Surgical Tribune Europe

Study promises improved treatment for aortic stenosis

By Surgical Tribune
December 19, 2019

OSLO, Norway: Aortic stenosis is caused by aortic valve calcification, a challenging condition for the health service and for affected patients. The only treatment currently available is surgery, which holds risks and challenges. Therefore, researchers from the University of Oslo have investigated possible pharmacological therapy options in order to develop a non-surgical treatment.

The research was conducted by PhD student Mariia Bogdanova and her research team at the university. The study examined the mechanisms behind aortic valve calcification and according to Bogdanova there are many similarities between the disease and the formation of bone.

The cells in the connective tissue are transformed into bone-forming cells which start to form calcium crystals in the valve sails. In order to study this process more closely, the research team isolated cells from human valves which were harvested during valve operations—a recognised model for reflecting the basal disease process.

Thereafter, the researchers looked at the interplay between factors which could contribute toward valve calcification and cell transformation, which included mechanical stress, inflammation and biochemical composition of the valve surfaces.

They discovered that cells from calcified valves had altered important properties and functions compared with cells from healthy aortic valves. These cells from healthy valves also had a greater potential for transforming themselves into other different types of cells compared with cells from calcified valves.

Currently, there is no medical or pharmacological treatment available to stop or prevent the progression of this disease. The only option is a surgical procedure or catheter-based replacement of the aortic valve.

“Aortic stenosis is the most common heart valve disease which is treated surgically around the world. If left untreated it is a potentially fatal disease. The treatment can also lead to significant complications,” explained Bogdanova’s principal supervisor Dr Arkady Rutkovskiy.

These compilations include that the new biological valves can become recalcified, while patients with mechanical valves have to take anticoagulants for the rest of their lives.

“We are proposing potential pharmacological treatment for aortic stenosis which could possibly stop or even reverse the disease process. This treatment is capable of stopping calcification in our cell culture, something which is the first step in trialling potential drugs. We have a long way to go, but we consider that these findings now represent a step forwards in the prevention or treatment of aortic stenosis,” concluded Bogdanova.

The doctoral thesis, titled Cellular and molecular mechanisms of human aortic valve calcification, was published in 2019 by the Faculty of Medicine at the University of Oslo.

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