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Lipid metabolism does not influence the expression of proximal aortopathy in bicuspid aortic valve disease
Journal of Cardiothoracic Surgery volume 10, Article number: A65 (2015)
Controversy exists regarding the pathogenesis of bicuspid aortic valve (BAV) associated aortopathy. Recent data indicate the potential role of lipid metabolism in the expression of aortopathy.
We aimed to correlate the markers of lipid metabolism with severity of proximal aortopathy in patients with BAV vs. tricuspid aortic valve (TAV) disease.
A total of 458 consecutive patients (mean age 64 ± 11 years, 68% male) underwent aortic valve replacement (AVR) with/without proximal aortic surgery from January,2008 through December,2014. All patients undergoing combined procedures (e.g., AVR+CABG) were excluded. Only patients in whom proximal aortic dimensions were defined by preoperative CT/MRI and/or TOE were included. Correlation analysis was performed between markers of lipid metabolism (i.e., cholesterol, LDL, HDL, and triglyceride) and maximal diameter of the proximal aorta in BAV subgroup (n = 273) vs. TAV subgroup (n = 185). Moreover, we compared correlation patterns between markers of lipid metabolism and maximal aortic diameter in BAV insufficiency (n = 46) vs. BAV stenosis (n = 227) cohorts. Logistic regression was performed to identify risk factors for proximal aortic diameter >40 mm in BAV and TAV subgroups.
No correlation was found between markers of lipid metabolism and proximal aortic diameter in BAV subgroup (r = -0.1, p = 0.1) and TAV subgroup (r = 0.006, p = 0.9). No significant differences in correlation patterns were found between markers of lipid metabolism and maximal aortic diameter in BAV insufficiency (r = 0.03, p = 0.8) vs. BAV stenosis (r = -0.1, p = 0.1) cohorts. Logistic regression analysis revealed triglyceride levels (HR 1.4, p = 0.05) and statin therapy (HR 0.4, p = 0.03) as predictors of proximal aortic diameter >40 mm in TAV subgroup only.
Our study demonstrates no linear correlation between markers of lipid metabolism and proximal aortic diameters in a surgical cohort of BAV and TAV patients. Statin therapy and triglyceride levels influence significantly proximal aortic diameter in patients with TAV, but not with BAV disease.
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Gross, T.M.S., Kuntze, T. & Girdauskas, E. Lipid metabolism does not influence the expression of proximal aortopathy in bicuspid aortic valve disease. J Cardiothorac Surg 10, A65 (2015). https://doi.org/10.1186/1749-8090-10-S1-A65
- Lipid Metabolism
- Triglyceride Level
- Statin Therapy
- Aortic Valve Replacement
- Correlation Pattern