Grant: Operating Grant

Aortic stenosis (AS) is a cardiac disease that is characterized by the progressive obstruction of the aortic valve, which is one of the 4 valves present in the heart. AS is one the most frequent heart disease and there is no drug to slow its progression. The only efficient treatment for this disease is to perform a heart surgery to replace the diseased valve by a prosthetic valve. In the past, AS was thought to be a degenerative disease because of time-dependent wear and-tear of the valve. There is now substantial scientific evidence that AS is caused by the accumulation of lipid and inflammation within the valve, a process called: atherosclerosis. Recently, we obtained preliminary data, suggesting that the progression of AS is accelerated in patients with excessive amount of intra-abdominal fat. The accumulation of fat in the abdomen indeed causes several metabolic abnormalities including the release of small particles of "bad" cholesterol into the blood. This may predispose to the penetration of bad cholesterol into the aortic valve and to the development of inflammation and mineralization. Moreover, these metabolic abnormalities may also have harmful effects on the cardiac muscle therefore further increasing the risk of adverse events. The objective of this study is to elucidate the mechanism responsible for the progression of AS and, more specifically, to determine which are the key metabolic factors responsible for faster progression in the AS population. Our study will be the first of its kind, as it will measure, in parallel, the metabolic disturbances linked to abdominal obesity, the progression AS by echocardiography, tomodensitometry, and cardiac resonance imaging, and the occurrence of adverse events in a cohort of 260 patients with AS. The new knowledge provided could lead to the development of new approaches for the prevention or treatment of AS. This could contribute to substantially reduce the number of valve replacements and deaths related to A