Clinical Implication of Aortic Wall Biopsy in Aortic Valve Disease with Bicuspid Valve Pathology.
10.5090/kjtcs.2016.49.6.443
- Author:
Yong Han KIM
1
;
Ji Seong KIM
;
Jae Woong CHOI
;
Hyoung Woo CHANG
;
Kwon Joong NA
;
Jun Sung KIM
;
Kyung Hwan KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Korea. kkh726@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Aortic valve;
Bicuspid aortic valve;
Matrix metalloproteinase 9;
Tissue inhibitor of metalloproteinase-2;
Endothelial nitric oxide synthase
- MeSH:
Aorta;
Aortic Valve*;
Bicuspid*;
Biopsy*;
Coronary Sinus;
Humans;
Matrix Metalloproteinase 9;
Mitral Valve*;
Nitric Oxide Synthase Type III;
Pathology*;
Tissue Inhibitor of Metalloproteinase-2
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2016;49(6):443-450
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Although unique aortic pathology related to bicuspid aortic valve (BAV) has been previously reported, clinical implications of BAV to aortopathy risk have yet to be investigated. We looked for potential differences in matrix protein expressions in the aortic wall in BAV patients. METHODS: Aorta specimens were obtained from 31 patients: BAV group (n=27), tricuspid aortic valve (TAV) group (n=4). The BAV group was categorized into three subgroups: left coronary sinus-right coronary sinus (R+L group; n=13, 42%), right coronary sinus-non-coronary sinus (R+N group; n=8, 26%), and anteroposterior (AP group; n=6, 19%). We analyzed the expression of endothelial nitric oxide synthase (eNOS), matrix metalloproteinase (MMP)-9, and tissue inhibitor of matrix metalloproteinase (TIMP)-2. RESULTS: Based on the mean value of the control group, BAV group showed decreased expression of eNOS in 72.7% of patients, increased MMP-9 in 82.3%, and decreased TIMP in 79.2%. There was a higher tendency for aortopathy in the BAV group: eNOS (BAV:TAV)= 53%±7%:57%±11%, MMP-9 (BAV:TAV)=48%±10%:38%±1%. The AP group showed lower expression of eNOS than the fusion (R+L, R+N) group did; 48%±5% vs. 55%±7% (p=0.081). CONCLUSION: Not all patients with BAV had expression of aortopathy; however, for patients who had a suspicious form of bicuspid valve, aortic wall biopsy could be valuable to signify the presence of aortopathy.
