Calcification formation on bioprosthetic valves

[Savymom]

Its probably much more of a complex process then that. ☺

 

[Paleowoman]

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.

Younger folks' bioprosthetic valves calcify quicker than older folks' bioprosthetic valves, so are you saying the inflmmatory response in younger folks is stronger and therefore leads to quicker calcification ? But when it comes to native valves, calcification doesn't happen with younger folks, only with oldies. Maybe the tissue valve causes inflmmation in and of itself as it is foreign ? Then why don't mechanical valves cause inflammation ? They're even more foreign than tissue valves surely ?

Certainly diet can lead to inflammation. I am diabetic and it's known that diabetics have higher levels of inflammation when they eat carbs or become insulin resistant because of the higher blood glucose levels they have - all carbs turn into glucose in the blood whether they are sweet carbs like pastries or savory carbs like bread. Diabetics get all sorts of complications as time passes due to the hgiher blood glucose. But anyone who has a diet high in carbohydrates can get inflammation due to the blood glucose 'spikes' they will get - sure their bodies will be able to deal with the 'spikes' because they can produce enough insulin, but the spikes nonetheless lead to inflammation. And vascular calcification happens where there is inflammation in the arterial walls. (I eat an extremely low carbohydrate diet so that my blood glucose levels are low). I'm not sure this explains the age difference when it comes to bioprosthetic calcification.

Btw, when I still had my bicuspid aortic valve, my cardiologist prescribed me Omacor (omega-3's) which are anti-inflammatory, in the hopes that this might help delay the stenosis. I've no idea if it helped since there isn't a me in a parallel universe who didn't get them to measure me against, but I'm carrying on getting them on prescription even now just in case they're helpful.

It's very dificult to discuss diet at the Dr Office - they learn very little about it at med school ! Most will also never have heard of vitamin K2 getting it mixed up with vitamin K1 which is very, very different, almost a different vitamin.

 

[Paleowoman]

I think a healthy total cholesterol should be below 5.5.

Hi Aglan - a healty total cholesterol can be higher than that depending on the cholesterol profile, you can't just go on the total. My high total is driven up by my extremely high HDL, the so called "good" cholesterol, of 3.7 (143 in the US - practically a world record I should think LOL). This means the cholesterol profile can be more protective than a person whose HDL is too low and whose total cholesterol is low. Also my triglycerides are extremely low which is again a good thing and another sign that the profile is good. I take a weeny dose of pravastatin, just 5mg/d, which gives a pleotropic effect rather than a cholesterol lowering effect. and is also anti-inflammatory. Btw, something like 50% of heart attack victims have cholesterol levels below 5 ! Of course my GP will probably freak when he sees my numbers but my endocrinologist is a very much superior doctor than my GP and by the time I see my GP he will have got the endo's report

 

[epstns]

Hi, gang! Sorry for my absence, but life somehow got in the way, again. (We are getting ready for the impending visit of our daughter, son-in-law and 3-month-old grandson.)

Anne - I would have to go to the "way back machine" to find some of the references needed for this discussion. It appears that dornole found some, maybe you found others.

Pellicle - as for your credibility here, I rate you at the top of the heap. I hope others to as well. It may just be that our presentation "tone" is so different that I (as a former salesman and public speaker) can simply "say" things and manage to have an audience accept them, while if you said the same thing you might be challenged for support. Personally I view this as "their loss" as I have learned an immense amount from you and from your posts.

Most of the time I have to rely on memory, as I do not have the time to research and re-find the materials. (That could change, if I ever retire.)

 

[cldlhd]

In my opinion most drs are more interested in selling the cure rather than helping to prevent. In their defense part of this is probably due to time constraints. As for a prescription for omega-3's that would save me some $$$. I currently take krill oil to help boost mine but that's at full retail.

 

[Paleowoman]

In my opinion most drs are more interested in selling the cure rather than helping to prevent. In their defense part of this is probably due to time constraints. As for a prescription for omega-3's that would save me some $$$. I currently take krill oil to help boost mine but that's at full retail.

Yes, I realise I'm very lucky. Prior to 2008 I was spending £££ on fish oils. Now that I am getting it on prescription it's free as I'm over 60 (NHS - I have paid into it all my life !). I do appreciate that the GP may take the Omacor away one day as it is pretty expensive....fingers crossed he doesn't. I eat some oily fish every day too.

 

[Paleowoman]

Anne - I would have to go to the "way back machine" to find some of the references needed for this discussion. It appears that dornole found some, maybe you found others.

I found some references yes thanks, but honestly they don't really show that it's the immunue system in the young which leads to increased calcification in them with bioprosthetic valves, there's just a "suggestion" of immune system not any explanation. Hence there are more questions than answers ! How do you measure a person's immune response ?

Bicuspid aortic valves appear to calcify due to turbulent blood flow, again just a suggestion, which would suggest inflammation, but they generally, though not always, calcify worse as the person gets older, not when they are younger.

And why do native normal valves calcify in older people but not in younger people ? Why does calcification occur anyway….and it does occur in a lot of people, not valvular calcification but vascular calcification which would appear to be an inflammatory response and which doesn't happen in younger people who supposedly have better immune systems ! So many questions !

 

[cldlhd]

If it is the immune system then there has to be a reason it effects replacement tissue valves in younger people more than older, the opposite of native valves. It's probably a combination of things at work. As for the Omacor if my Dr prescribed it for me it would cost me $7 as opposed to the twenty something I spend monthly on krill oil.

 

[Savymom]

Would overall use have anything to do with it? Or perhaps the combo of use and immune response. Just a generalization, but younger people may have more wear and tear do to a more active lifestyle?

Doesn't explain older native valves becoming calcified though.

In my own situation, my native valve did not become calcified, I had severe regurgitation. However, my Dr. Said my pregnancy and childbirth probably progressed the process. I can't speak of my tissue valve as of yet.

 

[Paleowoman]

If pregnancy and childbirth affected the progression of your valve regurgitation, Savymom, that would suggest a hormonal element wouldn't it ?

And hormones in younger people, even non pregnant young people, are different to those in older people !

I wonder about younger people having more active lifestyles being the cause of bioprosthetic calcification. I have seen that stated elswhere as a possible cause of increased calcification. I have to say that I am definitley tons more active now at 62 than I ever was when I was younger ! I wonder if we should all be advised to sit around to save our valves Maybe take hormones though ?

 

[neil]

I once asked a top cardio this same question about calcification, his reply was shrug of the shoulders and said we still don't know the full reason behind it, in most cases in his opinion it was down to the individual

 

[Savymom]

If pregnancy and childbirth affected the progression of your valve regurgitation, Savymom, that would suggest a hormonal element wouldn't it ?

Blood volume is increased 50% during pregnancy, then labor is a whole new story. but hormones I'm sure play a role.. When pregnant you have higher relaxin hormone ( spelling) which does just that, relax.. And allows things to stretch..

 

[Paleowoman]

When pregnant you have higher relaxin hormone ( spelling) which does just that, relax.. And allows things to stretch..

Which probably explains why my gums receded practically overnight in the days before my son was born - and they never went back to pre-"relaxin" levels