The relationship between serum trace elements and severity and progression of aortic stenosis

Introduction: Degenerative/calcific aortic stenosis is a very common disease in developed countries, affecting 21 - 26% of people over 65 years old and 48% of people over 85 years old. Progression rate is an important criteria in treatment of aortic stenosis (AS). However, which factors influence progression rate of AS is unknown. In this study, we investigated the effect of heavy metals on aortic valve progression. Materials and methods: A total of 55 patients (33 patients with mild AS and 22 patients with moderate AS) were included in the study, all had mild to moderate AS with a calcified aortic valve, were over 50 years of age, and had been diagnosed with aortic stenosis between 2011 and 2016. The mean of the annual velocity increase of all patients was calculated (0.17 m/s), and the patients with an increase below the mean were placed into group 1 (n = 29), and patients with a velocity change above the mean into group 2 (n = 26). Patients' blood heavy-metal levels and progression status (mean 3-year follow-up) were studied. Results: There were two groups of patients showing progressive and nonprogressive follow-up; 26 patients in the progressive group and 29 in the nonprogressive group were identified. Baseline characteristics were similar between the two groups. A significant difference was found between zinc, chromium, magnesium, and selenium in blood heavy-metal levels (p < 0.001). Conclusion: Changes in the levels of trace elements may cause oxidative stress and endothelial dysfunction leading to the development of calcific AS. Trace element levels may be indicative of rapid progression in patients with calcific AS.