VPB0516 - Lp(a) increase calcium phosphate aortic valve mineralization in patients with a previous myocardial infarction.

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Co-Author(s)

Ad

Aurora de la Peña

Professor
Universidad Nacional Autonoma de Mexico/Instituto Nacional de Cardiologia
Mexico City, Distrito Federal, Mexico

Presenting Author(s)

Mirthala Flores-Garcia, PhD

Researcher
Instituto Nacional de Cardiología Ignacio Chávez
CDMX, Distrito Federal, Mexico

Co-Author(s)

GC

Guillermo Cardoso-Saldaña

Researcher
Instituto Nacional de Cardiologia
CDMX, Distrito Federal, Mexico
VH

Valentin Herrera

Researcher
Instituto Nacional de Cardiologia
CDMX, Distrito Federal, Mexico
CL

Carlos Linares-Lopez

Rearcher
Universidad Nacional Autónoma de México
CDMX, Distrito Federal, Mexico
JV

Juan Carlos Villegas-Hernandez

Student
Instituto Nacional de Cardiología
CDMX, Distrito Federal, Mexico
RL

Ramón Ledezma

Student
Universidad Whesthill
CDMX, Distrito Federal, Mexico
MP

Marco Antonio Peña-Duque

Medical Doctor
Instituto Nacional de Cardiología
CDMX, Distrito Federal, Mexico
MM

Marco Antonio Martinez- Rios

Medical Doctor
Instituto Nacional de Cardiología
CDMX, Distrito Federal, Mexico
EA

Eduardo Angles-Cano

Directeur de Recherche
INSERM
Paris, Ile-de-France, France

Background: Lp(a) is composed by apolipoprotein(a), attached to the apolipoprotein B segment of an LDL-like particle. Apo(a) has sequence homology with plasminogen, inhibiting fibrinolysis and causing atherothrombosis, infarction and ischaemic stroke..Apo(a) increases calcific valvular aortic stenosis through endothelial dysfunction and pro-inflammatory responses, and pro osteogenic effects promoting calcification. X-ray diffraction electron microscopy allowed the direct study of all the minerals found in the aortic valve. In addition to calcium, other minerals, whose chemical composition is associated with the mineralisation process, were present in the aortic valve stenosis. This approach may shed light to the Lp(a) promoted mineralization.

Aims: To identify the correlations between the plasma concentration of Lp(a) and the concentration of minerals deposited in the aortic valve in patients with aortic stenosis.

Methods: We conducted a cross-sectional analytical study that included 68 patients, aged 19-81 years old, both sexes, diagnosed with aortic stenosis, who underwent aortic valve replacement surgery at the Ignacio Chávez National Institute of Cardiology.
Plasma concentration of Lp(a) was obtained by a nephelometric method. Aortic valves were preserved in 10% formaldehyde and conveniently prepared for X-ray diffraction electron microscopy study.
This study was approved by the INC ethics committee, followed all the ethical principles of the Declaration of Helsinki, and the participants provided their written informed consent.
Statistical tests were used for parametric and non-parametric variables, as appropriate, and Spearman's Rho.

Results: Aortic valve calcium as well as serum Lp(a), were 1.22, and 4 times higher in people with a previous myocardial infarction. Also only in those with a previous myocardial infarction a negative association with chlorus is observed.

Conclusion(s): High Lp(a) levels are associated with calcium deposition in the aortic valve.