Vascular Tumor Necrosis Factor-alpha Gene Expression in Human Aortic Valve Calcification---Expression of TNF-α in Calcified Aortic Valves

The intimate mechanisms involved in aortic valve calcification (AVC) are not completely known. It is more evident to suggest that cardiovascular calcification is an inflammatory condition. Tumor necrosis factor alpha (TNFα), a pro-inflammatory cytokine, is increased in valvular lesions besides areas of leukocyte infiltration. The aim of this study was to test the hypothesis that valvular calcification is part of a generalized inflammatory process involving the vascular wall. The differential gene expression of TNF-α in thoracic aortic samples from 49 patients with AVC has been assessed in comparison with samples from 94 patients with non-calcified valves. As compared with subjects without calcification, patients with AVC were older (P<0.01) and had an increased prevalence of coronary atherosclerotic disease (P=0.002), left ventricular hypertrophy (P<0.001), smoking habit (P=0.027) and hypertension (P=0.05). The incidence of AVC was significantly higher in smokers, hypertensives, and patients with coronary atherosclerosis. All thoracic aorta samples showed expression of TNF-α. The mRNA expression level of TNF-α was significantly higher in patients with AVC (P<0.01). Likewise, a significantly higher expression level of TNF-α was found in subjects with atherosclerotic coronary disease (P<0.01). Insignificant influence was detected for the effect of other variables, including smoking, diabetes, hypertension or gender. In conclusion, the present study supported the notion that valvular calcification is part of an inflammatory-based process affecting the vascular system.