title: Plasma fibulin-1 is linked to restrictive filling of the left ventricle and to mortality in patients with aortic valve stenosis.
abstract: BACKGROUND
  Plasma fibulin-1 levels have been associated with N-terminal pro-B-type natriuretic peptide levels and left atrial size and shown to be predictive of mortality in patients with diabetes. The mechanisms behind these connections are not fully understood but are probably related to its roles as an extracellular matrix protein in cardiovascular tissues.
  
  
  RESULTS
  One hundred twenty-five patients with severe aortic stenosis who were scheduled for aortic valve replacement (AVR) were evaluated with preoperative echocardiography and their plasma fibulin-1 levels were determined with ELISA. The cohort was followed for a median of 4 years after AVR. Increased restrictive left ventricular (LV) filling pattern was observed with increased plasma fibulin-1 levels (2% versus 29% versus 24% in low, middle, and high plasma fibulin-1 tertile groups, P=0.004). Likewise, reduced longitudinal systolic LV function (6.6 ± 1.1 versus 6.1 ± 1.3 versus 5.7 ± 1.5 cm/s, P=0.05) and increased LV filling pressures was systolic velocity of the mitral annulus observed with increasing plasma fibulin-1 concentrations (ratio of early transmitral flow velocity to early diastolic flow velocity of the mitral annulus 13 ± 4 versus 15 ± 5 versus 16 ± 6 in the fibulin-1 tertile groups, P=0.04).
  
  
  CONCLUSIONS
  In patients with symptomatic severe aortic stenosis undergoing AVR, plasma fibulin-1 is associated with restrictive filling of the LV, decreased longitudinal systolic function of the LV, and increased LV filling pressures.
  
  
  BACKGROUND
  URL: http://www.clinicaltrial.gov with Identifier: NCT00294775.
authors: Department of Cardiology, Odense University Hospital, Odense, Denmark. jordidahl@hotmail.com
authors: Jordi S
authors: JS
authors: Dahl
authors: Jacob E
authors: JE
authors: Møller
authors: Lars
authors: L
authors: Videbæk
authors: Mikael K
authors: MK
authors: Poulsen
authors: Torsten R
authors: TR
authors: Rudbæk
authors: Patricia A
authors: PA
authors: Pellikka
authors: W
authors: W
authors: Scott Argraves
authors: Lars Melholt
authors: LM
authors: Rasmussen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery; D001281:Atrial Fibrillation / Q000097:blood / Q000209:etiology; D002135:Calcium-Binding Proteins / Q000097:blood*; D015331:Cohort Studies; D004452:Echocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D002135:Calcium-Binding Proteins; C060820:fibulin
keywords: aortic valve stenosis; biomarkers; diastolic function; echocardiography