Calcified aortic valve disease complicated with and without diabetes mellitus: the underlying pathogenesis

Chen, Yujia; Xiao, Feng; Wang, Ruxing

doi:10.31083/j.rcm2301007

Cited by 7 publications

(7 citation statements)

References 72 publications

(87 reference statements)

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“…2 / (p1 − p2) 2 . The sample size for the impaired GLS group and the normal GLS group was calculated by software PASS 15 (NCSS, Kaysville, UT, USA).…”

Section: Sample Sizementioning

confidence: 99%

“…Valvular heart disease is a frequent cardiovascular disease, with a prevalence of 5.3%-7.7% in Chinese population [1]. Heart valve surgery is an effective treatment for severe valvular disease [2]. Conversely, valvular surgery may cause myocardial damage and aberrant ventricular wall motion, leading to postoperative complications such as hemodynamic instability and arrhythmias that require inotropic drugs to maintain hemodynamic stability.…”

Section: Introductionmentioning

confidence: 99%

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Association between Left Ventricular Longitudinal Strain (GLS) and Prognosis of the Patients Undergoing Heart Valve Surgery with Preserved Left Ventricular Ejection Fraction

Xue,

Chen,

Xiao

et al. 2023

HSF

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Purpose: Global longitudinal strain (GLS) seems accurate for detecting subclinical myocardial dysfunction. This study aimed to determine the association between GLS and postoperative intensity of inotropic support in the patients undergoing heart valve surgery with preserved left ventricular ejection fraction. Methods: 74 patients with preserved left ventricular ejection fraction who underwent valve surgery during the period between March 2021 and June 2022 were included in this prospective observational study. Transthoracic echocardiography including strain analysis with speckle tracking was performed before surgery. Patients were stratified according to the left ventricle (LV) GLS: LV-GLS ≥–16% (Impaired GLS group) and LV-GLS <–16% (Normal GLS group). The primary endpoint was postoperative vasoactive inotropic score. A high vasoactive inotropic score (VIS) was defined as a maximum VIS of ≥15 within 24 hours postoperatively. Postoperative adverse events, baseline clinical and echocardiographic data were also recorded. We invested the ability of preoperative GLS in predicting adverse postoperative outcomes, such as prolonged mechanical ventilation and the need for pharmacologic hemodynamic support after cardiac surgery. Results: Seventy-four patients were included and analyzed in this study, including thirty-three in impaired GLS group and forty-one in normal GLS group. In-hospital mortality was 1.27% (1/74). Patients in impaired GLS group were more likely to have prolonged mechanical ventilation (p = 0.041). Multivariable logistic regression analysis revealed that the apical four-chamber view of the left ventricle (A4C)-GLS was significantly associated with high VIS (OR 1.373, p = 0.007). A4C-GLS had a sensitivity of 62.5% and a specificity of 89.66% for predicting high VIS (area under the curve, 0.78). The relationships between GLS and other secondary outcome measures were not statistically significant. The optimal cutoff of A4C-GLS for postoperative high vasoactive inotropic score was –10.85%. Conclusion: Preoperative LV dysfunction is an independent risk factor for postoperative high VIS. A4C-GLS may be a reliable tool in predicting high VIS after cardiac surgery. Those patients with impaired contractility were at high risk for elevated inotropic support and prolonged mechanical ventilation after cardiac surgery. These findings suggest an important role for echocardiographic GLS in perioperative assessment of cardiac function in the patients undergoing cardiac surgery.

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“…2 / (p1 − p2) 2 . The sample size for the impaired GLS group and the normal GLS group was calculated by software PASS 15 (NCSS, Kaysville, UT, USA).…”

Section: Sample Sizementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between Left Ventricular Longitudinal Strain (GLS) and Prognosis of the Patients Undergoing Heart Valve Surgery with Preserved Left Ventricular Ejection Fraction

Xue,

Chen,

Xiao

et al. 2023

HSF

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“…Calcific aortic valve disease (CAVD) is the most common cardiovascular disease ( 1 ). As longevity increases and lifestyles adapt, the incidence of CAVD has risen notably, which could lead to aortic stenosis and heart failure ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Investigation of autophagy‑related genes and immune infiltration in calcific aortic valve disease: A bioinformatics analysis and experimental validation

