title: Elevated proportion of small, dense low-density lipoprotein particles and lower adiponectin blood levels predict early structural valve degeneration of bioprostheses.
abstract: OBJECTIVE
  Long-term durability of bioprosthetic heart valves (BPs) are limited by structural valve degeneration (SVD) leading to stenosis and/or regurgitation. In this study, we sought to determine the metabolic markers associated with SVD.
  
  
  METHODS
  In a cohort of 220 patients with an aortic BP (mean follow-up of 2.5 ± 1.2 years), we compared the metabolic and blood lipid profile including the levels of adiponectin and the proportion of small, dense low-density lipoprotein (LDL) particles (%LDL(<)(255Å)) in individuals developing echocardiographic evidence of early BP hemodynamic dysfunction with subjects having no features of BP dysfunction.
  
  
  RESULTS
  Patients developing BP dysfunction (n = 69; 31.3%) had a tendency of higher triglyceride levels. Moreover, patients with BP dysfunction had an increased proportion of %LDL(<)(255Å). In multivariate linear regression analysis, after adjustment for age, gender, BP size and hypertension, the %LDL(<)(255Å) (p = 0.04) was significantly associated with BP dysfunction. In addition, patients with an elevated level of %LDL(<)(255Å) along with a decreased plasma adiponectin level were at a very high risk of developing early BP hemodynamic dysfunction (OR = 2.54, p = 0.04).
  
  
  CONCLUSIONS
  BP dysfunction is significantly associated with an increased proportion of small, dense LDL.
authors.affiliation: Laboratoire d'Études Moléculaires des Valvulopathies, Groupe de Recherche en Valvulopathies, Quebec Heart Institute/Hôpital Laval Research Center, Department of Surgery, Laval University, 2725 Chemin Ste-Foy, Québec, QC, Canada.
authors.forename: Rahul
authors.initials: R
authors.lastname: Shetty
authors.forename: Nicolas
authors.initials: N
authors.lastname: Girerd
authors.forename: Nancy
authors.initials: N
authors.lastname: Côté
authors.forename: Benoit
authors.initials: B
authors.lastname: Arsenault
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Després
authors.forename: Philippe
authors.initials: P
authors.lastname: Pibarot
authors.forename: Patrick
authors.initials: P
authors.lastname: Mathieu
mesh_terms: D052242:Adiponectin / Q000378:metabolism*; D000368:Aged; D001021:Aortic Valve; D001022:Aortic Valve Insufficiency / Q000097:blood / Q000209:etiology; D001024:Aortic Valve Stenosis / Q000097:blood / Q000209:etiology; D015415:Biomarkers / Q000378:metabolism; D001705:Bioprosthesis; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008077:Lipoproteins, LDL / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D011475:Prosthesis Failure
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D008077:Lipoproteins, LDL