Small HDL particle levels were significantly lower in aortic stenosis patients compared to sclerosis patients and controls, despite similar total HDL cholesterol.
Do metabolic profiles differ between patients with aortic stenosis, aortic valve sclerosis, and healthy subjects?
Patients with aortic stenosis have significantly lower levels of small HDL particles compared to those with aortic sclerosis and healthy controls, suggesting distinct metabolic entities and a potential new therapeutic target.
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Abstract Background The prevalence of calcific aortic valve disease (CAVD) is on the increase due to ageing population. CAVD is ranging from mild aortic valve sclerosis to severe obstructive aortic stenosis (AS). CAVD shares the same risk factors including age, sex and hypertension as atherosclerotic vascular diseases (ASVD). However, in contrast to ASVD, treating risk factors has not proven to be effective in the prevention of CAVD and progression to AS. Consequently, there is a need for the development of new pharmacological treatment options for the prevention of CAVD. Purpose This study aims to investigate changes in metabolic profiles between patients with AS, aortic valve sclerosis (ASc) and healthy subjects. Circulating blood metabolites including lipids, amino acids and inflammation markers were measured by nuclear magnetic resonance (NMR) metabolomics. Overall, the aim is to reveal metabolic signatures of and thereby therapeutic and diagnostic targets for CAVD. Methods A total of 254 subjects (82 patients with aortic stenosis (AS), 72 patients with aortic valve sclerosis (ASc) and 101 healthy controls were recruited. NMR-based metabolite profiling of venous blood samples was conducted. Results We found that the study groups did not differ with respect to total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Levels of small HDL particles, but not total HDL cholesterol or level of large HDL particles were significantly lower in the AS group compared to ASc and controls whereas no differences were found between the ASc and controls. In addition, the levels of albumin and several amino acids were lower in the AS group when compared to ASc group. These results suggest that patients with AS and ASc have different metabolic profiles. Conclusions Our study is the first to show that the levels of small HDL rather than plasma HDL concentration are significantly lower in AS patients compared to ASc patients and healthy control whereas no difference was found between ASC and controls. This suggests that small HDL may be one missing link in the pathologic process between dyslipidemia and CAVD and provide new ideas for the development of therapies for the prevention of CAVD. The results also raise the question whether AS and ASc are different entities.
Koljonen et al. (Sat,) reported a other. Small HDL particle levels were significantly lower in aortic stenosis patients compared to sclerosis patients and controls, despite similar total HDL cholesterol.