title: New biomarkers for primary mitral regurgitation.
abstract: BACKGROUND
  Mitral regurgitation is a frequent valvular heart disease affecting around 2.5 % of the population with prevalence directly related to aging. Degeneration of mitral valve is broadly considered as a passive ongoing pathophysiological process and little is known about its physiological deregulation. The purpose of this study was to highlight new biomarkers of mitral regurgitation in order to decipher the underlying pathological mechanism as well as to allow the diagnosis and the monitoring of the disease.
  
  
  RESULTS
  Modulation of various blood proteins expression was examined in patients suffering from different grades of mitral regurgitation (mild, moderate and severe) compared to healthy controls. To this end, several routine clinical assays and the multi analyte profile technology targeting 184 proteins were used. High-density lipoprotein, apolipoprotein-A1, haptoglobin and haptoglobin-α2 chain levels significantly decreased proportionally to the degree of mitral regurgitation when compared to controls. High-density lipoprotein and apolipoprotein-A1 levels were associated with effective regurgitant orifice area and regurgitant volume. Apolipoprotein-A1 was an independent predictor of severe mitral regurgitation. Moreover, with ordinal logistic regression, apolipoprotein-A1 remained the only independent factor associated with mitral regurgitation. In addition, myxomatous mitral valves were studied by immunocytochemistry. We observed an increase of LC3, the marker of autophagy, in myxomatous mitral valves compared with healthy mitral valves.
  
  
  CONCLUSIONS
  These potential biomarkers of mitral regurgitation highlighted different cellular processes that could be modified in myxomatous degenerescence: reverse cholesterol transport, antioxidant properties and autophagy.
authors.affiliation: GIGA Proteomic Unit, Clinical Chemistry Laboratory, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Céline
authors.initials: C
authors.lastname: Deroyer
authors.affiliation: GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Julien
authors.initials: J
authors.lastname: Magne
authors.affiliation: GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Marie
authors.initials: M
authors.lastname: Moonen
authors.affiliation: Department of Clinical Chemistry, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Le Goff
authors.affiliation: GIGA-Cancer, Laboratory of Connective Tissues Biology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Laura
authors.initials: L
authors.lastname: Dupont
authors.affiliation: GIGA-Cancer, Laboratory of Connective Tissues Biology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Alexia
authors.initials: A
authors.lastname: Hulin
authors.affiliation: Department of Cardiovascular and Thoracic Surgery and Human Anatomy, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Radermecker
authors.affiliation: GIGA-Cancer, Laboratory of Connective Tissues Biology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Alain
authors.initials: A
authors.lastname: Colige
authors.affiliation: Department of Clinical Chemistry, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Etienne
authors.initials: E
authors.lastname: Cavalier
authors.affiliation: Department of Biomedical and Preclinical Sciences, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Kolh
authors.affiliation: GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Pierard
authors.affiliation: GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Lancellotti
authors.affiliation: Department of Clinical Chemistry, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Marie-Paule
authors.initials: MP
authors.lastname: Merville
authors.affiliation: GIGA Proteomic Unit, Clinical Chemistry Laboratory, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium ; Laboratory for the Analysis of Medicines, CIRM, University of Liège, CHU Sart Tilman, 4000 Liège, Belgium.
authors.forename: Marianne
authors.initials: M
authors.lastname: Fillet
keywords: Autophagy; Biomarkers; Lipid metabolism; Mitral regurgitation