Dyslipidemia as a cause of aortic stenosis. Review of literature and own experience of monitoring patients with familial hypercholesterolemia

Introduction . Aortic stenosis (AS) is the third leading cause of death from cardiovascular disease. AS is a multifactorial disease, and dyslipidemia is one of the possible etiopathogenetic mechanisms of its development. Familial hypercholesterolemia (FH) is a genetic disorder characterized by elevated total cholesterol and low-density lipoprotein cholesterol levels from birth. Aim : to analyze the contribution of dyslipidemia and elevated Lp(a) levels to the formation of AS in patients with FH. Materials and methods : 134 patients with heterozygous FH were examined (mean age 52.9±3.2 years, 85 (63.4%) men), of which 10 (7.46%) patients were diagnosed with AS. FH was diagnosed according to the Dutch Lipid Clinic Network criteria. Lipoprotein(a) (Lp(a)) concentration was measured using the turbometric method. Results . In patients with FH and AS, higher levels of total cholesterol were detected (11.88±1.83 mmol/l compared with 9.85±1.47 mmol/l without AS, p<0.01); higher levels of LDL cholesterol (9.24±1.2 mmol/l compared with 7.23±1.34 mmol/l without AS, p<0.001). An increase in Lp(a) by 1 unit of measurement (1 g/l) leads to a 10.6-fold increase in the OR for AS (OR = 10.5 [5.0; 21.9] p=0.0017). Conclusions : Increased levels of total cholesterol and LDL cholesterol, Lp(a) are associated with the development of AS in patients with FH.. The role of extraoral TAS2Rs and mechanisms of its regulation remain uncertain, that requires further research, including the field of respiratory pathology.