Circulating Lp-PLA2 is associated with high valvuloarterial impedance and low arterial compliance in patients with aortic valve bioprostheses.
BACKGROUND
We previously reported that plasma Lp-PLA2 was associated with aortic valve disease progression and degeneration of bioprostheses. Low systemic arterial compliance and high valvuloarterial impedance (Z(va)) are predictors of poor survival in patients with aortic valve disease. However, the prevalence of high Z(va) after AVR is largely unknown and whether Lp-PLA2 could predict Z(va) has not been documented. We investigated the relationships between plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity and valvuloarterial impedance (Z(va)), an index of global LV hemodynamic load, in patients that underwent aortic valve replacement (AVR).


METHODS
A total of 195 patients with aortic bioprostheses underwent echocardiographic assessment of the prosthetic aortic valve function 8±3.4 years after AVR. Lp-PLA2 mass and activity were measured.


RESULTS
In this group of patients, the mean Z(va) was elevated (5.73±1.21 mm Hg·ml(-1)·m(2)). In univariate analyses, Lp-PLA2 mass (p=0.003) and Lp-PLA2 activity (p=0.046) were associated with Z(va). After adjustment for covariates including age, gender, clinical risk factors, anti-hypertensive medications, body mass index and prosthesis size, Lp-PLA2 mass was associated with high Z(va) (≥4.5 mm Hg·ml(-1)·m(2)) (OR: 1.29, 95%CI: 1.10-1.53; p=0.005) and was inversely related with the systemic arterial compliance (β=-0.01, SEM=0.003; p=0.003).


CONCLUSIONS
An increased Z(va), an index of excessive hemodynamic load, was highly prevalent 8-year post-AVR and was independently related to circulating Lp-PLA2.
['Mahmut|Ablajan|A|', 'Mahjoub|Haïfa|H|', 'Boulanger|Marie-Chloé|MC|', 'Dahou|Abdellaziz|A|', 'Bouchareb|Rihab|R|', 'Capoulade|Romain|R|', 'Arsenault|Benoît J|BJ|', 'Larose|Eric|E|', 'Bossé|Yohan|Y|', 'Pibarot|Philippe|P|', 'Mathieu|Patrick|P|']
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase D000368:Aged D000369:Aged, 80 and over D001021:Aortic Valve D001158:Arteries D003187:Compliance D005260:Female D006350:Heart Valve Prosthesis D006801:Humans D008297:Male
Lp-PLA2 Valvuloarterial impedance Arterial compliance Lipoprotein-associated phospholipase A2 Bioprosthesis Calcific aortic valve disease