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Aortic stenosis (AS) is associated with significant morbidity and mortality. Recombinant apolipoprotein A-I Milano (rApoA-I_M) induces atherosclerotic plaque regression. The aims of this study were to determine the effects of rApoA-I_M on experimental aortic valve degeneration and its mechanisms of action.

New Zealand White rabbits (n = 20) were fed an atherogenic diet for 9 months and then randomized to either placebo or rApoA-I_M. Echocardiography was used to assess the effect of the treatments on AS. Porcine aortic valve myofibroblasts (PAVMF) treated with oxidized low-density lipoprotein served to define the effects of rApoA-I_M on the expression of monocyte chemoattractant protein-1 (MCP-1), nuclear factor (NF)-κB, and alkaline phosphatase (AP). Recombinant apolipoprotein A-I Milano increased aortic valve area (AVA) by 32% (0.25 ± 0.05 to …