Tissue resident C reactive protein in degenerative aortic valves: correlation with serum C reactive protein concentrations and modification by statins

• Published in: Heart (British Cardiac Society) Vol. 92; no. 4; pp. 495 - 498
• Main Authors: Skowasch, D, Schrempf, S, Preusse, C J, Likungu, J A, Welz, A, Lüderitz, B, Bauriedel, G
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.04.2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Aged; aortic stenosis; Aortic Valve - chemistry; Aortic Valve - metabolism; Aortic Valve - pathology; Aortic Valve Stenosis - blood; Aortic Valve Stenosis - drug therapy; Aortic Valve Stenosis - pathology; Atherosclerosis; Binding sites; Biological and medical sciences; C reactive protein; C-Reactive Protein - analysis; C-Reactive Protein - drug effects; C-Reactive Protein - metabolism; Cardiology. Vascular system; Cardiovascular Medicine; Cell adhesion & migration; CRP; Cytokines; degenerative aortic valve bioprosthesis; Disease; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypertension; Hypotheses; Inflammation; Male; Medical sciences; Middle Aged; non-rheumatic aortic valve stenosis; Patients; Phosphatase; Proteins; Statins; Statistics, Nonparametric; Studies; Treatment Outcome; valve bioprosthesis; Germany; Human; Modification; Correlation; Statin derivative; Concentration; Serum protein; Phlebology; Tissue; Resident(student); Resident; Circulatory system; Cardiology; C reactive protein; Aortic valve
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.2005.069815

Objective: To assess aortic valve probes for valvar C reactive protein (CRP) presence, the relation between valvar and serum CRP, and a possible modification of CRP by statin medication. Setting: Tertiary referral centre. Patients and design: End stage, degenerative valve tissue was taken from 81 patients, 57 with non-rheumatic aortic valve stenosis (AS) and 24 with degenerative aortic valve bioprosthesis (BP). Five non-stenosed valves served as controls. Tissue from four non-implanted bioprostheses was also examined. The presence and location of CRP was analysed by use of immunostaining and morphometry. Serum CRP concentrations were measured preoperatively. Results: The majority of AS and BP valves exhibited CRP labelled cells, predominantly localised to the valvar fibrosa. The expression of CRP was much higher in BP than in AS (by a factor of 3.7, p  =  0.03). Notably, non-stenosed aortic valves and non-implanted bioprostheses did not have CRP signalling. Serum CRP was also increased with BP (by a factor of 2.5, p  =  0.02) and was significantly correlated with valvar CRP expression (r  =  0.54, p < 0.001). The main finding in patients with (n  =  26) and without statin treatment (n  =  55) was that both valvar CRP expression (p  =  0.02) and serum CRP concentrations (p  =  0.04) were lower in the statin treated group. Conclusions: CRP was found in a large series of degenerative aortic valves, more often in bioprostheses than in native cusps. Serum CRP concentrations may reflect inflammatory processes within the aortic valve. The association of statin treatment with decreases in both valvar and serum CRP concentrations may explain known pleiotropic effects of statins in patients with aortic stenosis.