Regression of aortic valve stenosis by ApoA-I mimetic peptide infusions in rabbits.
OBJECTIVE
Aortic valve stenosis (AVS) is the most common valvular heart disease, and standard curative therapy remains open heart surgical valve replacement. The aim of our experimental study was to determine if apolipoprotein A-I (ApoA-I) mimetic peptide infusions could induce regression of AVS.


METHODS
Fifteen New Zealand White male rabbits received a cholesterol-enriched diet and vitamin D(2) until significant AVS was detected by echocardiography. The enriched diet was then stopped to mimic cholesterol-lowering therapy and animals were allocated randomly to receive saline (control group, n=8) or an ApoA-I mimetic peptide (treated group, n=7), three times per week for 2 weeks. Serial echocardiograms and post mortem valve histology were performed.


RESULTS
Aortic valve area increased significantly by 25% in the treated group after 14 days of treatment (P=0.012). Likewise, aortic valve thickness decreased by 21% in the treated group, whereas it was unchanged in controls (P=0.0006). Histological analysis revealed that the extent of lesions at the base of valve leaflets and sinuses of Valsalva was smaller in the treated group compared with controls (P=0.032). The treatment also reduced calcification, as revealed by the loss of the positive relationship observed in the control group (r=0.87, P=0.004) between calcification area and aortic valve thickness.


CONCLUSIONS
Infusions of ApoA-I mimetic peptide lead to regression of experimental AVS. These positive results justify the further testing of high-density lipoprotein (HDL)-based therapies in patients with valvular aortic stenosis. Regression of aortic stenosis, if achieved safely, could transform the clinical treatment of this disease.
Busseuil
D
D
Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
Shi
Y
Y
Mecteau
M
M
Brand
G
G
Kernaleguen
A-E
AE
Thorin
E
E
Latour
J-G
JG
Rhéaume
E
E
Tardif
J-C
JC
D000818:Animals; D001021:Aortic Valve / Q000473:pathology; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016632:Apolipoprotein A-I / Q000008:administration & dosage*; D002114:Calcinosis / Q000188:drug therapy*; D008076:Cholesterol, HDL / Q000378:metabolism; D004036:Diet, Atherogenic; D004195:Disease Models, Animal; D004452:Echocardiography; D008297:Male; D010455:Peptides / Q000008:administration & dosage*; D011817:Rabbits
D016632:Apolipoprotein A-I; D008076:Cholesterol, HDL; D010455:Peptides