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Evaluation of the Role of Oxidative Stress in Degenerative Aortic Stenosis.

BACKGROUND AND AIM OF THE STUDY: Calcific and degenerative aortic diseases (CDADs) are a group of disorders that mostly affect the elderly population and may progress and warrant aortic valve replacement. It is believed that oxidative stress plays a role in the progression of the diseases. Several markers of oxidative stress were evaluated in a small cohort of patients with CDADs, and a control group with similar characteristics.

METHODS: Thirty patients with aortic stenosis (AS) and 30 healthy subjects were included in the study. The activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) in both groups were studied as markers of oxidative stress. All patients and control subjects were evaluated echocardiographically for CDAD, and enzyme levels monitored biochemically.

RESULTS: The risk factors were similar in both groups, but levels of low-density lipoprotein (LDL) were higher in the CDAD group compared to controls (123.6 +/- 37.0 mg/dl versus 99.3 +/- 38.0 mg/dl, p < 0.01). The GSH-Px activity was significantly higher in the CDAD group than in controls (0.19 +/- 0.03 IU/ml versus 0.16 +/- 0.03 IU/ml, p < 0.01). A GSH-Px level > 0.18 IU/ml was found to be an indicator of CDAD, with a sensitivity of 70% and specificity of 73.3% on ROC analysis [AUC = 0.721, p < 0.05, 95% CI: 0.685 +/- 0.773]. SOD and CAT activities were similar in both groups (p > 0.05).

CONCLUSION: The study results showed that the activity of GSH-Px, a marker of oxidative stress, is increased in patients with degenerative AS. The increase in GSH-Px activity may be a protective response to remove reactive oxygen derivatives (RODs) from the body.

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