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ESC Congress 2003: C-reactive protein, an inflammatory biomarker, predicts progression of aortic valve stenosis

August 31, 2003

IMPORTANT: This press release accompanies a poster or oral session given at the ESC Congress 2003. Written by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology

Aortic stenosis (AS) is the narrowing or obstruction of the heart's aortic valve, which prevents it from opening properly and blocks the flow of blood from the left ventricle to the aorta. AS is common in the ageing population and has become the most frequent native valve disease in Europe. AS when severe, may cause left heart failure, fainting or angina, but the natural progression of less severe degrees is highly variable.

The risk factors for the development of AS are the same as that of atherosclerosis (male sex, smoking, hypertension, age, hypercholesterolemia, and diabetes), and some of these seem to have an effect on AS progression as well. Numerous studies have identified inflammation as a major component of atherosclerosis complications and have shown that blood levels of C-reactive protein are elevated many years before a first heart attack or stroke occurs. C-reactive protein is a protein in the body whose level increases when blood vessels become inflamed, so measuring cardiovascular risk is thought to be possible by assessing C-reactive protein levels.

Accordingly, to these data, we have studied the possible association between inflammation, as detected by C-reactive protein levels, and progression of AS.

Our study was carried out in Salamanca, Spain. We looked at 43 patients with AS. We performed an echocardiogram and measured the blood levels of C-reactive protein at the beginning of the study, and we saw that patients with higher levels of C-reactive protein had more rapid progression of AS than patients with lower levels, when we repeat the echocardiogram six months later.

The mechanism of this is still under investigation, but raises the possibility that AS and atherosclerosis may share common pathophysiology pathways. Ability to predict AS progression has clinical implications in patients with AS, and could help in the selection of patients who are likely to benefit from early aortic valve replacement.

Pedro L Sanchez
University Hospital, Salamanca, Spain

European Society of Cardiology (ESC)

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