Author + information
- Andreas Synetos,
- Konstantinos Toutouzas,
- Maria Drakopoulou,
- Konstantinos Stathogiannis,
- Georgios Benetos,
- Iosif Koutagiar,
- George Agrogiannis,
- Eftratios Patsouris,
- Constantinos Anagnostopoulos,
- Dennis Cokkinos and
- Dimitris Tousoutis
Background: Although bisphosphonates are compounds known to prevent medial vascular calcification, limited information regarding their effects on AV calcification exist. The aim of the present study was to evaluate in an experimental model of AV stenosis the effectiveness of local delivery of bisphosphonates on the inhibition of calcium formation by PET/CT in vivo and by histology ex vivo.
Methods: Sixteen New Zealand rabbits were placed on vitamin D enriched atherogenic diet for 3 weeks. At that time all animals underwent cardiac ultrasound to assess aortic stenosis and PET/CTwith 18F-NaF to assess calcification severity. Thereafter, 8 animals were subsequently treated with local delivery of a mixture containing 500 µg/l zoledronate that was delivered on the cusps of the aortic valve, by a dedicated balloon catheter. A placebo mixture was administered on the rest 8 animals (control group). At 28 days all animals underwent a follow-up cardiac imaging with PET-CT 18F-NaF. The progression of calcification was assessed by calculating the difference in SUVmax, SUVmean, TBRmax and TBR mean at baseline and at follow up both for AV and ascending aorta (AA). After the second PET/CT examination all animals were sacrificed and all aortic valves were analyzed by histology.
Results: At baseline, all animals developed AV stenosis with severe calcification. A total of 48 cusps were histologically examined. The cusps treated with zoledronate had significantly lower expression of calcium content compared to the cusps of the placebo group (16.40±0.90 vs 24.88±1.90 % of the area, p<0.0001), whereas the AA of both groups showed similar expression of calcium content (23.58±4.43 vs 23.12±5.05 % of the area, p=0.78). TBRmax and TBRmean showed an attenuation of calcification in AV the compared to AA (0.09±0.13vs 0.21±0.12, p=0.08 for TBRmax and -0.34±0.07vs 0.30±0.11, p=0.01 for TBRmean.). In the placebo group TBRmax and TBR mean did not show any significant difference both for AV and AA (0.38±0.27vs0.26±0.17, p=0.50 and 0.18±0.23vs0.12±0.12, p=0.56).
Conclusions: Inhibition of aortic valve calcification by local catheter-based delivery of zolendronic acid is effective without evident short-term complications.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Changing the Natural History of Valve Disease With Medical Therapy
Abstract Category: 37. Valvular Heart Disease: Therapy
Presentation Number: 1185-030
- 2017 American College of Cardiology Foundation