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. 2025 May 19;26(10):4873.
doi: 10.3390/ijms26104873.

Biomarkers of Calcification, Endothelial Injury, and Platelet-Endothelial Interaction in Patients with Aortic Valve Stenosis

Paweł Bańka  1   2 , Klaudia Męcka  1   2 , Adrianna Berger-Kucza  1   2 , Karolina Wrona-Kolasa  1   2 , Anna Rybicka-Musialik  1   2 , Beata Nowak  1   2 , Marek Elżbieciak  1   2 , Magdalena Mizia-Szubryt  1   2 , Wojciech Wróbel  1   2 , Tomasz Francuz  3 , Michał Lelek  1   2 , Agnieszka Kosowska  3 , Wojciech Garczorz  3 , Tomasz Bochenek  1   2 , Andrzej Swinarew  4   5 , Jarosław Paluch  6   7 , Maciej Wybraniec  1   2 , Katarzyna Mizia-Stec  1   2
Affiliations

Biomarkers of Calcification, Endothelial Injury, and Platelet-Endothelial Interaction in Patients with Aortic Valve Stenosis

Paweł Bańka et al. Int J Mol Sci. .

Abstract

Aortic stenosis (AS) is a progressive valvular heart disease characterized by fibrocalcific remodeling, inflammation, and hemodynamic disturbances. Serum biomarkers may indirectly reflect these processes. Autotaxin (ATX) and lysophosphatidic acid (LPA) have been implicated in osteogenic differentiation of valvular interstitial cells, while growth differentiation factor-15 (GDF-15) reflects cellular stress and vascular changes. Thrombomodulin (TM) indicates endothelial injury and interacts with thrombin. This study aimed to evaluate biomarkers focusing on serum ATX, LPA, GDF-15, and TM levels and flow-mediated dilatation (FMD) in patients with AS. Overall, 149 patients were included in the study: 86 consecutive patients with AS hospitalized due to qualification for invasive treatment of AS and 63 controls. The clinical characteristics, echocardiographic data, FMD, and the following biomarkers-ATX, LPA, GDF-15, and TM-were included in the analysis. AS patients presented increased serum levels of ATX, GDF-15, and TM as compared to the controls. Differences in LPA levels were not statistically significant. FMD values were significantly lower in AS patients. The biomarkers mentioned above and FMD correlated with AS severity. There were no differences in both biomarkers' serum levels and FMD regarding the hemodynamic AS phenotype. GDF-15 serum level was a risk factor for all-cause mortality and MACCE in the 12-month follow-up.

Keywords: aortic stenosis; autotaxin; biomarkers; endothelial injury; flow-mediated dilatation; growth differentiation factor-15; lysophosphatidic acid; platelets; thrombomodulin; valvular interstitial cells.

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Conflict of interest statement

The authors declare no conflicts of interest.

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