Hu,

Jiang,

Yang

et al. 2024

Exp Ther Med

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The present study aimed to elucidate the role of autophagy-related genes (ARGs) in calcific aortic valve disease (CAVD) and their potential interactions with immune infiltration via experimental verification and bioinformatics analysis. A total of three microarray datasets (GSE12644, GSE51472 and GSE77287) were obtained from the Gene Expression Omnibus database, and gene set enrichment analysis was performed to identify the relationship between autophagy and CAVD. After differentially expressed genes and differentially expressed ARGs (DEARGs) were identified using CAVD samples and normal aortic valve samples, a functional analysis was performed, including Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses, protein-protein interaction network construction, hub gene identification and validation, immune infiltration and drug prediction. The results of the present study indicated a significant relationship between autophagy and CAVD. A total of 46 DEARGs were identified. GO and pathway enrichment analyses revealed the complex roles of DEARGs in regulating CAVD, including multiple gene functions and pathways. A total of 10 hub genes were identified, with three (SPP1, CXCL12 and CXCR4) consistently upregulated in CAVD samples compared with normal aortic valve samples in multiple datasets and experimental validation. Immune infiltration analyses demonstrated significant differences in immune cell proportions between CAVD samples and normal aortic valve samples, thus showing the crucial role of immune infiltration in CAVD development. Furthermore, therapeutic drugs were predicted that could target the identified hub genes, including bisphenol A, resveratrol, progesterone and estradiol. In summary, the present study illuminated the crucial role of autophagy in CAVD development and identified key ARGs as potential therapeutic targets. In addition, the observed immune cell infiltration and predicted autophagy-related drugs suggest promising avenues for future research and novel CAVD treatments.

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“…The aortic valve microenvironment mainly includes valvular interstitial cells, valvular endothelial cells, and immune cells (7). Recent evidence suggests that CAVD is an active process involving multiple complex pathological factors such as valvular endothelial cell injury, valvular interstitial cell differentiation, chronic inflammation, fibrosis, matrix remodeling, mechanical stress, and neovascularization (1,(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

“…As the most prevalent valvular heart disease, calcific aortic valve disease (CAVD) is a major health problem with risk of severe morbidity and mortality ( 1 ). It ranges from valve thickening and mildly calcified to severe valve calcification with impaired leaflet motion and vast blood flow obstruction ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Shared gene characteristics and molecular mechanisms of macrophages M1 polarization in calcified aortic valve disease

Qin

Chen²,

Li³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundCAVD is a common cardiovascular disease, but currently there is no drug treatment. Therefore, it is urgent to find new and effective drug therapeutic targets. Recent evidence has shown that the infiltration of M1 macrophages increased in the calcified aortic valve tissues, but the mechanism has not been fully elucidated. The purpose of this study was to explore the shared gene characteristics and molecular mechanisms of macrophages M1 polarization in CAVD, in order to provide a theoretical basis for new drugs of CAVD.MethodsThe mRNA datasets of CAVD and M1 polarization were downloaded from Gene Expression Omnibus (GEO) database. R language, String, and Cytoscape were used to analyze the functions and pathways of DEGs and feature genes. Immunohistochemical staining and Western Blot were performed to verify the selected hub genes.ResultsCCR7 and GZMB were two genes appeared together in hub genes of M1-polarized and CAVD datasets that might be involved in the process of CAVD and macrophages M1 polarization. CCR7 and CD86 were significantly increased, while CD163 was significantly decreased in the calcified aortic valve tissues. The infiltration of M1 macrophages was increased, on the contrary, the infiltration of M2 macrophages was decreased in the calcified aortic valve tissues.ConclusionThis study reveals the shared gene characteristics and molecular mechanisms of CAVD and macrophages M1 polarization. The hub genes and pathways we found may provide new ideas for the mechanisms underlying the occurrence of M1 polarization during CAVD process.

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Calcified aortic valve disease complicated with and without diabetes mellitus: the underlying pathogenesis

Cited by 7 publications

References 72 publications

Association between Left Ventricular Longitudinal Strain (GLS) and Prognosis of the Patients Undergoing Heart Valve Surgery with Preserved Left Ventricular Ejection Fraction

Association between Left Ventricular Longitudinal Strain (GLS) and Prognosis of the Patients Undergoing Heart Valve Surgery with Preserved Left Ventricular Ejection Fraction

Investigation of autophagy‑related genes and immune infiltration in calcific aortic valve disease: A bioinformatics analysis and experimental validation

Shared gene characteristics and molecular mechanisms of macrophages M1 polarization in calcified aortic valve disease

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