title: Hypoadiponectinemia is associated with valvular inflammation and faster disease progression in patients with aortic stenosis.
abstract: OBJECTIVE
  Adiponectin is a protein secreted by adipocytes which has anti-inflammatory properties. The objective of this study was to examine the relationship between adiponectinemia and the hemodynamic progression of aortic stenosis (AS) as well as the degree of inflammation in the valve explanted at the time of aortic valve replacement (AVR).
  
  
  METHODS
  The plasma level of adiponectin was measured in 122 patients undergoing AVR. The explanted aortic valves were analyzed and the density of leukocytes (CD45+), T cells (CD3+) and blood vessels (von Willebrand factor positive; vWF+) was documented. Also, a subset of patients (n = 67) had ≥2 echocardiographic studies separated by at least 6 months, thereby allowing assessment of the rate of progression of stenosis during the preoperative period.
  
  
  RESULTS
  Patients with lower plasma levels of adiponectin (<5.4 μg/ml) had a faster progression rate of the mean transvalvular gradient before surgery than those with higher levels (9 ± 1 vs. 4 ± 1 mm Hg/year; p = 0.008). Moreover, these patients with hypoadiponectinemia had significantly more leukocytes (CD45+), T cells and blood vessels (vWF+) in their explanted valves compared to those with higher adiponectin levels.
  
  
  CONCLUSIONS
  These findings support the concept that adiponectin may play a protective role against the inflammatory process and progression of calcific AS.
authors: Laboratoire d'Études Moléculaires des Valvulopathies, Groupe de Recherche en Valvulopathies, Laval Hospital Research Center/Quebec Heart Institute, Department of Surgery, Laval University, Québec City, Qué., Canada.
authors: D
authors: D
authors: Mohty
authors: P
authors: P
authors: Pibarot
authors: N
authors: N
authors: Côté
authors: A
authors: A
authors: Cartier
authors: A
authors: A
authors: Audet
authors: J P
authors: JP
authors: Després
authors: P
authors: P
authors: Mathieu