High levels of platelet-monocyte aggregates after valve replacement for aortic stenosis: Relation to soluble P-selectin and P-selectin glycoprotein ligand-1 genes

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• 作者：Roza Badr Eslam^a ; Thomas Gremmel^a ; Alexandra Schneller^a ; ^b ; Michael Stegfellner^a ; ^b ; ^c ; Alexandra Kaider^d ; Christine Mannhalter^c ; Irene Lang^a ; ¹ ; Simon Panzer^b ; ¹ ; ^{simon.panzer@meduniwien.ac.at}
• 关键词：sP-selectin ; soluble P-selectin ; PSGL-1 ; P-selectin glycoprotein ligand-1 ; PMA ; platelets adhering to monocytes ; VNTR ; variable number of tandem repeats ; LA ; lupus anticoagulant ; OAC ; oral anticoagulation ; sE-selectin ; soluble E-selectin ; CRP ; C-reactive
• 刊名：Thrombosis Research
• 出版年：2012
• 期刊代码：247_00493848
• 类别：med
• 出版时间：April, 2012
• 卷：129
• 期：4
• 页码：453-458
• 文件大小：347 K

摘要

Background

Calcific aortic valve stenosis is linked to atherosclerosis. The latter is associated with increased levels of platelets adhering to monocytes (PMA).

Objective

The hemodynamic impairment in symptomatic aortic valve stenosis can be abated by valve replacement. We investigated the effect of valve replacement on PMA and receptor-ligand axis P-selectin - P-selectin glycoprotein ligand-1 (PSGL-1) in severe aortic valve stenosis.

Patients and Methods

PMA, plasma P-selectin (sP-selectin) and polymorphisms within the coding region for PSGL-1 (SELPLG) were determined in 42 patients with severe aortic valve stenosis before and 4 to 8 months after valve replacement. Ten patients suffered from significant coronary artery disease and received also a coronary artery bypass graft. Thirty-four patients received a bioprosthetic valve and 8 patients who were < 65 years old received a mechanical valve.

Results

Before the intervention, PMA levels were significantly higher in patients with aortic valve stenosis than in two control cohorts, namely healthy indviduals and 88 age- and sex-matched patients with severe atherosclerosis, but without aortic valve stenosis (p < 0.001). PMA decreased after surgery, but normalized in only 3 patients, while further increases were noted in 11 patients. sP-selectin was elevated in 3 and 4 patients before and after valve replacement, respectively. sP-selectin increased significantly after surgery, but remained within the normal range. There was no correlation between changes of PMA and sP-selectin or any of the polymorphisms within SELPLG.

Conclusions

Exceedingly high PMA in aortic stenosis are independent of SELPLG polymorphisms, and largely of the hemodynamic compromise caused by the stenotic valve.