CONGRESS ABSTRACT

The role of calcium metabolism in the development of degenerative Aortic Valve Stenosis (AVS) is not completely understood. Valvular cell modifications and passive calcification can be both involved in the diseases. Vitamin D (Vit D) and Parathyroid Hormone (PTH) are important factor in calcium regulation and data on their modification in AVS are scanty. Their potential role in AVS prevention is not yet identified. Osteocalcin can be considered a marker of calcification and its potential usefulness in identification of patient at risk for AVS was not studied. In order to correlate calcium metabolism to AVS development we have studied PTH, Vit D and Osteocalcin in a population of patients with AVS. We recruited 100 patients admitted in our Cardiac Surgery Unit for AVS confirmed by electrocardiogram, echocardiogram and hemodynamic evaluation. Subjects with rheumatic or congenital valvulopathy and infectious endocarditis were excluded from the study. Calcium, phosphorus, calcium-phosphorus ratio (Ca/P ratio), PTH, Vit D, renal function and osteocalcin were measured in each patient. In our population, 93.5% of patients had low levels of Vit D (<30 ng / ml), 42.4% had elevated levels of PTH (>38.4 pg / ml) and 28% had low levels of osteocalcin (<14 ng / ml). 87% of the population had normal calcium levels (8.4-10.2 mg / dl) and 93.3% had normal levels of phosphoremia (2.7-4.5 mg / dl). Defining as normal a Ca/P ratio between 1.5 and 2.5, 60.7% of our population had high levels of Ca/P. In conclusion, our findings suggest that patients suffering from AVS have abnormal levels of factors involved in the regulation of calcium metabolism. Some factors can be target for preventive therapies.