Association between apolipoprotein E alleles and calcific valvular heart disease

Area of Science:

• Cardiovascular Genetics
• Molecular Cardiology
• Valvular Heart Disease Research

Background:

• Apolipoprotein E (apoE) alleles, particularly apoE4, are established risk factors for coronary heart disease.
• Histological similarities exist between coronary artery disease and calcific valvular heart disease (aortic stenosis [AS] and mitral annular calcification [MAC]).

Purpose of the Study:

• To investigate the association between apolipoprotein E (apoE) alleles and the development of calcific valvular lesions, specifically AS and MAC.

Main Methods:

• Logistic regression analyses were performed on 802 patients undergoing transthoracic echocardiography.
• Genotype distribution and apoE4 allele prevalence were compared between patients with and without AS and MAC.
• Multivariate analyses adjusted for age, gender, LDL cholesterol, and coronary artery disease.

Main Results:

• No significant difference in apoE genotype distribution or apoE4 prevalence was found between patients with or without mitral annular calcification (MAC).
• A significant difference in apoE genotype distribution was observed in patients with aortic stenosis (AS) (P=0.03).
• The apoE4 allele was a significant independent predictor of AS (OR, 1.94; P=0.046) after adjusting for other risk factors.

Conclusions:

• The apolipoprotein E4 (apoE4) allele is associated with an increased risk of calcific aortic stenosis (AS).
• These findings suggest the apoE4 allele's role extends beyond atherosclerosis and Alzheimer's disease to include calcific AS.