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Concentration of Trace Elements in Patients with Aortic Stenosis and Coexisting Coronary Artery Disease: A Pilot
Anna Olasińska-Wiśniewska1, Tomasz Urbanowicz1, Marcin Misterski1
1Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-848 Poznan, Poland.
Insights
Patients with severe aortic stenosis and coronary artery disease (CAD) have lower blood trace element levels. Lower selenium in aortic blood predicts advanced CAD, highlighting trace elements
Area of Science:
- Cardiology
- Biochemistry
- Trace Element Research
Background:
- Coronary artery disease (CAD) and aortic stenosis (AS) often coexist, sharing inflammatory and metabolic pathways.
- Trace elements play crucial roles in physiological processes and can be altered in disease states.
Purpose of the Study:
- To compare trace metal concentrations in patients with severe aortic stenosis (AS) with and without coexisting coronary artery disease (CAD).
Main Methods:
- Analysis of trace element concentrations in peripheral and aortic blood samples from 53 severe AS patients.
- Coronary angiography and revascularization history were used to assess CAD presence and severity.
Main Results:
- Patients with CAD exhibited lower peripheral blood concentrations of aluminum and calcium, and aortic concentrations of manganese and selenium.
- Advanced CAD correlated with lower peripheral magnesium, calcium, nickel, copper, and aortic chromium and selenium.
- Aortic selenium levels were predictive of advanced CAD.
Conclusions:
- Severe AS patients with coexisting CAD demonstrate significantly reduced blood trace element concentrations compared to those with isolated AS.
- Trace element dysregulation may be implicated in the pathophysiology of coexisting AS and CAD.
Abstract:
Background/Objectives: Coronary artery disease (CAD) and aortic stenosis (AS) frequently coexist and share similar pathophysiological pathways, including inflammation, lipid deposition, and extracellular matrix remodeling. Trace elements are involved in cellular and physiological processes, playing regulatory and signaling roles. Their concentrations may be altered in various pathological conditions. The aim of our study was to compare trace metal concentrations in patients with severe aortic stenosis with and without coexisting coronary artery disease. Methods: In 53 patients (25 male, 47.2%, median age of 78 (75-81) years) with severe aortic stenosis, CAD coexistence and progression were analyzed based on the most recent coronary angiography report and history of revascularization. Blood samples for trace element analysis were collected prior to the implantation of the prosthesis, from the peripheral artery and by the pigtail catheter at the aortic root. Results: Twenty-six patients presented any degree of CAD, and were further differentiated into more advanced disease stages. The analysis found that patients with CAD had lower median concentrations of aluminum and calcium in the peripheral blood, and manganese and selenium in the aorta. Furthermore, in most advanced CAD patients, the concentration of magnesium, calcium, nickel, and copper in peripheral blood, along with chromium and selenium in aortic blood, was found to be lower compared to non-CAD patients. Lower selenium in aortic blood samples was predictive of an advanced stage of CAD. Conclusions: Patients with severe aortic stenosis and coexisting CAD present significantly lower blood concentrations of trace elements compared to those with the isolated disease.
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