title: Relation of circulating C-reactive protein to progression of aortic valve stenosis.
abstract: C-reactive protein (CRP) is a marker of inflammation and predicts outcome in apparently healthy subjects and patients with coronary artery disease. Systemic inflammation is present in patients with aortic valve stenosis (AS). The aim of this prospective study was to assess whether CRP levels predict the progression of AS severity. Blood samples for high-sensitivity CRP measurements and echocardiographic data were obtained in 43 patients (70% men; mean age 73 +/- 8 years) with asymptomatic degenerative AS at study entry. On the basis of repeat echocardiographic assessment at 6 months, patients were grouped as (1) slow progressors (a decrease in aortic valve area [AVA] <0.05 cm2 and/or an increase in aortic peak velocity <0.15 m/s) and (2) rapid progressors (a decrease in AVA > or =0.05 cm2 and/or an increase in aortic peak velocity > or =0.15 m/s). Plasma CRP levels were significantly higher in rapid progressors than slow progressors (median 5.1 [range 2.3 to 11.3] vs 2.1 [range 1.0 to 3.1] mg/L, p = 0.007). In multivariate analysis, CRP levels >3 mg/L were independently associated with rapid AS progression (odds ratio 9.1, 95% confidence interval 2.2 to 37.3). In conclusion, CRP levels are higher in patients with degenerative AS who show rapid valve disease progression. These findings suggest that inflammation may have a pathogenic role in degenerative AS.
authors.affiliation: Instituto de Ciencias del Corazón, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. pedrolsanchez@secardiologia.es
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Sánchez
authors.forename: Jose L
authors.initials: JL
authors.lastname: Santos
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Kaski
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cruz
authors.forename: Antonio
authors.initials: A
authors.lastname: Arribas
authors.forename: Eduardo
authors.initials: E
authors.lastname: Villacorta
authors.forename: Manuel
authors.initials: M
authors.lastname: Cascon
authors.forename: Igor F
authors.initials: IF
authors.lastname: Palacios
authors.forename: Candido
authors.initials: C
authors.lastname: Martin-Luengo
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000000981:diagnostic imaging*; D001783:Blood Flow Velocity; D002097:C-Reactive Protein / Q000032:analysis*; D002114:Calcinosis / Q000097:blood / Q000000981:diagnostic imaging; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D002097:C-Reactive Protein