Stenotic Bicuspid and Tricuspid Aortic Valves　- Micro-Computed Tomography and Biological Indices of Calcification.
Valve calcification is well estimated by ex-vivo micro-computed tomography (micro-CT). The objective of this study was to investigate the associations between micro-CT findings and biological indices of calcification in aortic stenosis (AS), as well as differences between bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV).



Aortic valves and plasma were obtained from patients undergoing valve surgery. Valves were dissected and underwent micro-CT, genetic analyses, and calcium content assessment. Plasma levels of calcification markers were measured. Forty-two patients with isolated severe AS, including 22 with BAV, were studied. BAV patients had a lower median CT value (140.0 [130.0-152.0] vs. 157.0 [147.0-176.0], P=0.002) and high-density calcification (HDC) fraction (9.3 [5.7-23.3] % vs. 21.3 [14.3-31.2] %, P=0.01), as compared with TAV. Calcification fraction (CF) correlated with AS severity (measured as maximal transvalvular pressure gradient [r=0.34, P=0.03], maximal flow velocity [r=0.38, P=0.02], and indexed aortic valve area [r=-0.37, P=0.02]). For TAV patients only, mRNA expression of integrin-binding sialoprotein correlated with CF (r=0.45, P=0.048), and the receptor activator of the nuclear factor κ-B ligand transcript correlated with HDC corrugation (r=0.54, P=0.01).



TAV patients with AS present more mineralized calcifications in micro-CT than BAV subjects. The relative volume of calcifications increases with the AS severity. In TAV patients, upregulated expression of genes involved in osteoblastogenesis in AS correlates with leaflet mineralization in micro-CT.
John Paul II Hospital.|Institute of Cardiology, Jagiellonian University Medical College Krakow.
Piotr
P
Mazur
John Paul II Hospital.|Institute of Cardiology, Jagiellonian University Medical College Krakow.
Ewa
E
Wypasek
Institute of Cardiology, Jagiellonian University Medical College Krakow.
Bogusław
B
Gawęda
Institute of Cardiology, Jagiellonian University Medical College Krakow.
Dorota
D
Sobczyk
John Paul II Hospital.|Institute of Cardiology, Jagiellonian University Medical College Krakow.
Przemysław
P
Kapusta
John Paul II Hospital.|Institute of Cardiology, Jagiellonian University Medical College Krakow.
Joanna
J
Natorska
Faculty of Health Science, Jagiellonian University Medical College Krakow.
Krzysztof Piotr
KP
Malinowski
Department of Condensed Matter Physics, Faculty of Physics and Applied Computer Science, AGH University of Science and Technology.
Jacek
J
Tarasiuk
John Paul II Hospital.|Institute of Cardiology, Jagiellonian University Medical College Krakow.
Maciej
M
Bochenek
Department of Condensed Matter Physics, Faculty of Physics and Applied Computer Science, AGH University of Science and Technology.
Sebastian
S
Wroński
Department of Condensed Matter Physics, Faculty of Physics and Applied Computer Science, AGH University of Science and Technology.
Katarzyna
K
Chmielewska
John Paul II Hospital.|Institute of Cardiology, Jagiellonian University Medical College Krakow.
Bogusław
B
Kapelak
John Paul II Hospital.|Institute of Cardiology, Jagiellonian University Medical College Krakow.
Anetta
A
Undas
D000368:Aged; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000378:metabolism; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D058574:Integrin-Binding Sialoprotein / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000378:metabolism; D053245:RANK Ligand / Q000096:biosynthesis*; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000378:metabolism; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000378:metabolism; D055114:X-Ray Microtomography
D058574:Integrin-Binding Sialoprotein; D053245:RANK Ligand; C505688:TNFSF11 protein, human
Aortic stenosis; Bicuspid aortic valve; Genes; Micro-computed tomography