In this study, 36 male patients (age: 61.5 ± 2 years) with AS undergoing an aortic valve replacement were investigated. Plasma levels of adiponectin, oxidized-LDL (ox-LDL), angiotensinogen (AGN) and angiotensin I-II (Ang I-II) were measured. On explanted aortic valves, immunohistochemistry studies and quantitative PCR (q-PCR) analyses were performed to document the expression of inflammatory cytokines.
Systolic blood pressure (SBP) was positively correlated with plasma level of ox-LDL (r = 0.4; p = 0.02), AGN (r = 0.41; p = 0.01), and white blood cells count (r = 0.33; p = 0.04), whereas it was inversely related to plasma level of adiponectin (r = − .35; p = 0.04). After adjustment for covariates, plasma level of ox-LDL (p = 0.01) remained significantly associated with SBP (p = 0.01). Within the aortic valve, expression of TNF-α was significantly associated with plasma levels of ox-LDL (r = 0.58; p = 0.03), Ang II (r = 0.69; p = 0.013), and waist circumference (r = 0.60; p = 0.02), whereas valvular expression of IL-6 was associated with plasma level of Ang II (r = 0.51; p = 0.03). In explanted AS valves, ox-LDL was documented near calcified areas and colocalized with Ang II, IL-6, and TNF-α.
Conditions associated with a higher oxidative stress and activation of the renin angiotensin system, such as encountered in viscerally obese and prehypertensive patients, contribute to higher valvular inflammation in AS.