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Article Dans Une Revue Archives of cardiovascular diseases Année : 2024

Angiopoietin-2 as a potential biomarker predictive of aortic valve stenosis progression

Résumé

Introduction Aortic valve stenosis (AS) is the most prevalent valvular heart disease and constitutes a major public health issue. Endothelial injury is an early event that might play a significant role in the setting of calcific deposits leading to AS. Assessment of endothelial dysfunction may therefore be of interest in the assessment AS. Objective Angiopoietin-2 (Ang-2) is a factor secreted by endothelial cells that have gained attention in recent years as potential biomarkers of endothelial injury. Our study aims to evaluate the usefulness of circulating Ang-2 for diagnosis and progression of AS. Method The prospective COFRASA/GENERAC cohort was used for this study which focuses on 208 asymptomatic AS patients with a tricuspid valve. At baseline and yearly thereafter, patients underwent clinical examination, blood measurement, transthoracic echocardiography (TTE), and multi-slice computed tomography (MSCT). Serum was used to measure Ang-2 concentration using an immunoassay commercial kit. Disease severity was assessed using a combination of the usual haemodynamic and morphological TTE parameters ie mean pressure gradient (MPG), peak transvalvular velocity (PV) aortic valve area (AVA) and aortic valve calcification (AVC) by MSCT. Progression was defined as the mean annual increase in either MPG, PV, AVA and AVC and rapid progression as a progression higher than the cohort's median progression for each parameter. Results Serum Ang-2 concentrations were significantly higher in AS patients as compared to a healthy control group (P < 0.0001) and were also higher in the severe AS group as compared to moderate AS or mild AS groups (P < 0.05). Independent association of Ang-2 with progression of MPG, PV, and AVC was shown through multivariate analysis using Cox proportional hazards ratio (P < 0.001). ROC curve analysis identified a possible Ang-2 serum threshold of 3.89 ng/mL. AS patients were then separated in 2 groups and LogRank analysis of Kaplan-Meier curves showed patients with Ang-2 higher than 3.89 ng/mL progressed more rapidly than their counterparts (P < 0.05). Conclusion These results suggest that Ang-2 could be a useful parameter to consider when evaluating AS patients’ severity and risk for rapid progression, in conjunction with traditional criteria. However, further studies are needed to corroborate our findings and determine clinical use.
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Dates et versions

hal-04627550 , version 1 (27-06-2024)

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Mamoune El Alami, Youssef Bennis, Carine Avondo, Christophe Tribouilloy, David Messika-Zeitoun, et al.. Angiopoietin-2 as a potential biomarker predictive of aortic valve stenosis progression. Archives of cardiovascular diseases, 2024, 117 (6-7), pp.S194. ⟨10.1016/j.acvd.2024.05.069⟩. ⟨hal-04627550⟩

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