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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1996;16:523-532.)
© 1996 American Heart Association, Inc.


Articles

Apolipoproteins B, (a), and E Accumulate in the Morphologically Early Lesion of `Degenerative' Valvular Aortic Stenosis

Presented in part at the Western Section, American Federation for Clinical Research, Carmel, Calif, February 11, 1994.

Kevin D. O'Brien; Dennis D. Reichenbach; Santica M. Marcovina; Johanna Kuusisto; Charles E. Alpers; Catherine M. Otto

From the Division of Cardiology (K.D.O'B., J.K., C.M.O.) and Northwest Lipid Research Laboratories (S.M.M.), Departments of Medicine and Pathology (D.D.R., C.E.A.), University of Washington, Seattle. Dr Kuusisto is now with Kuopio (Finland) University.

Correspondence to Kevin D. O'Brien, MD, Division of Cardiology, Box 356422, University of Washington, Seattle, WA 98195-6422.

Abstract Nonrheumatic aortic stenosis of trileaflet aortic valves has been considered to be a "degenerative" process, but the early lesion of aortic stenosis contains the chronic inflammatory cells, macrophages and T lymphocytes. Because lipoprotein deposition is prominent in atherosclerosis, another chronic inflammatory process, this study examined whether lipoproteins accumulate in aortic valve lesions. Immunohistochemical studies were performed to detect apolipoprotein (apo) B, apo(a), apoE, macrophages, and {alpha}-actin–expressing cells on 18 trileaflet aortic valves that ranged from normal to stenotic. All three apolipoproteins were detected in early through end-stage lesions of aortic stenosis but not in histologically normal regions. Comparison with oil red O staining suggested that most of the extracellular neutral lipid in these valves was associated with either plasma-derived or locally produced apolipoproteins. Thus, in early through end-stage aortic valve lesions, apolipoproteins accumulate and are associated with the majority of extracellular valve lipid. These results are consistent with the hypothesis that lipoprotein accumulation in the aortic valve contributes to pathogenesis of aortic stenosis.


Key Words: lipids • macrophages • inflammation • foam cells




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J. Am. Coll. Cardiol., November 20, 2002; 40(10): 1723 - 1730.
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J Am Coll CardiolHome page
A. S. Pearlman
Medical treatment ofaortic stenosis: Promising, or wishful thinking?
J. Am. Coll. Cardiol., November 20, 2002; 40(10): 1731 - 1734.
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CirculationHome page
K. D. O'Brien, D. M. Shavelle, M. T. Caulfield, T. O. McDonald, K. Olin-Lewis, C. M. Otto, and J. L. Probstfield
Association of Angiotensin-Converting Enzyme With Low-Density Lipoprotein in Aortic Valvular Lesions and in Human Plasma
Circulation, October 22, 2002; 106(17): 2224 - 2230.
[Abstract] [Full Text] [PDF]


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HeartHome page
C M Otto
Calcification of bicuspid aortic valves
Heart, October 1, 2002; 88(4): 321 - 322.
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HeartHome page
L Wallby, B Janerot-Sjoberg, T Steffensen, and M Broqvist
T lymphocyte infiltration in non-rheumatic aortic stenosis: a comparative descriptive study between tricuspid and bicuspid aortic valves
Heart, October 1, 2002; 88(4): 348 - 351.
[Abstract] [Full Text] [PDF]


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Eur Heart JHome page
B. Iung, C. Gohlke-Barwolf, P. Tornos, C. Tribouilloy, R. Hall, E. Butchart, and A. Vahanian
Recommendations on the management of the asymptomatic patient with valvular heart disease
Eur. Heart J., August 2, 2002; 23(16): 1253 - 1266.
[PDF]


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Int J EpidemiolHome page
L. L Demer
Vascular calcification and osteoporosis: inflammatory responses to oxidized lipids
Int. J. Epidemiol., August 1, 2002; 31(4): 737 - 741.
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CirculationHome page
N. M. Rajamannan, M. Subramaniam, M. Springett, T. C. Sebo, M. Niekrasz, J. P. McConnell, R. J. Singh, N. J. Stone, R. O. Bonow, and T. C. Spelsberg
Atorvastatin Inhibits Hypercholesterolemia-Induced Cellular Proliferation and Bone Matrix Production in the Rabbit Aortic Valve
Circulation, June 4, 2002; 105(22): 2660 - 2665.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
F. Robicsek, M. J. Thubrikar, and A. A. Fokin
Cause of degenerative disease of the trileaflet aortic valve: review of subject and presentation of a new theory
Ann. Thorac. Surg., April 1, 2002; 73(4): 1346 - 1354.
[Abstract] [Full Text] [PDF]


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ANGIOLOGYHome page
I. Hisar, M. Ileri, E. Yetkin, I. Tandogan, S. Cehreli, R. Atak, K. Senen, and D. Demirkan
Aortic Valve Calcification: Its Significance and Limitation as a Marker for Coronary Artery Disease
Angiology, March 1, 2002; 53(2): 165 - 169.
[Abstract] [PDF]


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HeartHome page
C. M OTTO and K. D O'BRIEN
Why is there discordance between calcific aortic stenosis and coronary artery disease?
Heart, June 1, 2001; 85(6): 601 - 602.
[Full Text]


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NEJMHome page
C. M. Otto
Aortic Stenosis -- Listen to the Patient, Look at the Valve
N. Engl. J. Med., August 31, 2000; 343(9): 652 - 654.
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J. Am. Soc. Nephrol.Home page
G. M. LONDON, B. PANNIER, S. J. MARCHAIS, and A. P. GUERIN
Calcification of the Aortic Valve in the Dialyzed Patient
J. Am. Soc. Nephrol., April 1, 2000; 11(4): 778 - 783.
[Full Text] [PDF]


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LupusHome page
A. Wierzbicki
Lipids, cardiovascular disease and atherosclerosis in systemic lupus erythematosus
Lupus, March 1, 2000; 9(3): 194 - 201.
[Abstract] [PDF]


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NEJMHome page
C. M. Otto, B. K. Lind, D. W. Kitzman, B. J. Gersh, D. S. Siscovick, and The Cardiovascular Health Study
Association of Aortic-Valve Sclerosis with Cardiovascular Mortality and Morbidity in the Elderly
N. Engl. J. Med., July 15, 1999; 341(3): 142 - 147.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
M. Olsson, J. Thyberg, and J. Nilsson
Presence of Oxidized Low Density Lipoprotein in Nonrheumatic Stenotic Aortic Valves
Arterioscler Thromb Vasc Biol, May 1, 1999; 19(5): 1218 - 1222.
[Abstract] [Full Text] [PDF]


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CirculationHome page
K. D. O'Brien, K. L. Olin, C. E. Alpers, W. Chiu, M. Ferguson, K. Hudkins, T. N. Wight, and A. Chait
Comparison of Apolipoprotein and Proteoglycan Deposits in Human Coronary Atherosclerotic Plaques : Colocalization of Biglycan With Apolipoproteins
Circulation, August 11, 1998; 98(6): 519 - 527.
[Abstract] [Full Text] [PDF]


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CirculationHome page
C. M. Otto, I. G. Burwash, M. E. Legget, B. I. Munt, M. Fujioka, N. L. Healy, C. D. Kraft, C. Y. Miyake-Hull, and R. G. Schwaegler
Prospective Study of Asymptomatic Valvular Aortic Stenosis : Clinical, Echocardiographic, and Exercise Predictors of Outcome
Circulation, May 6, 1997; 95(9): 2262 - 2270.
[Abstract] [Full Text]