Inflammatory Characteristics of Stenotic Aortic Valves: A Comparison between Rheumatic and Nonrheumatic Aortic Stenosis

Background. Although our comprehension of nonrheumatic aortic stenosis (NRAS) has increased substantially during the last decade, less is known about the histopathology of rheumatic aortic stenosis (RAS). The aim of this study was to investigate rheumatic aortic stenosis by means of analyses previou...

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Main Authors: Lars Wallby, Thora Steffensen, Lena Jonasson, Mats Broqvist
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2013/895215
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author Lars Wallby
Thora Steffensen
Lena Jonasson
Mats Broqvist
author_facet Lars Wallby
Thora Steffensen
Lena Jonasson
Mats Broqvist
author_sort Lars Wallby
collection DOAJ
description Background. Although our comprehension of nonrheumatic aortic stenosis (NRAS) has increased substantially during the last decade, less is known about the histopathology of rheumatic aortic stenosis (RAS). The aim of this study was to investigate rheumatic aortic stenosis by means of analyses previously used in nonrheumatic stenosis. Material and Methods. Valve specimens were obtained from 39 patients referred to hospital due to significant aortic stenosis. According to established macroscopic criteria the valves were divided into two groups consisting of 29 NRAS and 10 RAS valves. Mononuclear inflammatory cells and apolipoproteins were investigated using immunohistochemical analyses. Results. The localisation of calcification differed in tricuspid nonrheumatic valves when compared to bicuspid nonrheumatic and rheumatic valves. The RAS valves revealed a lower degree of T lymphocyte infiltration compared with the NRAS valves. Infiltration of macrophages was seen in all valves and there were no differences regarding deposition of apolipoprotein. Conclusion. Rheumatic and nonrheumatic aortic stenotic valves show a similar and significant chronic inflammation. The similarities regarding the localisation of calcification indicate that the valve anomaly/morphology can influence the pathogenesis of aortic stenosis. Finally, our findings highlight the question of a postinflammatory valvular disease of other causes than rheumatic fever.
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spelling doaj-art-be9c2fe6b30642a0a3ad7ee0290c62d12025-02-03T01:28:06ZengWileyCardiology Research and Practice2090-80162090-05972013-01-01201310.1155/2013/895215895215Inflammatory Characteristics of Stenotic Aortic Valves: A Comparison between Rheumatic and Nonrheumatic Aortic StenosisLars Wallby0Thora Steffensen1Lena Jonasson2Mats Broqvist3Department of Clinical Physiology, Linköping Heart Centre, Linköping University Hospital, 581 85 Linköping, SwedenDepartment of Pathology, University Hospital of Iceland, 101 Reykjavik, IcelandDepartment of Cardiology, Linköping University Hospital, Linköping, SwedenDepartment of Cardiology, Linköping University Hospital, Linköping, SwedenBackground. Although our comprehension of nonrheumatic aortic stenosis (NRAS) has increased substantially during the last decade, less is known about the histopathology of rheumatic aortic stenosis (RAS). The aim of this study was to investigate rheumatic aortic stenosis by means of analyses previously used in nonrheumatic stenosis. Material and Methods. Valve specimens were obtained from 39 patients referred to hospital due to significant aortic stenosis. According to established macroscopic criteria the valves were divided into two groups consisting of 29 NRAS and 10 RAS valves. Mononuclear inflammatory cells and apolipoproteins were investigated using immunohistochemical analyses. Results. The localisation of calcification differed in tricuspid nonrheumatic valves when compared to bicuspid nonrheumatic and rheumatic valves. The RAS valves revealed a lower degree of T lymphocyte infiltration compared with the NRAS valves. Infiltration of macrophages was seen in all valves and there were no differences regarding deposition of apolipoprotein. Conclusion. Rheumatic and nonrheumatic aortic stenotic valves show a similar and significant chronic inflammation. The similarities regarding the localisation of calcification indicate that the valve anomaly/morphology can influence the pathogenesis of aortic stenosis. Finally, our findings highlight the question of a postinflammatory valvular disease of other causes than rheumatic fever.http://dx.doi.org/10.1155/2013/895215
spellingShingle Lars Wallby
Thora Steffensen
Lena Jonasson
Mats Broqvist
Inflammatory Characteristics of Stenotic Aortic Valves: A Comparison between Rheumatic and Nonrheumatic Aortic Stenosis
Cardiology Research and Practice
title Inflammatory Characteristics of Stenotic Aortic Valves: A Comparison between Rheumatic and Nonrheumatic Aortic Stenosis
title_full Inflammatory Characteristics of Stenotic Aortic Valves: A Comparison between Rheumatic and Nonrheumatic Aortic Stenosis
title_fullStr Inflammatory Characteristics of Stenotic Aortic Valves: A Comparison between Rheumatic and Nonrheumatic Aortic Stenosis
title_full_unstemmed Inflammatory Characteristics of Stenotic Aortic Valves: A Comparison between Rheumatic and Nonrheumatic Aortic Stenosis
title_short Inflammatory Characteristics of Stenotic Aortic Valves: A Comparison between Rheumatic and Nonrheumatic Aortic Stenosis
title_sort inflammatory characteristics of stenotic aortic valves a comparison between rheumatic and nonrheumatic aortic stenosis
url http://dx.doi.org/10.1155/2013/895215
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AT thorasteffensen inflammatorycharacteristicsofstenoticaorticvalvesacomparisonbetweenrheumaticandnonrheumaticaorticstenosis
AT lenajonasson inflammatorycharacteristicsofstenoticaorticvalvesacomparisonbetweenrheumaticandnonrheumaticaorticstenosis
AT matsbroqvist inflammatorycharacteristicsofstenoticaorticvalvesacomparisonbetweenrheumaticandnonrheumaticaorticstenosis