high (≥75 nmol/L, n = 27) or low (<75 nmol/L, n = 28) Lp(a) levels, 18F-sodium fluoride positron emission tomography/computed tomography was performed to determine the difference in mean tissue-to-background ratio (TBR) of the aortic valve. Results Patients with CAVS had 62.0% higher Lp(a) (median = 28.7, interquartile range [8.2-116.6] vs 10.9 [3.6-28.8] nmol/L, P < 0.0001), 50% higher OxPL-apolipoprotein-B (2.2 [1.3-6.0] vs 1.1 [0.7-2.6] nmol/L, P < 0.0001), and 69.9% higher OxPL-apolipoprotein(a) (7.3 [1.8-28.4] vs 2.2 [0.8-8.4] nmol/L, P < 0.0001) levels compared with individuals without CAVS (all P < 0.0001). Individuals without CAVS but elevated Lp(a) had 40% higher mean TBR compared with individuals with low Lp(a) levels (mean TBR = 1.25 ± 0.23 vs 1.15 ± 0.11, P = 0.02). Conclusions Elevated Lp(a) and OxPL levels are associated with prevalent CAVS in patients studied in an echocardiography laboratory setting. In individuals with elevated Lp(a), evidence of aortic valve microcalcification by 18F-sodium fluoride positron emission tomography/computed tomography is present before the development of clinically manifested CAVS.
Source: CJC Open
Authors: Audrey-Anne Després, Nicolas Perrot, Anthony Poulin, Lionel Tastet, Mylène Shen, Hao Yu Chen, Raphaëlle Bourgeois, Mikaël Trottier, Michel Tessier, Jean Guimond, Maxime Nadeau, James C. Engert, Sébastien Thériault, Yohan Bossé, Joseph L. Witztum, Patrick Couture, Patrick Mathieu, Marc R. Dweck, Sotirios Tsimikas, George Thanassoulis, Philippe Pibarot, Marie-Annick Clavel, Benoit J. Arsenault
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,100
Funders: Amgen, Pfizer, Sanofi, Heart and Stroke Foundation of Canada, Ionis Pharmaceuticals, British Heart Foundation, National Institutes of Health, University of California, San Diego, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Canadian Institutes of Health Research, Fonds de Recherche du Québec - Santé, National Heart, Lung, and Blood Institute
Awards: G1176573702, Nucleolin Regulation of miRome by Shear Stress, G1780385220, G1958357183, G2229856676, Molecular Imaging of Platelets and Oxidative Stress in Atherosclerosis, G2680770050, G360079621, Immune Cells in Atherosclerosis and Vascular Disease, Modification of calcification activity and 18F-fluoride positron emission tomography uptake in cardiovascular disease, G5331384145, AIBP and Endothelial Function, G5704955928, G5852570041, G6205407, G6467796949, G7352890976, Molecular and Genetic Epidemiology of Lp(a)-mediated Calcific Aortic Valve Disease, Role of Immune Mechanisms in Athersclerosis and Inflammation, G8815928316, G896474620, G896480970
OpenAlex ID: W2937077063