Role of serum hdl level and HDL functions on progression of calcific aortic stenosis

Calcific aortic stenosis is a disease continuum ranging from mild valve thickening to impaired leaflet mobility with extensive calcification. Clinical and epidemiological data well defines the role of atherosclerotic risk factors in pathogenesis of aort stenosis. Especially dyslipidemia with elevated total and LDL cholesterol levels exerts certain histopathological changes on calcified valve tissue. Low HDL levels were also demonstrated as a risk factor yet the exact role of HDL in this process is unkown. In an effort to evaluate calcific aortic stenosis-HDL relationship 42 patients (26 female; 16 male) with mild to moderate isolated aortic valve stenosis were evaluated in terms of demographic features; progression rates, serum lipid profiles with special focus on HDL; HDL subspecies, serum apoA1 levels and HDL related PON1 and PAF-AH enzyme activities. Progression rates were found to be positively correlated with serum LDL levels while negatively correlated with serum HDL levels. HDL2 subset demonstrated positive correlation with progression while HDL3 and serum apoA1 levels were independent of disease progression. A strong negative relationship was documented betweeen HDL2 AND apoA1. Among HDL related enzymes serum PON1 activity declines as stenosis progresses. No correlation between PAF-AH activity and progression was documented.