Association between plasma LDL particle size, valvular accumulation of oxidized LDL, and inflammation in patients with aortic stenosis
Association between plasma LDL particle size, valvular accumulation of oxidized LDL, and inflammation in patients with aortic stenosis
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DOI：
10.1161/atvbaha.107.154989
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发表时间：
2008-01-01
影响因子：
8.7
通讯作者：
Mathieu, Patrick
中科院分区：
文献类型：
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作者：
Mohty, Dania;Pibarot, Philippe;Mathieu, Patrick
目的：研究重度主动脉瓣狭窄（AS）患者主动脉瓣内氧化型低密度脂蛋白（oxLDL）含量与炎症和重构程度的关系;（2）血浆中小而致密的LDL颗粒的比例和瓣膜中oxLDL的存在沿着瓣膜狭窄的血流动力学进展。我们检查了102个植入的AS瓣膜。组织重塑，炎症，oxLDL的积累进行了测定。获得完整的血浆脂质谱，包括测量小低密度脂蛋白（% LDL < 255埃）的相对比例。oxLDL含量较高的瓣膜具有显著较高的炎性细胞密度、肿瘤坏死因子（TNF）-α表达和组织重塑评分。< 255埃的LDL %与主动脉瓣内oxLDL评分显著相关。在59名测量狭窄进展的患者中，% LDL < 255埃与年峰值梯度相关（r = 0.29; P = 0.04）。结论-循环小密度LDL颗粒比例增加与狭窄进展速度加快和主动脉瓣中oxLDL积累增加相关。这些研究结果表明，旨在降低AS患者小而致密的LDL颗粒产生的治疗干预可能是一种潜在的有趣治疗途径。
Objective - In patients with severe aortic stenosis ( AS), we examine the association between: ( 1) the content of oxidized LDL (oxLDL) in the aortic valve and the degree of inflammation and remodeling; (2) The proportion of small dense LDL particles in the plasma and the presence of oxLDL in the valve along with hemodynamic progression of valve stenosis.Methods and Results - We have examined 102 explanted AS valves. Tissue remodeling, inflammation, and accumulation of oxLDL were determined. A complete plasma lipid profile including the measurement of the relative proportion of small low-density lipoprotein (% LDL < 255 angstrom) was obtained. Valves with higher oxLDL content had a significantly higher density of inflammatory cells, expression of tumor necrosis factor (TNF)-alpha, and increased tissue remodeling score. The % LDL < 255 angstrom was significantly associated with oxLDL score within the aortic valve. In a subset of 59 patients in whom stenosis progression was measured, the % LDL < 255 angstrom correlated with the annualized peak gradient (r = 0.29; P = 0.04).Conclusion - Increased proportion of circulating small dense LDL particles is associated with faster progression rate of stenosis and greater accumulation of oxLDL in the aortic valve. These findings suggest that therapeutic interventions aimed at lowering the production of small dense LDL particles in patients with AS might represent a potentially interesting therapeutic avenue.