Calcification formation on bioprosthetic valves

[Paleowoman]

Starting a new thread here as I don't want to hijack jlcsn's thread where I read this.

Steve wrote:

They are also sure that the older the patient at time of implant, the longer it will take for calcification to form on the prosthetic valve. That is because the immune system is what causes calcification, and the immune systems of younger patients are more active than those of older patients.

Do you have a reference for this Steve ?

It sounds intriguing that it may be the immune system which may be the thing which causes calcification.

 

[dornole]

Certainly for me with rheumatic heart disease, the immune system is directly responsible.

 

[cldlhd]

I wonder if theres also a connection that involves the theory involving a lack of vitamin k2 and how that may cause calcification of soft tissue.

 

[pellicle]

Hi

Do you have a reference for this Steve ?

It sounds intriguing that it may be the immune system which may be the thing which causes calcification.

I believe you will find that theory trails observation. We know it happens, we are unable to explain exactly why. Here is a thread (which you participated in) that contains a reference to a theory.

It is none the less a statistical fact that calcification of tissue valves occurs, faster in some than others, typically faster in the young than the elderly. I am developing the feeling that if (say) steve says it he is believed but if I say it it must be wrong. Even more curious is that in the main I provide supporting links for what I say I think to be true but noone seems to actually read them or understand why they are there.

 

[DebbyA]

Pellicle, your role is to provide the links to research. Mine is to pipe up as the outlier and say "well, I got a tissue valve at 60 and it calcified in 6 years.". I think human chemistry is still more unknown and more complex than theories and practices allow for. I also think 'age' at the cellular level is not related to the calendar. But I was an English major, and just had two glasses of wine...

 

[Paleowoman]

Hi
I believe you will find that theory trails observation. We know it happens, we are unable to explain exactly why. Here is a thread (which you participated in) that contains a reference to a theory.

Hi Pell, I know that calcification occurs more quickly in younger people but I wanted a reference to the study which implicated the immune system and thought Steve might have it judging from what he had said in that other thread which I didn't wish to hijack. Maybe Steve hasn't read this thread yet ?

Anyway, I couldn't find the thread you refer to above…….can you post the link please ? As I said, I know about calcification but would like some science behind the theory that it a more active immune system which is the thing which causes increased calcification in the young, and less active immune system in the older peeps. I would like to know a study implicating the immune system and also how they measure the activity of the immune system.

Cihid - I take 300mcg vitamin K2 as MK7 per day to help with my osteoporosis. I was taking that for three years prior to AVR as I hadn't discovered about K2 until then, and my bicuspid valve was only moderatley calcified - of course impossible to say whether or not the K2 was helping or not in that respect !

 

[cldlhd]

Hi Pell, I know that calcification occurs more quickly in younger people but I wanted a reference to the study which implicated the immune system and thought Steve might have it judging from what he had said in that other thread which I didn't wish to hijack. Maybe Steve hasn't read this thread yet ?

Anyway, I couldn't find the thread you refer to above…….can you post the link please ? As I said, I know about calcification but would like some science behind the theory that it a more active immune system which is the thing which causes increased calcification in the young, and less active immune system in the older peeps. I would like to know a study implicating the immune system and also how they measure the activity of the immune system.

Cihid - I take 300mcg vitamin K2 as MK7 per day to help with my osteoporosis. I was taking that for three years prior to AVR as I hadn't discovered about K2 until then, and my bicuspid valve was only moderatley calcified - of course impossible to say whether or not the K2 was helping or not in that respect !

I get 200 mcg of k2 from my multivitamin which I believe is mk4 and I take 100mcg of k2 mk7 after dinner. Maybe it helps prevent calcification maybe not but I'm assuming it doesn't hurt so I figure what the hell....

 

[Paleowoman]

Bumping this thread up in the hope that Steve and Pell see it and respond....please ? I always knew that bioprosthetic valves calcify quicker in younger people than older people, but what I would like is a scientific reference for the increased calcification being caused by more active immune systems which Steve wrote in another thread.

