Circulating Lp-PLA2 is associated with high valvuloarterial impedance and low arterial compliance in patients with aortic valve bioprostheses

Abstract

BackgroundWe previously reported that plasma Lp-PLA2 was associated with aortic valve disease progression and degeneration of bioprostheses. Low systemic arterial compliance and high valvuloarterial impedance (Zva) are predictors of poor survival in patients with aortic valve disease. However, the prevalence of high Zva after AVR is largely unknown and whether Lp-PLA2 could predict Zva has not been documented. We investigated the relationships between plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity and valvuloarterial impedance (Zva), an index of global LV hemodynamic load, in patients that underwent aortic valve replacement (AVR). MethodsA total of 195 patients with aortic bioprostheses underwent echocardiographic assessment of the prosthetic aortic valve function 8±3.4years after AVR. Lp-PLA2 mass and activity were measured. ResultsIn this group of patients, the mean Zva was elevated (5.73±1.21mmHg·ml−1·m2). In univariate analyses, Lp-PLA2 mass (p=0.003) and Lp-PLA2 activity (p=0.046) were associated with Zva. After adjustment for covariates including age, gender, clinical risk factors, anti-hypertensive medications, body mass index and prosthesis size, Lp-PLA2 mass was associated with high Zva (≥4.5mmHg·ml−1·m2) (OR: 1.29, 95%CI: 1.10–1.53; p=0.005) and was inversely related with the systemic arterial compliance (β=−0.01, SEM=0.003; p=0.003). ConclusionsAn increased Zva, an index of excessive hemodynamic load, was highly prevalent 8-year post-AVR and was independently related to circulating Lp-PLA2.