cholecalciferol and Aortic-Valve-Stenosis

Topics: Aortic Valve Stenosis; Calcium; Calcium Metabolism Disorders; Cholecalciferol; Ergocalciferols; Female; Humans; Hydroxycholecalciferols; Hypercalcemia; Hypophosphatemia, Familial; Infant; Kidney; Nutritional Requirements; Pregnancy; Skin; Vitamin D; Vitamin D Deficiency

The use of animal models of aortic stenosis (AS) remains essential to further elucidate its pathophysiology and to evaluate new therapeutic strategies. The waved-2 mouse AS model has been proposed; data have indicated that while aortic regurgitation (AR) is effectively induced, development of AS is rare. We aimed to evaluate the effect of high-fat diet (HFD) and vitamin D. HFD and subcutaneous vitamin D. Total cholesterol and 1,25(OH). These results suggest that HFD and vitamin D

Topics: Animals; Aortic Valve Stenosis; Cholecalciferol; Cholesterol; Diet, High-Fat; Dietary Supplements; Disease Models, Animal; ErbB Receptors; Female; Humans; Male; Mice

Data suggest a link of aortic stenosis (AS) with calcium and bone metabolism. To further investigate this, the following parameters were analyzed in 38 patients with severe AS and in 38 age- and gender-matched controls, without obstructive coronary artery disease and with preserved renal function: calcium, phosphate, 1,25(OH(2))-vitamin D(3), intact parathyroid hormone (iPTH), and osteoprotegerin. Patients with AS had significantly higher serum levels of calcium (2.63 +/- 0.28 vs 2.48 +/- 0.23 mmol/L, p <0.01) and phosphate (1.56 +/- 0.33 vs 1.38 +/- 0.26 mmol/L, p <0.01) and increased calcium-phosphorus products (4.16 +/- 1.13 vs 3.44 +/- 0.89 mmol/L(2), p = 0.003). Notably, the iPTH concentration in the AS group was lower, and significantly more patients in the AS group had levels less than the study median of 60 ng/L. Osteoprotegerin was elevated in patients with AS, confirming reports in other populations (9.94 +/- 5.96 vs 6.73 +/- 4.28 pmol/L, p = 0.009). The relations of several parameters to iPTH were also altered (AS vs controls): calcium and iPTH, 0.071 +/- 0.034 versus 0.046 +/- 0.023, p <0.0001; phosphate and iPTH, 0.042 +/- 0.020 versus 0.025 +/- 0.013, p <0.0001; vitamin D and iPTH, 0.99 +/- 0.61 versus 0.63 +/- 0.46, p = 0.006; and osteoprotegerin and iPTH, 0.24 +/- 0.15 versus 0.12 +/- 0.09, p <0.0001. In conclusion, these data support a hypothesis connecting (severe) AS to altered calcium and bone homeostasis.

Topics: Aged; Aortic Valve Stenosis; Calcium; Cholecalciferol; Creatinine; Female; Humans; Kidney Function Tests; Male; Osteoprotegerin; Parathyroid Hormone; Phosphates

Valvular calcification in chronic haemodialysis patients has already been reported in the literature, particularly the abnormally high incidence of aortic stenosis. In this study, 112 haemodialysis patients were followed up by Doppler echocardiography for a period of 36 months. Sixteen patients developed aortic valvular calcification with aortic stenosis over an 18.7 +/- 7.5 months period. The indexed aortic valve surface area decreased from 1.24 +/- 0.9 cm2/m2 to 0.66 +/- 0.21 cm2/m2 with abnormally rapid progression. Eight patients with aortic stenosis died during the 3 year study period. These results reflect the abnormal extra-skeletal calcification of chronic haemodialysis patients. Several predisposing factors were demonstrated: age (68.5 +/- 11.1 years versus 57.1 +/- 16.3 years in patients without calcifications), male gender, a longer period of dialysis than the patients without aortic stenosis (8.1 +/- 5.3 versus 5.9 +/- 5.7 years), abnormalities of calcium and phosphate metabolism, increased of the phosphocalcic product by hyperphosphoraemia and not by hypercalcaemia, hypoparathyroidism in 62% and hyperparathyroidism in 38% an increase in vitamin D 3 (19.7 +/- 14 ng/ml versus 9.6 +/- 6.3 ng/ml) biological signs of adynamic osteodystrophy. Calcific aortic stenosis is a commonly observed valvular lesion in haemodialysis patients: its progression may be very rapid, associated with a poor prognosis. Old age, male gender, duration of haemodialysis, hyperphosphataemia associated with hypoparathyroidism and raised Vitamin D3 are predisposing factors.

Topics: Aged; Aged, 80 and over; Aortic Valve Stenosis; Calcinosis; Calcium Metabolism Disorders; Cholecalciferol; Female; Follow-Up Studies; Humans; Kidney Failure, Chronic; Male; Middle Aged; Phosphorus Metabolism Disorders; Prognosis; Renal Dialysis; Risk Factors; Ultrasonography