Abstract 288: Circulating sRAGE Identifies Bicuspid Aortic Valve Patients and Associated Aortopathies in Patients Referred for Surgery
Background: Thirty to 50% of Bicuspid Aortic Valve (BAV) patients require surgery for aortic valve replacement (AVR), ascending aortic replacement (AA), or both. To prevent adverse aortic events they are risk-stratified using imperfect criteria based on metric measurements of the ascending aorta. As a result, a significant number of aortic dissections occur outside of the parameters suggested by the guidelines. Advanced Glycation End products (AGE) are associated with valve and vascular remodeling and trigger the release of a soluble receptor (sRAGE). We hypothesize that circulating sRAGE may identify BAV patients and that its levels may be used as risk stratification tool for adverse aortic events.
Methods: sRAGE was measured in 135 patients (BAV n=74; Tricuspid Aortic Valve (TAV) n=61) meeting inclusion criteria over 338 enrolled patients undergoing AVR and/or AA. Logistic regression and multivariate analysis were performed.
Results: sRAGE identified BAV patients independently of age, gender, and common risk-factors for vascular disease (p<0.001). Within the BAV cohort, patients referred for AA and AVR had higher sRAGE values than patients undergoing AVR only (p=0.002). BAV patients younger than 60 years of age, presenting with both valve and aortic diseases (fast progressors), had higher sRAGE than older patients who only needed AVR (“slow progressors”). Histological analysis showed that sRAGE correlates with dysfunctional aortic microstructure and does not correlate with aortic diameter (R2=0.007, p=0.51) or diameter/BSA (R2=0.011, p=0.42).
Conclusions: These results advocate for a blood test to diagnose BAV and to risk-stratify these patients for aortopathies independently of metric measurements.
Author Disclosures: E. Branchetti: None. P. Poggio: None. J.B. Grau: None. R.E. Shaw: None. N.D. Desai: None. J.H. Gorman: None. R.C. Gorman: None. J.E. Bavaria: None. G. Ferrari: None.
- © 2014 by American Heart Association, Inc.