title: Serum Dickkopf-1 signaling and calcium deposition in aortic valve are significantly related to the presence of concomitant coronary atherosclerosis in patients with symptomatic calcified aortic stenosis.
abstract: BACKGROUND
  The study aimed to assess serum RANKL:OPG ratio, Dkk-1 and deposition of calcium in aortic valve in relation to the presence of concomitant coronary atherosclerosis in patients with symptomatic calcified aortic stenosis (CAS).
  
  
  METHODS
  OPG, soluble RANKL and Dkk-1 were measured in 218 consecutive patients who were undergoing cardiac catheterization because of symptomatic CAS. Values of studied compounds were compared between patients without (Group A) and with (Group B) coronary atherosclerosis. Computed tomography derived Agatston score was assessed by using 256-slice CT.
  
  
  RESULTS
  Presence of coronary atherosclerosis was related to significantly (p = 0.007) higher OPG and to significantly (p = 0.004) lower Dkk-1. Coronary atherosclerosis was also associated with a trend towards a decrease of RANKL. RANKL/OPG Ratios (mean (95% C.I.)) were: 20.04 (16.58; 24.23) in Group A and 12.69 (9.96; 16.17) in Group B, resp., p = 0.018). After adjustment, the difference in RANKL:OPG ratios was no longer significant. Multivariable regression underscored the significance of difference in Dkk-1 (pafter adjustement = 0.020). Group A patients had significantly higher Dkk-1, significantly higher deposition of calcium in aortic valve and were symptomatic in significantly younger age (p < 0.001) as compared to group B patients: Agatston score (mean (95% C.I.)) 4069.9 (3211.8; 5134.5) and 2413.5 (1821.3; 3198.1), p = 0.007.
  
  
  CONCLUSIONS
  Dkk-1 and deposition of calcium in aortic valve differ significantly in relation to the presence/absence of coronary atherosclerosis in patients with symptomatic CAS. A positive association was found between Dkk-1 and calcium load in aortic valve in patients with symptomatic CAS and angiographically normal coronary arteries.
authors.affiliation: Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. zuzana.motovska@fnkv.cz.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Motovska
authors.affiliation: Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. teodora.vichova@fnkv.cz.
authors.forename: Teodora
authors.initials: T
authors.lastname: Vichova
authors.affiliation: Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. magdalena.doktorova@fnkv.cz.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Doktorova
authors.affiliation: Department, of Radiology, University Hospital Kralovske Vinohrady, Prague, Czech Republic. marek.labos@fnkv.cz.
authors.forename: Marek
authors.initials: M
authors.lastname: Labos
authors.affiliation: National Institute of Public Health, Prague, Czech Republic. mmaly@szu.cz.
authors.forename: Marek
authors.initials: M
authors.lastname: Maly
authors.affiliation: Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. petr.widimsky@fnkv.cz.
authors.forename: Petr
authors.initials: P
authors.lastname: Widimsky
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000000981:diagnostic imaging; D001846:Bone Development; D002114:Calcinosis / Q000097:blood* / Q000000981:diagnostic imaging; D002118:Calcium / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008954:Models, Biological; D015398:Signal Transduction; D014057:Tomography, X-Ray Computed
chemical_list: C501126:DKK1 protein, human; D036341:Intercellular Signaling Peptides and Proteins; D002118:Calcium