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J Thorac Cardiovasc Surg 2009;138:196-199
© 2009 The American Association for Thoracic Surgery

Perioperative Management

Correlation between plasma osteopontin levels and aortic valve calcification: Potential insights into the pathogenesis of aortic valve calcification and stenosis

^a Department of Cardiothoracic Surgery, New York University Medical Center, New York, NY
^b Department of Medicine, Division of Cardiology, New York University Medical Center, New York, NY

Received for publication June 20, 2008; revisions received September 21, 2008; accepted for publication October 31, 2008.

^_* Address for reprints: Juan B. Grau, MD, New York University Medical Center, 530 First Ave, Skirball Institute Suite 9V, New York, NY 10016. (Email: jbgrau{at}yahoo.com).

Objective: The inflammatory process of aortic stenosis involves the differentiation of aortic valve myofibroblasts into osteoblasts. Osteopontin, a proinflammatory glycoprotein, both stimulates differentiation of myofibroblasts and regulates the deposition of calcium by osteoblasts. Osteopontin levels are increased in patients with such conditions as end-stage renal disease, ectopic calcification, and autoimmune disease. We hypothesized that increased plasma osteopontin levels might be associated with the presence of aortic valve calcification and stenosis.

Methods: Venous blood from volunteers older than 65 years undergoing routine echocardiographic analysis or aortic valve surgery for aortic stenosis was collected. Plasma osteopontin levels were measured by means of enzyme-linked immunosorbent assay. The presence of aortic stenosis was defined as an aortic valve area of less than 2.0 cm². Aortic valve calcification was assessed by using a validated echocardiographic grading system (1, none; 2, mild; 3, moderate; 4, severe). Comparisons were performed with nonpaired t tests.

Results: Aortic stenosis was present in 23 patients (mean age, 78 years) and was absent in 7 patients (mean age, 72 years). Aortic valve calcification scores were 3.5 ± 0.6 and 1.3 ± 0.5 in patients with and without aortic stenosis, respectively (P < .001). Patients with no or mild aortic valve calcification had lower osteopontin levels compared with patients with moderate or severe aortic valve calcification (406.1 ± 165.8 vs 629.5 ± 227.5 ng/mL, P = .01). Similarly, patients with aortic stenosis had higher osteopontin levels compared with patients without aortic stenosis (652.2 ± 218.7 vs 379.7 ± 159.9 ng/mL, P < .01).

Conclusion: Increased levels of plasma osteopontin are associated with the presence of aortic valve calcification and stenosis. These findings suggest that osteopontin might play a functional role in the pathogenesis of calcific aortic stenosis.

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