One-year observation of inflammatory markers in patients with aortic valve stenosis.
OBJECTIVE
The study aim was to conduct an annual evaluation of plasma levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and antibodies against Chlamydia pneumoniae during a 12-month period following the natural course of aortic valve stenosis (AVS).


METHODS
A total of 60 patients with AVS and 14 control subjects underwent echocardiographic examinations at the start of the study period, and again after a 12-month follow up period. Subsequently, the AVS patients were allocated retrospectively to two groups (n = 30 in each) according to their echocardiographic parameters: patients who showed a progressive deterioration of valvular function (PAVS group); and those who showed a lack of such progression (LPAVS group). Plasma concentrations of CRP, TNF-alpha, IL-6, and antichlamydial IgA, IgG, and IgM antibodies were evaluated at the start of the study, and again during the 12th month.


RESULTS
During the study, CRP levels were increased only in the AVS group. TNF-alpha and IgM levels were higher in the AVS group compared to controls, at both the initial visit and the final observation. During the 12-month observation period the TNF-alpha level was increased in the PAVS group, whereas CRP levels in the LPAVS group were decreased. TNF-alpha levels were higher in the PAVS group than the LPAVS group, at both the initial visit and after 12 months; CRP levels did not differ between these groups. In the PAVS group, the IL-6 level was higher after 12 months, but the IgM level was higher at the initial visit. The results of a factorial analysis identified the main factors responsible for the decrease in aortic valve area to be TNF-alpha and CRP.


CONCLUSIONS
TNF-alpha, CRP, and IgM antichlamydial antibodies should be further investigated as potential predictive factors for the progression of AVS.
II Department of Cardiology, Jagiellonian University Medical College, Cracow, Poland. grasshoppers@interia.eu
Jolanta
J
Swierszcz
Jacek S
JS
Dubiel
Jozef
J
Krzysiek
Krystyna
K
Sztefko
D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D016993:Chlamydophila pneumoniae / Q000276:immunology; D004452:Echocardiography; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
D000907:Antibodies, Bacterial; D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein