Role of Active Valvular Calcification and Inflammation in Patients With Aortic Stenosis

University of Edinburgh

Status: Completed

Conditions: Aortic Stenosis

Study type: Observational

Funder types: Other

Identifiers

NCT01358513

RING OF FIRE

Details and patient eligibility

About

The aortic valve is the main outlet valve from the heart. This valve can become diseased and narrowed when it needs to be replaced with an artificial valve. Currently, this is the commonest reason for someone to undergo a heart valve operation in the UK. Unfortunately, there are no medical treatments that can prevent or delay the progression of this disease process. Here, the investigators propose to use new state-of-the-art imaging techniques to better understand the disease process so that the investigators can effectively design and assess potential new treatments. The ultimate aim is to stop this disease before patients need to have surgery. In addition the investigators believe this technique will allow us to predict the rate of progression of the disease

Full description

Aortic stenosis is the commonest valvular heart disease in the western world and is the leading indication for valve surgery. Histological studies have suggested similarities with atherosclerosis including inflammation, lipid deposition, increased macrophage activity and calcification. However, recent randomised controlled trials have failed to demonstrate a reduction in the rate of disease progression with statin therapy and the investigators believe there is now a need to re-evaluate the underlying factors involved in the initiation and progression of aortic stenosis. The investigators propose to assess the role of inflammation and calcification in the pathogenesis and progression of aortic stenosis by using positron emission tomography with [18F]-fluorodeoxyglucose and [18F-]-fluoride in patients with a range of aortic valve disease. The investigators hypothesise that increasing severity of valvular inflammation and calcification will correlate with disease severity and rate of disease progression. This work will lay the foundation for the subsequent application of interventions targeted at inflammation and calcification.

Enrollment: 121 patients

Sex: All

Ages: 50 to 100 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age > 50 years

Exclusion criteria

• Age < 50 years
• Life expectancy < 2 years
• Insulin dependent diabetes mellitus
• Connective Tissue disorders

Trial design

121 participants in 5 patient groups

Control Patients

Description:

Patients with normal aortic valves

Aortic sclerosis

Description:

To undergo PET imaging and follow up with CT and echo for 2 years

Mild Aortic stenosis

Description:

To undergo PET imaging and follow up with CT and echo for 2 years

Moderate Aortic stenosis

Description:

To undergo PET imaging and follow up with CT and echo for 2 years

Severe aortic stenosis

Description:

To undergo PET imaging and follow up with CT and echo for 2 years