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Metabolomics of aortic valve stenosis: Are aortic valve stenosis and sclerosis different diseases?

Elisa Koljonen1, Olli Kärkkäinen2, Retu Haikonen3

  • 1Heart Center, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland.

Atherosclerosis
|October 24, 2025
PubMed

Insights

Small HDL particles, not overall HDL levels, are lower in aortic stenosis (AS) patients. This finding may explain the link between dyslipidemia and calcific aortic valve disease (CAVD) and suggests AS and aortic valve sclerosis (ASc) might be distinct conditions.

Area of Science:

  • Cardiovascular Medicine
  • Metabolomics
  • Biochemistry

Background:

  • Calcific aortic valve disease (CAVD) shares risk factors with atherosclerotic vascular diseases (ASVD).
  • Current treatments targeting ASVD risk factors are ineffective for preventing CAVD and aortic stenosis (AS).
  • The precise pathophysiology of CAVD remains undetermined.

Purpose of the Study:

  • To investigate metabolic signatures associated with CAVD.
  • To differentiate metabolic profiles between AS, aortic valve sclerosis (ASc), and healthy controls.

Main Methods:

  • Nuclear Magnetic Resonance (NMR) metabolomics was used for analysis.
  • Blood samples from 255 subjects (82 AS, 72 ASc, 101 controls) were analyzed.
  • Measurements included lipoproteins, lipids, amino acids, and inflammatory markers.

Main Results:

  • No significant differences in total cholesterol, HDL, LDL, or triglycerides were observed.
  • Small HDL particle levels were significantly lower in AS patients compared to ASc and control groups.
  • Albumin and certain amino acids were reduced in AS patients relative to ASc patients.

Conclusions:

  • Small HDL particle levels, not total HDL concentration, are significantly lower in AS patients.
  • Small HDL may represent a key factor linking dyslipidemia to CAVD pathophysiology.
  • The distinct metabolic profiles suggest AS and ASc may represent separate disease entities.
Abstract

Keywords:
Aortic valve sclerosisAortic valve stenosisCalcific aortic valve diseaseCardiovascular diseasesHigh density lipoproteinMetabolomics

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