SVF
Level C· Early human research exploring benefitsRetrospective StudyPubMed

Understanding the structural features of symptomatic calcific aortic valve stenosis: A broad-spectrum clinico-pathologic study in 236 consecutive surgical cases.

Galli D., Manuguerra R., Monaco R., Manotti L., Goldoni M., Becchi G.

Retrospective Study with a reported sample of 40 on Hip, Systemic / IV, published in Int J Cardiol (2016) — summary generated from the PubMed abstract.

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Level C· Early human research exploring benefitsEvidence level of this study

Early human evidence such as case series or small samples is exploring possible benefits.

  • Level A · Stronger Clinical Evidence
  • Level B · Emerging clinical evidence with positive signals
  • Level C · Early human research exploring benefits
  • Level D · Scientific groundwork from lab and animal studies
  • Emerging · Emerging topic under active research
Read the A–D evidence level guide

This page is generated from the PubMed record. The Thai description is an automated summary of bibliographic fields and the abstract, not a full translation, and is not medical advice.

Study type
Retrospective Study
Journal
Int J Cardiol (2016)
Country
Netherlands
Reported sample size
40
Source database
PubMed
PMID
27866029
DOI
10.1016/j.ijcard.2016.11.180

Abstract (original English)

With age, aortic valve cusps undergo varying degrees of sclerosis which, sometimes, can progress to calcific aortic valve stenosis (AVS). To perform a retrospective clinico-pathologic investigation in patients with calcific AVS. We characterized and graded the structural remodeling in 236 aortic valves (200 tricuspid and 36 bicuspid) from patients with calcific AVS (148 males; average 72years); possible relationships between general/clinical/echocardiographic characteristics and the histopathologic changes were explored. Twenty autopsy aortic valves served as controls. In 40 cases, we also tested the immunohistochemical expression of metalloproteinases and cytokines, and characterized the inflammatory infiltrate. In 5 cases, we cultured cusp stem cells and explored their potential to differentiate into osteoblasts/adipocytes. AVS cusps showed structural remodeling as severe fibrosis (100%), calcific nodules (100%), neoangiogenesis (81%), inflammation (71%), bone metaplasia with or without hematopoiesis (6% and 53%, respectively), adipose metaplasia (16%), and cartilaginous metaplasia (7%). At multivariate analysis, AVS degree and interventricular septum thickness were the only predictors of remodeling (barring inflammation). All the tested metalloproteinases (except MMP-13) and cytokines were expressed in AVS cusps. Inflammation mainly consisted of B and T lymphocytes (CD4+/CD8

What this study does not prove

  • • This study does not prove SVF is an approved treatment or a replacement for standard care.
  • • Without an adequate control group, treatment effects cannot be separated from other factors.

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

How we grade evidence
Age FactorsAgedAged, 80 and overAnalysis of VarianceAortic ValveAortic Valve StenosisAutopsyBiopsy, NeedleCalcinosisCase-Control Studies
HipSystemic / IV
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