Rare Earth Elements in Human Calcified Aortic Valves and Epicardial Adipose Tissue

Background/Objectives: Rare earth elements (REEs) are emerging environmental pollutants, with human exposure increasing due to recent industrial and technological activities. While most studies have focused on detecting REEs in human fluids, their presence in tissues remains understudied. Aortic valve degeneration is known to facilitate the adsorption of various chemical elements; however, the occurrence of REEs in human valves has not yet been investigated. This exploratory study aimed to determine the presence of REEs in the aortic valves of patients with aortic stenosis undergoing surgical valve replacement. It also analyzed potential correlations between REE levels in the valves, epicardial adipose tissue, serum, and selected disease markers. Methods: Samples of aortic valve, epicardial adipose tissue, and serum were collected from 20 adult patients undergoing elective aortic valve replacement. The concentrations of 14 REEs in these samples were measured using inductively coupled plasma mass spectrometry. Biochemical and clinical parameters of the patients were also considered to explore potential associations with the determined REE levels. Results: Total REEs, heavy REEs, and light REEs in aortic valves, epicardial fat, and serum were not intercorrelated. Moreover, for any sample type, they were not significantly related to the patient's demographics (age and sex), clinical characteristics (body mass index, heart failure severity, and systolic pressure gradients), kidney function (estimated glomerular filtration rate), and biochemical markers (creatinine, lipoprotein(a), total cholesterol, HDL, LDL, and fibrinogen). Smoking was the only factor influencing REE burden in studied patients, with active smokers revealing 61% higher serum REE concentrations and past smokers exhibiting 133% higher REE valvular deposition. Conclusions: The findings suggest that REE accumulation in aortic valve tissues occurs independently of systemic and clinical parameters but may be promoted by smoking, highlighting the need to investigate the underlying mechanisms of REE deposition. Given the small sample size and the cross-sectional, hypothesis-generating design, these observations should be interpreted with caution and treated as preliminary. Larger, longitudinal studies are needed to validate these results and explore potential causal relationships. Further research should also include the tissue originating from individuals without aortic stenosis for comparison. A deeper understanding of the pathways and health risks associated with REEs in cardiovascular tissues may offer valuable insights into their broader implications for human health.