title: Angiotensin receptor blockers are associated with reduced fibrosis and interleukin-6 expression in calcific aortic valve disease.
abstract: BACKGROUND
  Calcific aortic valve disease (CAVD) is a chronic disorder characterized by the mineralization of the aortic valve and involving fibrosis.
  
  
  OBJECTIVE
  In this work we sought to determine if the fibrotic component of the remodeling process of CAVD was related to the use of angiotensin-converting enzyme inhibitors (ACEi) and/or angiotensin receptor blockers (ARBs).
  
  
  METHODS
  In 477 patients with CAVD, the aortic valve was examined by histology. A semiquantitative score of fibrosis was generated and associations with clinical/cardiometabolic variables examined. In a subset of 103 patients the aortic valve was available to study the infiltration by inflammatory cells and expression of interleukin-6 (IL-6) by quantitative real-time PCR.
  
  
  RESULTS
  The fibrosis score of the aortic valve was independently related to the hemodynamic severity of CAVD measured by echocardiography. The fibrotic score of the aortic valve was also related to the expression of IL-6. The use of ARBs but not of ACEi was associated with a lower fibrosis score of the aortic valve even after correction for covariates. In addition, patients under ARBs had lower aortic valve inflammation and expression of IL-6.
  
  
  CONCLUSIONS
  These findings suggest that ARBs may alter the fibrotic process of the aortic valve in CAVD, possibly by lowering tissue inflammation.
authors: Laboratoire d'Études Moléculaires des Valvulopathies, Groupe de Recherche en Valvulopathies, Quebec Heart and Lung Institute Research Center, Department of Surgery, Quebec, Que., Canada.
authors: Nancy
authors: N
authors: Côté
authors: Ablajan
authors: A
authors: Mahmut
authors: Dominique
authors: D
authors: Fournier
authors: Marie-Chloé
authors: MC
authors: Boulanger
authors: Christian
authors: C
authors: Couture
authors: Jean-Pierre
authors: JP
authors: Després
authors: Sylvain
authors: S
authors: Trahan
authors: Yohan
authors: Y
authors: Bossé
authors: Sylvain
authors: S
authors: Pagé
authors: Philippe
authors: P
authors: Pibarot
authors: Patrick
authors: P
authors: Mathieu
mesh_terms: D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D001021:Aortic Valve / Q000276:immunology / Q000473:pathology; D000082882:Bicuspid Aortic Valve Disease; D002114:Calcinosis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology*; D005260:Female; D005355:Fibrosis; D006330:Heart Defects, Congenital / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology*; D006349:Heart Valve Diseases / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D015850:Interleukin-6 / Q000032:analysis / Q000096:biosynthesis*; D008297:Male; D060888:Real-Time Polymerase Chain Reaction
chemical_list: D057911:Angiotensin Receptor Antagonists; C508600:IL6 protein, human; D015850:Interleukin-6