{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:32:59Z","timestamp":1790357579936,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,11,28]],"date-time":"2013-11-28T00:00:00Z","timestamp":1385596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In this study, we sought to determine the metabolic markers associated with structural valve degeneration (<jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Structural valve degeneration (<jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content>) is the major cause of bioprosthetic valve failure leading to bioprostheses (<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>s) stenosis or regurgitation. We hypothesized that lipoprotein\u2010associated phospholipase <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>2 (<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>p\u2010<jats:styled-content style=\"fixed-case\">PLA<\/jats:styled-content>2) is involved in the <jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content> of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 197 patients who underwent aortic valve replacement with a bioprosthetic valve and had echocardiographic follow\u2010up to evaluate valve function. Moreover, explanted <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>s (<jats:italic>n<\/jats:italic>\u00a0=\u00a039) were analysed by immunohistochemistry for the expression of <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>p\u2010<jats:styled-content style=\"fixed-case\">PLA<\/jats:styled-content>2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After a mean follow\u2010up of 7\u00b79\u00a0\u00b10\u00b72\u00a0years, forty\u2010one patients (21%) were identified as developing <jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content>. Patients with <jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content> had significantly higher plasma level of Lp\u2010<jats:styled-content style=\"fixed-case\">PLA<\/jats:styled-content>2 mass (151\u00b78\u00a0\u00b1\u00a09\u00b72\u00a0ng\/mL vs. 133\u00b72\u00a0\u00b1\u00a03\u00b74\u00a0ng\/mL, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b703) and activity (27\u00b76\u00a0\u00b1\u00a00\u00b79\u00a0nmol\/min\/mL vs. 25\u00b70\u00a0\u00b1\u00a00\u00b74\u00a0nmol\/min\/mL, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7005). Multivariate analysis revealed that <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>p\u2010<jats:styled-content style=\"fixed-case\">PLA<\/jats:styled-content>2 activity (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 1\u00b709, 95% CI: 1\u00b701\u20131\u00b718; <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b703) was the strongest independent predictor of <jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content>. Immunohistochemistry studies of explanted <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> showed that 77% of explanted <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>s had the expression of <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>p\u2010<jats:styled-content style=\"fixed-case\">PLA<\/jats:styled-content>2, which correlated with the density of macrophages (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>68), and ox\u2010<jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content> levels in bioprosthetic tissues.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increased blood plasma activity of Lp\u2010<jats:styled-content style=\"fixed-case\">PLA<\/jats:styled-content>2 is associated with higher prevalence of <jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content>. These findings open new avenues for the identification of patients at risk for <jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content> and for the development of pharmacotherapy aiming at the prevention of <jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.12199","type":"journal-article","created":{"date-parts":[[2013,11,6]],"date-time":"2013-11-06T15:09:26Z","timestamp":1383750566000},"page":"136-145","source":"Crossref","is-referenced-by-count":34,"title":["<scp>L<\/scp>p\u2010<scp>PLA<\/scp>2 is associated with structural valve degeneration of bioprostheses"],"prefix":"10.1111","volume":"44","author":[{"given":"Ablajan","family":"Mahmut","sequence":"first","affiliation":[{"name":"Laboratoire d'\u00c9tudes Mol\u00e9culaires des Valvulopathies (LEMV) Groupe de Recherche en Valvulopathies (GRV) Department of Surgery Quebec Heart and Lung Institute\/Research Center Laval University Quebec QC 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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Pierre","family":"Despr\u00e9s","sequence":"additional","affiliation":[{"name":"Institut universitaire de cardiologie et de pneumologie de Qu\u00e9bec Qu\u00e9bec QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Pibarot","sequence":"additional","affiliation":[{"name":"Institut universitaire de cardiologie et de pneumologie de Qu\u00e9bec Qu\u00e9bec QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Mathieu","sequence":"additional","affiliation":[{"name":"Laboratoire d'\u00c9tudes Mol\u00e9culaires des Valvulopathies (LEMV) Groupe de Recherche en Valvulopathies (GRV) Department of Surgery Quebec Heart and Lung Institute\/Research Center Laval University Quebec QC 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