Vitamin K2 doesn't hurt from what I have been able to discover cldlhd

 

[dornole]

Found this on the internets paleogirl

http://www.ncbi.nlm.nih.gov/pubmed/22877802

 

[Paleowoman]

Many thanks Dormole ! Your link to that study has enabled me to find more. Not that I understand them fully:

'Immune response in patients receiving a bioprosthetic heart valve: lack of response with decellularized valves': http://www.ncbi.nlm.nih.gov/pubmed/21557643

'Bioprosthetic Valves and Laudable Inflammation?' http://circ.ahajournals.org/content/114/4/261.full

Now I wonder how you measure how active or robust someone's immune system is ?!?! All very interesting. I see that Edwards Lifesciences treats their valves with something to help stop calcification.

 

[AZ Don]

Even more curious is that in the main I provide supporting links for what I say I think to be true but noone seems to actually read them or understand why they are there.

Pellicle, I have read many of your links and I appreciate your taking the time to post them, as well as of those that posted the links above. I think studies are a valuable source of information in helping us understand ourselves and the world around us ... at least when I can understand what they are saying.

 

[Paleowoman]

Hi Pellicle - I read the links you post and always find them informative too. If you once posted a link about the immune system being the driving force behind calcification on bioprsthetic valves and I forgot it I apologise. I would be really happy to read it again please.

Also, in your post above, the link to the thread in which you say I contributed (about immune system and calcification) is missing and I can't find where I wrote about it before. Please can you post the link.

 

[pellicle]

Hi

Also, in your post above, the link to the thread in which you say I contributed (about immune system and calcification) is missing and I can't find where I wrote about it before. Please can you post the link.

clearly I failed to put that link in properly ... here it is again
http://www.valvereplacement.org/forums/forum/heart-talk/854703-new-discovery-regarding-calcification

lets hope I don't goof it this time

 

[pellicle]

http://circinterventions.ahajournals.org/content/5/4/605.full

interesting reading for the hearty minded

 

[pellicle]

Hi

Pellicle, I have read many of your links and I appreciate your taking the time to post them,

I'm sorry (addressed to all) ... probably I'm just somewhere on my personal anxiety curve where I was feeling fragile and irrational. I've had a weekend away (which was lovely) in my (just had the engine rebuilt) 4WD and am feeling more like a human ... had some interactions with (adopted) family and now feeling comfortable after processing some images and some bird recordings.

took this shot on the drive back down the range to the coast.

its beautiful country side

 

[Paleowoman]

Hi Pell - Hope you are feeling much refreshed after your weekend. That countryside looks beautiful, a cross between the UK west country and some mountains !

Thanks for that link to the thread about calcification that Neo posted in March in which he posted a link about calcification. Yes I did contribute to that thread but there's nothing in that study about the immune system causing calcification.

The link you posted above: http://circinterventions.ahajournals...t/5/4/605.full certainly does mention an immune response but the weird thing is they're talking about aortic valve stenosis that is age related in older people ! And even that bioprosthetic calcification appears age related too even though they are suggesting an inflammatory immune response. Why have they not addressed the calcification that appears in bioprosthetic valves more quickly in younger people ? I would have thought that a significant area of interest as it may explain that it is not a degenerative process after all ?

They also bring in the lipid nut again which is practically consigned to the dustbin. Gving statins to people with bicuspid aortic valve and other valvular disease has not been shown to do anything to lessen the progression of the stenosis, in fact the study ends the lipid section by stating "failed to show a benefit for statins to limit the progression of AVC".

Ummm, I may up my intake of vitamin K2 since the above study mentions the involvement of osteoblast type cells… something that has been known about for a long time that people with osteoporosis often have aortic valve calcification because 'bone' is laid down in the arteries instead of the bones. The medication I take for osteoporosis, Strontium Ranelate, which I hasten to add is not a bisphosphonate, stimulates the osteoblasts to make healthy bone, so some years ago my GP contacted the pharmacutical company to ask them if the med had a side effect of increased coronary calcification - they said it did not. Vitamin K2 is being studied, and sometimes shown, to prevent coronary calcification: here's one of the clinical trials: https://clinicaltrials.gov/ct2/show/NCT01002157 and some studies: http://www.ncbi.nlm.nih.gov/pubmed/18722618 http://www.ncbi.nlm.nih.gov/pubmed/22516723

So I'm still not sure of the immune response implication since younger people with bioprosthetic aortic valves get calcification more quickly than oldies yet these studies are implying that there is a degenerative process going on which causes inflammation…….

