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Circulating soluble receptor for advanced glycation end product identifies patients with bicuspid aortic valve and

Emanuela Branchetti1, Joseph E Bavaria1, Juan B Grau1

  • 1From the Department of Surgery, Thoracic Aortic Program, Perelman School of Medicine at University of Pennsylvania, Philadelphia (E.B., J.E.B., J.B.G., P.P., E.K.L., N.D.D., J.H.G., R.C.G., G.F.); and Department of Surgery, Valley Hospital, Columbia University, Ridgewood, NJ (R.E.S.).

Arteriosclerosis, Thrombosis, and Vascular Biology
|September 19, 2014
PubMed

Insights

Elevated soluble receptor for advanced glycation end product (sRAGE) levels indicate bicuspid aortic valve (BAV) presence and related aortic diseases, irrespective of aortic diameter. This biomarker aids in risk stratification for BAV patients needing surgery.

Area of Science:

  • Cardiovascular Medicine
  • Biomarker Discovery
  • Aortic Disease Research

Background:

  • Bicuspid aortic valve (BAV) affects 1-2% of the population, often requiring aortic valve replacement (AVR) and/or ascending aortic (AA) surgery.
  • Current risk stratification for BAV patients relies on imaging, which has limitations, leading to preventable aortic events.
  • Advanced glycation end products (AGEs) and their soluble receptor (sRAGE) are implicated in vascular remodeling and disease.

Purpose of the Study:

  • To evaluate the diagnostic and risk-stratification utility of circulating sRAGE in patients with BAV undergoing AVR and/or AA.
  • To determine the association between sRAGE levels and the presence of BAV and associated aortopathies.

Main Methods:

  • sRAGE levels were measured in 135 patients (74 BAV, 61 tricuspid aortic valve) undergoing AVR and/or AA.
  • Statistical analyses, including univariate and multivariate models, were performed to assess associations.
  • Histological analysis examined the correlation between sRAGE and aortic microstructure, diameter, and body surface area.

Main Results:

  • sRAGE levels were significantly higher in patients with BAV compared to those with a tricuspid aortic valve, independent of traditional risk factors.
  • Patients with BAV requiring both AVR and AA exhibited higher sRAGE levels than those needing AVR alone.
  • Elevated sRAGE correlated with dysfunctional aortic microstructure but not with aortic diameter or indexed aortic diameter.

Conclusions:

  • Circulating sRAGE is a significant biomarker associated with the presence of BAV and related aortopathies.
  • sRAGE levels provide valuable information for risk stratification in BAV patients, independent of aortic dimensions.
  • sRAGE may help identify 'fast progressors' with BAV who present with both valve and aortic disease at younger ages.
Abstract

Keywords:
advanced glyosylation end-product receptoraortic aneurysm, thoracicbicuspid aortic valve

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