Artemijs Vasjanovics, Lukas Weber, Simge Baydar, Marco Cremonesi, Marinos Kallikourdis, Attila Kiss, Bruno Podesser and Georgios Kararigas
Introduction: Aortic stenosis (AS) causes pressure overload and hypertrophy of the left ventricle. Aortic valve replacement (AVR) relieves the pressure overload. However, the left ventricular hypertrophy (LVH) often does not regress fully and this has been associated with worse prognosis. The goal of this study was to identify molecular factors, which may have prognostic value on the regression of LVH.
Methods: Samples were collected from cardiac tissue of 18 patients (9 biologically female, median age 74.2 years), who underwent surgical AVR due to moderate or severe AS. Expression of two selected genes, i.e. ADGRL4 and AQP7, was quantified using PCR and assessed with relative regression of left ventricular mass index (LVMi, postoperative LVMi – preoperative LVMi) / preoperative LVMi) approximately four months after AVR according to echocardiography using linear regression. Pearson’s correlation test had an α-level of 0.05.
Results: In biologically male patients, a significant relationship was found between lower expression of ADGRL4 (P < 0.05, R2 = 0.497) and AQP7 (P < 0.05, R2 = 0.576) and increased relative regression of LVMi after AVR. This relationship was not significant for neither ADGRL4 (P = 0.704, R2 = 0.0214) nor AQP7 (P = 0.860, R2 = 0.00477) in biologically female patients. Conclusions: Measurement of the expression of ADGRL4 and AQP7 could lead to more aggressive medical treatment for male patients in whom LVH regression after surgery is expected to be poor. Thus, their prognosis could improve. This would need to be confirmed in a larger study.
