Evaluation of the Role of Oxidative Stress in Degenerative Aortic Stenosis

Background and aim of the study: Calcific and degenerative aortic diseases (CDADs) are a group of disorders that mostly affect the elderly population and may progress and warrant aortic valve replacement. It is believed that oxidative stress plays a role in the progression of the diseases. Several markers of oxidative stress were evaluated in a small cohort of patients with CDADs, and a control group with similar characteristics.

Methods: Thirty patients with aortic stenosis (AS) and 30 healthy subjects were included in the study. The activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) in both groups were studied as markers of oxidative stress. All patients and control subjects were evaluated echocardiographically for CDAD, and enzyme levels monitored biochemically.

levels of low-density lipoprotein (LDL) were higher in the CDAD group compared to controls (123.6 ± 37.0 mg/dl versus 99.3 ± 38.0 mg/dl, p <0.01). The GSH-Px activity was significantly higher in the CDAD group than in controls (0.19 ± 0.03 IU/ml versus 0.16 ± 0.03 IU/ml, p <0.01). A GSH-Px level >0.18 IU/ml was found to be an indicator of CDAD, with a sensitivity of 70% and specificity of 73.3% on ROC analysis (AUC = 0.721, p <0.05, 95% CI: 0.685-0.773). SOD and CAT activities were similar in both groups (p >0.05).

Conclusion: The study results showed that the activity of GSH-Px, a marker of oxidative stress, is increased in patients with degenerative AS. The increase in GSH-Px activity may be a protective response to remove reactive oxygen derivatives (RODs) from the body.

The Journal of Heart Valve Disease 2015;24:445-450