Aortic valve disease is the most common form of heart valve disease and is a major burden to
society. Aortic valve disease is also expected to become more prevalent with the aging of the
Canadian population. Currently, over 1 million individuals in North America have aortic
stenosis, which is a narrowing of the aortic valve, and leads to symptoms of heart failure
and sometimes death. Valve replacement with its potential costs and complications remains the
only avenue for treatment, once symptoms develop. Despite the major importance of this
disease, there are currently no medical treatments to prevent the development of aortic
stenosis.The lack of preventative treatments stems in large part to a poor understanding of
the causes of this disease.
Using cutting-edge genetic technologies, the investigators have recently identified that
individuals with a genetic predisposition to elevations in a type of cholesterol not normally
screened, called lipoprotein(a), have a much higher risk of developing aortic valve disease.
The investigators have also shown that lipoprotein(a) causes hardening of the valve, a very
early sign of valve narrowing. The investigators plan to evaluate in a randomized controlled
trial whether lowering this unusual form of cholesterol at an early stage of this disease
could slow or stop the development of aortic valve narrowing
The investigators are currently proposing a pilot project to evaluate the feasibility of this
type of study. If successful, our proposed treatment would be notable in two ways. First, it
would represent the first medical treatment to prevent valve disease, which could lead to
major reductions in the societal burden of this important disease. And second, it would
herald a major success for genomic medicine as it would represent one of the first treatments
borne from recent genetic studies. In these ways, our proposal could significantly impact the
health of many Canadians while also highlighting the innovative research performed in Canada.
Recruitment (n=238) for this project will be from the echocardiography laboratories of McGill
University affiliated hospitals. Individuals with aortic sclerosis or mild aortic stenosis
(aortic valve area [AVA] >1.5 cm2, mean gradient [MG] < 25 mmHG) and high Lp(a) will be
eligible for inclusion into this proposed study.
Phase:
Early Phase 1
Details
Lead Sponsor:
George Thanassoulis
Collaborators:
Jewish General Hospital Laval University Quebec Heart Institute