Grant: Operating Grant

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. 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, we 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 developping aortic valve disease. We have also shown that lipoprotein(a) causes hardening of the valve, a very early sign of valve narrowing. We 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. We are currently proposing a pilot project to evaluate the feasibility of this type of study. If succesful, 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.