What is the clinical evidence from this study?

Study design: Other. Population: Calcific aortic valve disease (CAVD) and renal failure (n=28). Intervention: 0.5% adenine diet vs. Standard diet. Primary outcome: Calibrated integrated backscatter (cIB) of the total aortic valve (ROI AVTOT) at week 9 (p=0.001).

January 1, 2013Open Access

Echocardiographic integrated backscatter for detecting progression and regression of aortic valve calcifications in rats

BRBram RoosensVrije Universiteit Brussel GBGezim BalaElectrophysiology KGKris GillisAZ Sint-Jan

Key Result

A 0.5% adenine diet significantly increased aortic valve calibrated integrated backscatter values at 9 weeks (16.4 vs 13.3 dB, p=0.001), which normalized after 12 weeks of diet cessation.

Structured PICO

Can echocardiographic calibrated integrated backscatter (cIB) accurately monitor the progression and regression of aortic valvular calcifications in a rat model of CAVD?

Population

28 male Wistar rats, 7 weeks old, followed for 21 weeks to evaluate the progression and regression of aortic valve calcifications induced by an adenine diet.

Intervention

Echocardiographic calibrated integrated backscatter (cIB) to monitor progression and regression of aortic valvular calcifications

Comparator

Histological measurement of calcified area (Ca Area) and age-matched controls on standard diet

Outcome

Progression and regression of aortic valvular calcifications as measured by cIB and compared to histological calcified area at baseline, 9 weeks, and 21 weekssurrogate

Echocardiographic calibrated integrated backscatter is a valid non-invasive tool for quantitatively monitoring the progression and regression of calcific aortic valve disease in a rat model.

Main Result

Absolute Event Rate: 16.4% vs 13.3%

p-value: p=0.001

Limitations

Animal model (rats) may not fully replicate human calcific aortic valve disease
Small sample size
Renal function only partially recovered after diet cessation, possibly due to rat strain susceptibility differences

Abstract

BACKGROUND: Calcification is an independent predictor of mortality in calcific aortic valve disease (CAVD). The aim of this study was to evaluate the use of non-invasive, non-ionizing echocardiographic calibrated integrated backscatter (cIB) for monitoring progression and subsequent regression of aortic valvular calcifications in a rat model of reversible renal failure with CAVD, compared to histology. METHODS: 28 male Wistar rats were prospectively followed during 21 weeks. Group 1 (N=14) was fed with a 0.5% adenine diet for 9 weeks to induce renal failure and CAVD. Group 2 (N=14) received a standard diet. At week 9, six animals of each group were killed. The remaining animals of group 1 (N=8) and group 2 (N=8) were kept on a standard diet for an additional 12 weeks. cIB of the aortic valve was calculated at baseline, 9 and 21 weeks, followed by measurement of the calcified area (Ca Area) on histology. RESULTS: At week 9, cIB values and Ca Area of the aortic valve were significantly increased in the adenine-fed rats compared to baseline and controls. After 12 weeks of adenine diet cessation, cIB values and Ca Area of group 1 decreased compared to week 9, while there was no longer a significant difference compared to age-matched controls of group 2. CONCLUSIONS: cIB is a non-invasive tool allowing quantitative monitoring of CAVD progression and regression in a rat model of reversible renal failure, as validated by comparison with histology. This technique might become useful for assessing CAVD during targeted therapy.

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