title: Circulating Lp-PLA2 is associated with high valvuloarterial impedance and low arterial compliance in patients with aortic valve bioprostheses.
abstract: BACKGROUND
  We previously reported that plasma Lp-PLA2 was associated with aortic valve disease progression and degeneration of bioprostheses. Low systemic arterial compliance and high valvuloarterial impedance (Z(va)) are predictors of poor survival in patients with aortic valve disease. However, the prevalence of high Z(va) after AVR is largely unknown and whether Lp-PLA2 could predict Z(va) has not been documented. We investigated the relationships between plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity and valvuloarterial impedance (Z(va)), an index of global LV hemodynamic load, in patients that underwent aortic valve replacement (AVR).
  
  
  METHODS
  A total of 195 patients with aortic bioprostheses underwent echocardiographic assessment of the prosthetic aortic valve function 8±3.4 years after AVR. Lp-PLA2 mass and activity were measured.
  
  
  RESULTS
  In this group of patients, the mean Z(va) was elevated (5.73±1.21 mm Hg·ml(-1)·m(2)). In univariate analyses, Lp-PLA2 mass (p=0.003) and Lp-PLA2 activity (p=0.046) were associated with Z(va). After adjustment for covariates including age, gender, clinical risk factors, anti-hypertensive medications, body mass index and prosthesis size, Lp-PLA2 mass was associated with high Z(va) (≥4.5 mm Hg·ml(-1)·m(2)) (OR: 1.29, 95%CI: 1.10-1.53; p=0.005) and was inversely related with the systemic arterial compliance (β=-0.01, SEM=0.003; p=0.003).
  
  
  CONCLUSIONS
  An increased Z(va), an index of excessive hemodynamic load, was highly prevalent 8-year post-AVR and was independently related to circulating Lp-PLA2.
authors.affiliation: Laboratoire d'Études Moléculaires des Valvulopathies (LEMV), Groupe de Recherche en Valvulopathies (GRV), Quebec Heart and Lung Institute/Research Center, Department of Surgery, Laval University, Quebec, Canada.
authors.forename: Ablajan
authors.initials: A
authors.lastname: Mahmut
authors.affiliation: Department of Medicine, Laval University, Québec, Canada.
authors.forename: Haïfa
authors.initials: H
authors.lastname: Mahjoub
authors.affiliation: Laboratoire d'Études Moléculaires des Valvulopathies (LEMV), Groupe de Recherche en Valvulopathies (GRV), Quebec Heart and Lung Institute/Research Center, Department of Surgery, Laval University, Quebec, Canada.
authors.forename: Marie-Chloé
authors.initials: MC
authors.lastname: Boulanger
authors.affiliation: Department of Medicine, Laval University, Québec, Canada.
authors.forename: Abdellaziz
authors.initials: A
authors.lastname: Dahou
authors.affiliation: Laboratoire d'Études Moléculaires des Valvulopathies (LEMV), Groupe de Recherche en Valvulopathies (GRV), Quebec Heart and Lung Institute/Research Center, Department of Surgery, Laval University, Quebec, Canada.
authors.forename: Rihab
authors.initials: R
authors.lastname: Bouchareb
authors.affiliation: Department of Medicine, Laval University, Québec, Canada.
authors.forename: Romain
authors.initials: R
authors.lastname: Capoulade
authors.affiliation: Department of Medicine, Laval University, Québec, Canada.
authors.forename: Benoît J
authors.initials: BJ
authors.lastname: Arsenault
authors.affiliation: Department of Medicine, Laval University, Québec, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Larose
authors.affiliation: Department of Molecular Medicine, Laval University, Québec, Canada.
authors.forename: Yohan
authors.initials: Y
authors.lastname: Bossé
authors.affiliation: Department of Medicine, Laval University, Québec, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Pibarot
authors.affiliation: Laboratoire d'Études Moléculaires des Valvulopathies (LEMV), Groupe de Recherche en Valvulopathies (GRV), Quebec Heart and Lung Institute/Research Center, Department of Surgery, Laval University, Quebec, Canada. Electronic address: patrick.mathieu@chg.ulaval.ca.
authors.forename: Patrick
authors.initials: P
authors.lastname: Mathieu
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001158:Arteries / Q000503:physiopathology*; D003187:Compliance; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male
chemical_list: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase
keywords: Arterial compliance; Bioprosthesis; Calcific aortic valve disease; Lipoprotein-associated phospholipase A2; Lp-PLA2; Valvuloarterial impedance