title: Identification of Patients Affected by Mitral Valve Prolapse with Severe Regurgitation: A Multivariable Regression Model.
abstract: Background. Mitral valve prolapse (MVP) is the most common cause of severe mitral regurgitation. Besides echocardiography, up to now there are no reliable biomarkers available for the identification of this pathology. We aim to generate a predictive model, based on circulating biomarkers, able to identify MVP patients with the highest accuracy.Methods. We analysed 43 patients who underwent mitral valve repair due to MVP and compared to 29 matched controls. We assessed the oxidative stress status measuring the oxidized and the reduced form of glutathione by liquid chromatography-tandem mass spectrometry method. Osteoprotegerin (OPG) plasma levels were measured by an enzyme-linked immunosorbent assay. The combination of these biochemical variables was used to implement several logistic regression models.Results. Oxidative stress levels and OPG concentrations were significantly higher in patients compared to control subjects (0.116 ± 0.007 versus 0.053 ± 0.013 and 1748 ± 100.2 versus 1109 ± 45.3 pg/mL, respectively;p< 0.0001). The best regression model was able to correctly classify 62 samples out of 72 with accuracy in terms of area under the curve of 0.92.Conclusions. To the best of our knowledge, this is the first study to show a strong association between OPG and oxidative stress status in patients affected by MVP with severe regurgitation.
authors.affiliation: Centro Cardiologico Monzino IRCCS, Milan, Italy; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Songia
authors.affiliation: Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Benedetta
authors.identifier: 0000-0002-4019-4618
authors.initials: B
authors.lastname: Porro
authors.affiliation: Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Chiesa
authors.affiliation: Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Veronika
authors.identifier: 0000-0001-8414-5300
authors.initials: V
authors.lastname: Myasoedova
authors.affiliation: Centro Cardiologico Monzino IRCCS, Milan, Italy; Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Alamanni
authors.affiliation: Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Tremoli
authors.affiliation: Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Paolo
authors.identifier: 0000-0002-7225-3379
authors.initials: P
authors.lastname: Poggio
mesh_terms: D015415:Biomarkers / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology*; D008945:Mitral Valve Prolapse / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D015999:Multivariate Analysis; D053244:Osteoprotegerin / Q000097:blood; D018384:Oxidative Stress; D012044:Regression Analysis
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human