Adipocytes in Aortic Stenosis: Association With Clinical and Morphological Indices

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Severe aortic stenosis (n=25). Intervention: PLIN1(+) valvular adipocytes. Primary outcome: Presence of adipocytes within the aortic stenotic valve.

Q: What does this research mean for the field?

Valvular adipocytes are present in a majority of severe aortic stenosis valves and are independently associated with lower echocardiographic mean gradients. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.ESTABLISHES_NEW_DIRECTION.

Elena Zoico; Tanaz Saatchi; Silvia Urbani; Vanni Rizzatti; Gloria Mazzali; Francesco Fantin; Silvia Faccioli; Alessandro Gavras; Mauro Zamboni; Anna Giani

doi:10.1002/ca.70045

November 9, 2025Clinical AnatomyOpen Access

Adipocytes in Aortic Stenosis: Association With Clinical and Morphological Indices

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Key result

Valvular adipocytes appear in 76% of severe AS samples and link to decreased mean gradients.

n=25

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Why the study?

The role of mature adipocytes in aortic stenosis and their association with histologic, clinical, and echocardiographic data was previously overlooked.

Key Points

To assess the presence of mature adipocytes in stenotic aortic valves and evaluate their relationship with clinical, echocardiographic, and ventricular histological features.
Enrolled 25 patients (15 women, 10 men) with severe aortic stenosis undergoing elective aortic valve replacement who completed preoperative clinical and transthoracic echocardiographic assessments.
Collected excised aortic valve specimens and left ventricular septal biopsies, utilizing perilipin 1 (PLIN1) immunohistochemistry to detect valvular adipocytes and examining ventricular M1 macrophage infiltration.
PLIN1-positive adipocytes were detected in 76% of aortic valve specimens, clustering primarily adjacent to calcified regions.
Patients with higher valvular PLIN1-positive adipocyte levels showed trends toward older age (p = 0.06) and lower BMI (p = 0.06), alongside significantly reduced mean transvalvular gradients and lower ventricular M1 macrophage infiltration.
Binary regression analysis revealed that only the mean transvalvular gradient was independently associated with valvular PLIN1-positive adipocytes after adjusting for age, BMI, and ventricular M1 macrophage counts.

Study Design

Type

Observational (n=25)

Structured PICO

P

Population

25 patients (15 women and 10 men) with severe aortic stenosis undergoing elective aortic valve replacement

I

Intervention

Assessment of valvular adipocytes using perilipin 1 (PLIN1) immunohistochemistry on excised aortic valves and left ventricular septal biopsies

O

Outcome

Presence of adipocytes within the valve and their association with histologic, clinical, and echocardiographic datasurrogate

Mature adipocytes are frequently present in severe aortic stenosis valves and are associated with echocardiographic mean gradients, suggesting a potential novel pathogenetic mechanism in disease progression.

Limitations

Preliminary findings requiring more investigation
Small sample size

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Implication

Valvular adipocytes should not alter aortic stenosis management; leaves open their role in progression pending prospective studies.

Abstract

Recently, great attention has been given to understanding the new pathogenetic mechanisms underlying aortic stenosis ( AS ). The study aims to understand the role of mature adipocytes in AS and their association with histologic, clinical, and echocardiographic data, an area previously overlooked in AS research. We enrolled 25 patients (15 women and 10 men) with severe AS undergoing elective aortic valve replacement. Each patient underwent clinical and transthoracic echocardiographic evaluations before surgery. We obtained AS valves and left ventricular ( LV ) septal biopsies to assess the presence of adipocytes within the valve using perilipin 1 ( PLIN1 ) immunohistochemistry, and we also examined other histological characteristics of the ventricular biopsies. Adipocytes were detected in 76% of the aortic stenotic valve samples, often grouped adjacent to calcified areas. Patients with higher values of PLIN1 valvular adipocytes were generally older ( p = 0.06) and had lower BMI values ( p = 0.06). Moreover, the group with a higher presence of PLIN1(+) valvular adipocytes had significantly decreased mean gradient values and reduced M1 macrophage infiltration in ventricular biopsies. In a binary regression analysis, only mean gradient was significantly associated with the presence of PLIN1(+) adipocytes in the valve, regardless of age, BMI and ventricular M1 macrophage levels. These preliminary findings suggest that valvular adipocytes could be related to the progression of AS , but more investigation is necessary.

Discussion

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Cite This Study

Zoico et al. (2025) conducted an observational in Severe aortic stenosis (n=25). PLIN1(+) valvular adipocytes was evaluated on Presence of adipocytes within the aortic stenotic valve. Valvular adipocytes were detected in 76% of severe aortic stenosis samples and were significantly associated with decreased mean gradient values.

synapsesocial.com/papers/6a0d6ba2389a567298ba7e51 https://doi.org/10.1002/ca.70045

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Adipocytes in Aortic Stenosis: Association With Clinical and Morphological Indices

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Adipocytes in Aortic Stenosis: Association With Clinical and Morphological Indices

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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