Aortic valve sclerosis was independently associated with a higher MMP-9/TIMP-1 ratio (β 0.78) compared to normal aortic valves, indicating an active proteolytic and inflammatory profile.
Cross-Sectional (n=168)
No
Aortic valve sclerosis is characterized by an active proteolytic and inflammatory biomarker profile, specifically elevated MMP-9 and TNF with reduced TIMP-1, distinguishing it from normal valves and aortic stenosis.
Effect estimate: β 0.78 (95% CI 0.52-1.04)
Absolute Event Rate: 11% vs 4.8%
p-value: p=<0.001
Introduction Aortic valve sclerosis (AVSc) is an active pathological process driven by extracellular matrix remodeling, consistent with a potentially reversible early stage of aortic valve disease. Methods In this cross-sectional study of 168 participants (29, normal aortic valve NAV; 98, AVSc; 41, aortic stenosis AS), serum levels of matrix metalloproteinase (MMP)-1, -2, -3, and -9, tissue inhibitor of metalloproteinases-1 (TIMP-1), tumor necrosis factor (TNF), interleukin-6 (IL-6), and transforming growth factor-beta (TGF-β) were measured. Multivariable adjustments were performed. Results Compared with AS, AVSc was associated with higher circulating MMP-9 levels, with MMP-9 also increased relative to NAV. TIMP-1 concentrations were reduced in AVSc compared with both AS and NAV. TNF levels were higher in AVSc than in AS, while IL-6 and TGF-β did not differ among groups. Notably, MMP-9/TIMP-1 ratio was markedly increased in AVSc. Discussion Our findings suggest that AVSc may exhibit an active proteolytic and inflammatory profile amenable to targeted anti-inflammatory and anti-proteolytic interventions.
Chan-Delgado et al. (2026) conducted a cross-sectional in Aortic valve sclerosis (n=168). Aortic valve sclerosis (AVSc) vs. Normal aortic valve (NAV) was evaluated on Log (MMP-9/TIMP-1) ratio (β 0.78, 95% CI 0.52-1.04, p=<0.001). Aortic valve sclerosis was independently associated with a higher MMP-9/TIMP-1 ratio (β 0.78) compared to normal aortic valves, indicating an active proteolytic and inflammatory profile.