Abstract 11908: Osteoprotegerin and Myocardial Fibrosis in Patients With Aortic Stenosis
Introduction: Understanding the mechanistic role of valve calcification and myocardial fibrosis in patients with aortic stenosis (AS) remains challenging. Osteoprotegerin (OPG), a member of the TNF receptor family, is known to mediate valve calcification in AS; however its role on myocardial fibrosis has not been evaluated.
Hypothesis: We hypothesized that OPG stimulates common pathways for valve calcification and myocardial fibrosis and investigated the association of OPG and presence of myocardial fibrosis.
Methods: Between 2011 and 2015, consecutive consenting patients with moderate (1.0-1.5cm2) or severe (<1cm2) AS who had cardiovascular magnetic resonance (CMR) with late gadolinium enhancement were included. CMR parameters were analysed by blinded observers and patients characterized into 3 groups according to the pattern of fibrosis: presence of midwall fibrosis, presence of chronic infarction or absence of fibrosis. OPG levels were measured using ELISA and compared between the 3 groups.
Results: 113 patients (76±10 years, 78 male) were included. 37 patients had no fibrosis, 40 patients had midwall fibrosis and 34 had chronic infarction. Max OPG level was 23.01 pmol/, min 2.22 pmol/L and mean 7.24± 3.45pmol/L. OPG per group was: no fibrosis= 6.29 pmol/L, midwall fibrosis=7.13 pmol/L and chronic infarction=8.42 pmol/L. There was no association between OPG level and presence of midwall fibrosis compared to no fibrosis (p=0.114). However, patients with chronic myocardial infarction had higher OPG than patients with no fibrosis (p=0.007).
Conclusions: OPG is known to promote valve calcification in patients with AS. This is the first study to demonstrate that there is no association between the level of OPG and presence of myocardial midwall fibrosis. However higher OPG was observed in patients with chronic ischemia when compared to patients with no fibrosis.
Author Disclosures: V. Vassiliou: None. C.E. Raphael: Research Grant; Modest; British Heart Foundation. T. Malley: None. N. Aggarwal: None. S. Selvendran: None. H. Berry: None. J. Donovan: None. E. Nyktari: None. D. Auger: None. D.J. Pennell: Research Grant; Significant; NIHR. Consultant/Advisory Board; Significant; Siemens, ApoPharma. S.K. Prasad: Speakers Bureau; Modest; Bayer.
- © 2015 by American Heart Association, Inc.