title: In vivo aortic valve thermal heterogeneity in patients with nonrheumatic aortic valve stenosis the: first in vivo experience in humans.
abstract: OBJECTIVE
  We investigated in vivo in aortic valve stenosis (AVS) whether there is: 1) thermal heterogeneity within the valve leaflets; 2) temperature difference between the leaflets and the ascending aortic wall; and 3) a possible correlation between heat production, inflammation, and neoangiogenesis.
  
  
  BACKGROUND
  Histological studies have demonstrated a potential role of inflammation and neoangiogenesis in AVS.
  
  
  METHODS
  We examined 96 leaflets scheduled for aortic valve replacement. Twenty-five patients had AVS, and 7 had aortic valve insufficiency (AVI). Temperature measurements were performed right before hypothermic cardioplegia. Temperature difference (DeltaT) was assigned as the mean temperature of each leaflet minus the temperature of the aortic wall. Histological, immunohistological analysis, and vascular endothelial growth factor (VEGF) immunoreactivity was performed.
  
  
  RESULTS
  Significant thermal heterogeneity was recorded within the leaflets of AVS, compared with AVI (1.52 +/- 1.35 degrees C vs. 0.13 +/- 0.11 degrees C, p < 0.01). In AVS DeltaT was greater in all leaflets compared with the AVI group (p < 0.01). Leaflets of AVS had increased inflammatory cell infiltration, calcium deposit, and anti-VEGF expression compared with AVI (p < 0.01).
  
  
  CONCLUSIONS
  Thermal heterogeneity is increased in AVS and correlates with inflammatory mononuclear cell infiltration, expression of pro-inflammatory cytokines and neoangiogenic factors.
authors: First Department of Cardiology, Hippokration Hospital, Athens, Greece. ktoutouz@otenet.gr
authors: Konstantinos
authors: K
authors: Toutouzas
authors: Maria
authors: M
authors: Drakopoulou
authors: Andreas
authors: A
authors: Synetos
authors: Eleftherios
authors: E
authors: Tsiamis
authors: George
authors: G
authors: Agrogiannis
authors: Nikolaos
authors: N
authors: Kavantzas
authors: Eustratios
authors: E
authors: Patsouris
authors: Dimitris
authors: D
authors: Iliopoulos
authors: Stergios
authors: S
authors: Theodoropoulos
authors: Magdi
authors: M
authors: Yacoub
authors: Christodoulos
authors: C
authors: Stefanadis
mesh_terms: D000368:Aged; D001011:Aorta; D001024:Aortic Valve Stenosis / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D001831:Body Temperature; D016022:Case-Control Studies; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D022722:Thermogenesis / Q000502:physiology*; D013817:Thermography
chemical_list: D016207:Cytokines