title: Values of osteoprotegerin in aortic valve tissue in patients with significant aortic stenosis depend on the existence of concomitant coronary artery disease.
abstract: BACKGROUND
  Calcific aortic valve stenosis (CAVS) is a serious clinical problem. The strongest predictor of CAVS progression is the amount of calcium in the aortic valve. The pathogenesis of CAVS is largely consistent with the pathogenesis of atherosclerosis; however, about 50% of patients with CAVS do not exhibit significant atherosclerosis. Cardiovascular calcification is currently considered an actively regulated process, in which the important role is attributed to the RANKL/RANK/OPG (receptor activator of nuclear factor κB ligand/RANK/osteoprotegerin) axis. We measured OPG levels in the tissue of calcified, stenotic aortic valves in relation to the presence or absence of coronary artery disease (CAD).
  
  
  METHODS
  Aortic valve samples were collected from 105 patients with calcified, mainly severe aortic stenosis, who were divided into two groups according to the presence of CAD. In Group A (n=44), there were normal coronary artery findings, while in Group B (n=61), there was angiographically demonstrated >50% stenosis of at least one coronary artery. The control Group C (n=21) consisted of patients without aortic stenosis and with normal angiographic findings on coronary arteries.
  
  
  RESULTS
  The highest tissue concentrations of OPG [median (pmol/L), 25th-75th percentile] were found in Group A [6.95, 3.96-18.37], which was significantly different compared to the other two groups (P=.026 and .001, respectively). The levels of OPG in Group B [4.15, 2.47-9.16] and in Group C [2.25, 1.01-5.08] did not differ significantly (P=.078); however, the lowest concentrations of OPG were found in Group C. Neither age nor gender in our study had effect on tissue levels of OPG (P=.994 for gender; P=.848 for age).
  
  
  CONCLUSIONS
  Calcified and narrowed aortic valves, compared to the normal valves, were accompanied by a change in tissue concentrations of OPG, which is, in addition, dependent on the presence or absence of CAD. The highest tissue concentrations of OPG in our work were found in patients with significant aortic stenosis without concomitant CAD.
authors.affiliation: Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
authors.forename: Richard
authors.initials: R
authors.lastname: Fojt
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Pirk
authors.affiliation: Assistance Publique - Hôpitaux de Paris and Service d'Endocrinologie et des Maladies de la Reproduction, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Peter
authors.initials: P
authors.lastname: Kamenický
authors.affiliation: Biovendor - Laboratorní Medicína, Brno, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Karpíšek
authors.affiliation: Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
authors.forename: Zbyněk
authors.initials: Z
authors.lastname: Straka
authors.affiliation: National Institute of Public Health, Prague, Czech Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Malý
authors.affiliation: Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. Electronic address: zuzana.motovska@fnkv.cz.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Moťovská
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000378:metabolism / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D002114:Calcinosis / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D003324:Coronary Artery Disease / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000032:analysis / Q000378:metabolism*
chemical_list: D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human
keywords: Aortic; Coronary; OPG; Stenosis