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Plasma Metabolomic Profiling Associates Bicuspid Aortic Valve Disease and Ascending Aortic Dilation with a Decrease

Neus Martínez-Micaelo1, Carme Ligero1,2, Borja Antequera-González1

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Bicuspid aortic valve (BAV) disease is linked to lower antioxidant levels and increased inflammation and endothelial damage. Measuring alpha-Tocopherol, C-reactive protein (CRP), and endothelial microparticles (EMPs) may aid in diagnosing BAV and its progression.

Keywords:
alpha-Tocopherolantioxidantascending aortic dilationbicuspid aortic valveinflammationmetabolomics

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Area of Science:

  • Cardiovascular Medicine
  • Biomarker Discovery
  • Metabolomics

Background:

  • Bicuspid aortic valve (BAV) is the most common congenital heart defect, increasing the risk of potentially fatal ascending aorta dilation.
  • Current diagnostic and prognostic tools for BAV lack established risk biomarkers.

Purpose of the Study:

  • To investigate plasma metabolite levels in patients with BAV compared to tricuspid aortic valves.
  • To explore the role of alpha-Tocopherol in BAV pathogenesis, particularly in relation to ascending aortic dilation.

Main Methods:

  • Employed an untargeted metabolomic approach on plasma samples from 212 patients with BAV or tricuspid aortic valves, including those with aortic dilation or stenosis.
  • Analyzed associations between alpha-Tocopherol, inflammation, oxidative stress, and endothelial damage biomarkers.

Main Results:

  • BAV patients, especially those with ascending aortic dilation, exhibited reduced antioxidant capacity (lower alpha-Tocopherol, paraoxonase 1, HDL) and increased inflammation (higher CRP) and endothelial damage (higher EMPs).
  • Random forest analysis demonstrated the capacity of alpha-Tocopherol, CRP, and EMPs to differentiate BAV patients based on aortic valve morphology.

Conclusions:

  • Decreased antioxidant capacity, elevated inflammation, and endothelial damage are implicated in BAV pathogenesis and aortic dilation progression.
  • Plasma levels of alpha-Tocopherol, CRP, and EMPs show potential for improving BAV diagnosis in broader populations.