Serum Osteoprotegerin in Patients with Calcified Aortic Valve Stenosis in Relation to Heart Failure

Makarović, Sandra; Makarović, Zorin; Bilić-Ćurčić, Ines; Mihaljević, Ivan; Franceschi, Maja; Jukić, Tomislav

doi:10.20471/acc.2017.56.04.22

Cited by 4 publications

(3 citation statements)

References 41 publications

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“…We found low levels of OPG in mechanical prostheses; in relation, this finding has been found that low levels of OPG lead to an osteoclastic transformation of the valve, 22 and on the other hand, there is a negative correlation between native AVA and OPG. 23 Increased ET-1 and endothelin receptor-A levels have been identified in patients with native AS, 24 and endothelin A and B receptors are located on the leaflets' tips and surface.…”

Section: Valvular Heart Diseasesupporting

confidence: 72%

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Bioprosthesis in aortic valve replacement: long-term inflammatory response and functionality

et al. 2022

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BackgroundThe evaluation of long-term inflammatory response and function in postoperative patients with aortic valve replacement (AVR) deserves special analysis because it is important to try to prevent reoperation and improve durability and functionality of the prostheses. It is our objectiveMethodsIn this study, we included a cohort of patients with aortic valve damage treated by AVR with mechanical prosthesis, bio prosthesis and we included a control group.ResultsWe found that IL-4 and osteopontin levels were higher in patients with mechanical vs biological prostheses (p=0.01 and p=0.04, respectively), osteoprotegerin (OPG) levels were decreased (p=0.01), women had lower levels of ET-1 and IL-6, (p=0.02) (p=0.04), respectively. Patients older than 60 years had decreased levels of IL-1ß p<0.001) and a higher concentration of IL-4 p<0.05). IL-1ß, OPG and TNFα were higher in patients with less than 5 years of evolution vs more than 10 years (p=0.004, p=0.02 and p=0.03, respectively). Factors such as age, gender, prosthetic and elevated IL-1B and ET-1 levels are associated with valve dysfunction prosthetic. These results indicate that the inflammatory involvement present prior to valve replacement may be perpetuated by various factors in the long term.ConclusionsThe findings provide us with the opportunity to effectively treat patients with AVR in the postoperative period, which could prolong the functionality of the bio prostheses.Trial registration numberNCT04557345.

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Section: Valvular Heart Diseasesupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Bioprosthesis in aortic valve replacement: long-term inflammatory response and functionality

et al. 2022

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“…We hypothesize that patients undergoing surgery of the aortic valve and/or thoracic aorta have a more profound immune response and are more prone to PPS. Calcified aortic stenosis has been linked with increased serum concentrations of potential inflammatory markers in previous studies ( 11 ). It would be interesting to prospectively investigate the efficacy of prophylactic treatment with colchicine or corticosteroids in this patient population, with analysis of the impact of age, sex and other comorbidities on the development of PPS.…”

Section: Discussionmentioning

confidence: 94%

Postpericardiotomy Syndrome Incidence, Diagnostic and Treatment Strategies: Experience at Two Collaborative Centers

Gabaldo

Sutlić

Mišković

et al. 2019

ACC

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SUMMARY Postpericardiotomy syndrome (PPS) is worsening or new formation of pericardial and/or pleural effusion mostly 1 to 6 weeks after cardiac surgery, as a result of autoimmune inflammatory reaction within pleural and pericardial space. Its incidence varies among different studies and registries (2% to 30%), as well as according to the type of cardiac surgery performed. We conducted this retrospective analysis of PPS incidence and diagnostic and treatment strategies in patients referred for cardiac surgery for revascularization, valvular and/or aortic surgery. We retrospectively analyzed 461 patients referred for an urgent or elective cardiac surgery procedure between 2009 and 2015. PPS diagnosis was established using well defined clinical criteria. Demographic and clinical characteristics were used in regression subanalysis among patients having undergone surgery of aortic valve and/or ascending aorta. Within 6 weeks after cardiac surgery, 47 (10.2%) patients had PPS. The median time from the procedure to PPS diagnosis was 14 days. The incidence of PPS was 26% after aortic valve and/or aorta surgery, and 7.9% and 8.3% after coronary bypass and mitral valve surgery, respectively. Among patients subjected to aortic valve and/or aortic surgery, regression analysis showed significant association of fever, C-reactive protein (CRP) elevation between 5 and 100 mg/L, urgent procedure and postoperative antibiotic use with PPS diagnosis, whereas younger age showed near-significant association. All patients had complete resolution of PPS, mostly after corticosteroid therapy, with only 2 cases of recurrent PPS that successfully resolved after colchicine therapy. Pleural drainage was indicated in 15 (32%) patients, whereas only one patient required pericardial drainage. In conclusion, PPS incidence in our retrospective analysis was similar to previous reports. Patients having undergone aortic valve and/or aortic surgery were most likely to develop PPS. The most relevant clinical criteria for diagnosis in these patients were fever, CRP elevation between 5 and 100 mg/L, and pericardial and/or pleural effusion formation or worsening 2 weeks after cardiac surgery.

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Osteoporosis Entwined with Cardiovascular Disease: The Implication of Osteoprotegerin and the Example of Statins

Deligiorgi

Panayiotidis

Siasos

et al. 2021

CMC

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: Beyond being epiphenomenon of shared epidemiological factors, the integration of osteoporosis (OP) with cardiovascular disease (CVD)− termed "calcification paradox"− reflects a continuum of aberrant cardiometabolic status. The present review provides background knowledge on "calcification paradox", focusing on the endocrine aspect of vasculature orchestrated by the osteoblastic molecular fingerprint of vascular cells, acquired via imbalance among established modulators of mineralization. Osteoprotegerin (OPG)–the well-established osteoprotective cytokine−has recently been shown to exert a vessel-modifying role. Prompted by this notion, the present review interrogates OPG as the potential missing link between OP and CVD. However, so far, the confirmation of this hypothesis is hindered by the equivocal role of OPG in CVD, being both proatherosclerotic and antiatherosclerotic. Further research is needed to illuminate whether OPG could be biomarker of the "calcification paradox". Moreover, the present review brings into prominence the dual role of statins−cardioprotective and osteoprotective− as potential illustration of the integration of CVD with OP. Considering that the statins-induced modulation of OPG is central to the statins-driven osteoprotective signalling, statins could be suggested as illustration of the role of OPG in the bone/vessels crosstalk, if further studies consolidate the contribution of OPG to the cardioprotective role of statins. Another outstanding issue that merits further evaluation is the inconsistency of the osteoprotective role of statins. Further understanding of the varying bone-modifying role of statins, likely attributed to the unique profile of different classes of statins defined by distinct physicochemical characteristics, may yield tangible benefits for treating simultaneously OP and CVD.

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Serum Osteoprotegerin in Patients with Calcified Aortic Valve Stenosis in Relation to Heart Failure

Cited by 4 publications

References 41 publications

Bioprosthesis in aortic valve replacement: long-term inflammatory response and functionality

Bioprosthesis in aortic valve replacement: long-term inflammatory response and functionality

Postpericardiotomy Syndrome Incidence, Diagnostic and Treatment Strategies: Experience at Two Collaborative Centers

Osteoporosis Entwined with Cardiovascular Disease: The Implication of Osteoprotegerin and the Example of Statins

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