More questions than answers !

 

[cldlhd]

Well I found it pretty interesting that "in animals vitamin k2 supplementation caused regression of existing arterial calcification". As I consider myself an animal, as some who know me well will surely attest, this definitely would be what I consider " a good thing". Also although all my pre surgery tests showed no VISIBLE signs of calcification of my aortic valve when I read over my post surgical report it said the surgeon did a treatment for removing calcium and I think preventing future buildup.
As for the statins not having any noticeable effect tell my cardiologist. My LDL levels were at the top end of normal , I got them way down naturally, but she still wants me on a mild statin . Part of the reason is because my ct scan showed some calcification within my one arterial wall but the cardiac cath showed the inside of my arteries were as clear as a babies conscience. When I mentioned to her K2 and the possibilities it could help she 1st seemed to confuse it with k1 and started talking about warfarin. When I corrected her she said she wouldn't expect k2 to achieve more than a 5% reduction but she thought the statin might help. I think if it's not a pharmaceutical they're often not interested whether it's because of financial interest or just the way they're trained to think. Malice or ignorance perhaps. I plan on asking my surgeon his opinion on when I see him in February , he seems more up on these things.

 

[Paleowoman]

Just thinking and remembering. When I was first diagnosed with osteoporosis I heard from a research team who told me that bisphosphonates, ie Fosimax/alendronic acid (which I wouldn't touch with a barge pole) help prevent coronary calcification in osteoporotic people because they halt osteoblasts from working (bisphosphonates shut down both osteoclast and osteoblast activity). Osteoblasts are what make bone, osteoclasts remove 'old' bone, so if they're both working fine the person has healthy bones. When women get older and reach the menopause both the osteoblasts and osteoclasts work less well and sometimes this can result in osteoporosis. Soooooo......it would seem that in younger people osteoblasts are working well making healthy bone.....soooo......in younger people who have bioprosthetic heart valves maybe the osteoblasts lay down bone, aka calcification, more easily in the valve, but with older people, even those who don't have osteoporosis, the osteoblasts aren't working so efficiently as when they were younger and so calcification in the bioprosthetic heart valve doesn't happen so quickly ? This is just my theory on thinking about osteoblast activity and how it affects both healthy bone formation and coronary calcification. Mind you, that doesn't explain exactly why aortic calcification can happen in osteoporotic people - though it doesn't happen in all osteoporostic people - I know this from discussions on the osteoporosis forum I'm on. If there's some substance there then all the more reason to take vitamin K2.

Cldhld - my lipid levels are all way above "normal" except for my triglycerides. My latest results last Friday: total cholesterol 9.1 (351), HDL 3.7 (143), LDL 5.2 (201) by Friedewald formula, and Trigs 0.4 (35). My total/HDL ratio is 2.5 - extremely protective and my endo was fine with the results

 

[Agian]

I think a healthy total cholesterol should be below 5.5.

 

[Savymom]

Very interesting article. Here's what I understood from the article. Before the valve becomes calcified, there is an inflammatory response in the body.. The blood passing through the valve is carrying inflammatory cells. That triggers a response in the valve..
This made me think..
I wonder if diet and overall health have anything to do with calcification on the valve? Diets rich in inflammatory foods causing inflammation in the body, disease, and a host of other problems triggering the calcification. Younger folks might be able to handle the inflammation better just because of age.
There is a lot of research on food and the effects it has on inflammation in the body, yet I feel like its not something ever discussed at the Dr. Office.

Thoughts?

Btw, I'm 10 years post avr with a tissue valve, received when I was 25.