A history of tumors (N=85) versus no oncological history (N=91) in patients undergoing valve replacement was associated with increased markers of inflammation, remodeling, and calcification.
Observational (n=176)
Does a history of cancer treatments alter markers of inflammation, remodeling, and calcification in patients undergoing mitral or aortic valve replacement?
Prior oncological treatments are associated with increased markers of inflammation, remodeling, and calcification in patients undergoing valve replacement, highlighting potential mechanisms of cardiotoxicity-induced valve disease.
Abstract Introduction/background Oncological treatments can lead to cardiotoxicity, often resulting in heart valve disease. However, the impact of anti-neoplasic therapy on valve damage is not well understood. This study aims to investigate the relationship between a history of cancer treatments and the extent of valve deterioration in patients undergoing mitral or aortic valve replacement. Purpose To identify markers of pathological processes associated with valve damage in patients with a previous tumor history who were undergoing mitral or aortic valve replacement. Methods We analyzed cellular markers of inflammation, fibrosis, angiogenesis, and calcification in the mitral or aortic valves of patients undergoing valve replacement due to mitral valve disease (MVD), aortic regurgitation (AR), or aortic stenosis (AS), with or without prior tumor history. Serum markers of valve-related damage were also assessed by ELISA. Results We included 176 patients, 47.2% of patients had a history of tumours (N=85), while 52.8% had no oncological history (N=91). Among patients with MVD (N=100), 47% had prior tumor (N=47), with 10 of them having received radiotherapy or chemotherapy. Regarding aortic valve disease, the AR group included 50% of patients (N=8) with record of tumor, 5 of them having undergone anti-neoplasic treatment. In AS, half of the patients had a tumor history (N=30), and among them, 20 had received anti-neoplastic therapy. In mitral valves of patients with MVD and oncological records, we observed an increased inflammatory response, evidenced by higher TNF-α levels, but a reduction in matrix remodeling markers (TIMP-1, TIMP-2, and MMP-9). In contrast, aortic valve disease exhibited both heightened inflammation (increased levels of IL-33 in AR and of ST2, ICAM-1, Gal-3, and RANTES in AS) and enhanced matrix remodeling (higher levels of TIMP-2 in both diseases, and of ADAMTS-5, MMP-1, and TIMP-1 in AS). Notably, aortic valves in cancer patients exhibited higher calcification markers, including OPN (in both AR and AS), as well as BMP-2, BMP-4, and OCN (specifically in AS). Interestingly, oncological AS patients also exhibited increased circulating levels of the angiogenic markers VEGF and VEGFR2. Conclusions These findings suggest that oncological treatments may contribute to valve degeneration through inflammation, remodeling, and calcification processes.
Garmendia et al. (Sat,) conducted a observational in Mitral or aortic valve disease requiring valve replacement (n=176). History of tumors and oncological treatments vs. No oncological history was evaluated on Cellular and serum markers of inflammation, fibrosis, angiogenesis, and calcification. A history of tumors (N=85) versus no oncological history (N=91) in patients undergoing valve replacement was associated with increased markers of inflammation, remodeling, and calcification.