Key result
Calcified aortic valves show significantly higher concentrations of multiple metals and trace elements vs. healthy controls.
Why the study?
Non-infectious influences represented by biological effects of metal pollutants may participate in the inflammatory etiopathogenesis of acquired calcified aortic valve stenosis.
Does tissue accumulation of metal pollutants and trace elements differ between calcified aortic valves and healthy control valves?
Case-Control (n=83)
No
Does tissue accumulation of metal pollutants and trace elements differ between calcified aortic valves and healthy control valves?
Calcified aortic valves accumulate significantly higher levels of various metals and trace elements compared to healthy valves, suggesting environmental metal exposure could contribute to the degenerative calcification process.
Metal accumulation in calcified valves may reflect environmental exposure; hypothesis-generating for its role in degeneration and requires prospective confirmation.
BACKGROUND: Acquired calcified aortic valve stenosis is the most common valve disease in adulthood. In the etiopathogenesis of this complex pathology, the importance of inflammation is mentioned, in which non-infectious influences represented by the biological effects of metal pollutants may participate. The main goal of the study was to determine the concentration of 21 metals and trace elements-aluminium (Al), barium (Ba), cadmium (Cd), calcium (Ca), chrome (Cr), cobalt (Co), copper (Cu), gold (Au), lead (Pb), magnesium (Mg), mercury (Hg), molybdenum (Mo), nickel (Ni), phosphorus (P), selenium (Se), strontium (Sr), sulfur (S), tin (Sn), titanium (Ti), vanadium (V) and zinc (Zn)-in the tissue of calcified aortic valves and to compare them with the concentrations of the same elements in the tissue of healthy aortic valves in the control group. MATERIAL AND METHODS: The study group consisted of 49 patients (25 men, mean age: 74) with acquired, severe, calcified aortic valve stenosis with indicated heart surgery. The control group included 34 deceased (20 men, median age: 53) with no evidence of heart disease. Calcified valves were explanted during cardiac surgery and deep frozen. Similarly, the valves of the control group were removed. All valves were lyophilized and analyzed by inductively coupled plasma mass spectrometry. The concentrations of selected elements were compared by means of standard statistical methods. Significant positive correlations of concentrations between the pairs Ca-P, Cu-S and Se-S and strong negative correlations between the elements Mg-Se, P-S and Ca-S were found in the affected valves. CONCLUSION: Aortic valve calcification is associated with increased tissue accumulation of the majority of the analyzed elements, including metal pollutants. Some exposure factors may increase their accumulation in the valve tissue. A relationship between exposure to environmental burden and the aortic valve calcification process cannot be ruled out. Advances in histochemical and imaging techniques allowing imaging of metal pollutants directly in valve tissue may represent an important future perspective.
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Tomášek et al. (2023) conducted a case-control in Acquired calcified aortic valve stenosis (n=83). Environmental metal and trace element exposure vs. Healthy aortic valves was evaluated on Concentration of 21 metals and trace elements in aortic valve tissue (p=< 0.05). Calcified aortic valves exhibited significantly higher concentrations of Ba, Ca, Co, Cr, Mg, P, Pb, Se, Sn, Sr, and Zn compared to healthy control valves (p<0.05).
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