Back to Search
Start Over
Changes in Plasma Angiopoietin Levels After Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement: A Prospective Cohort Study
- Source :
- Journal of Cardiothoracic and Vascular Anesthesia. 35:3215-3222
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- OBJECTIVE Angiopoietins (Angs) regulate endothelial permeability. Ang-1 and 2 (Ang-1 and Ang-2) are implied in endothelial stability through an antagonism effect. The objectives of the present study were to describe and compare changes in Ang levels after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). DESIGN A prospective, single-center study. PARTICIPANTS Adult patients with aortic stenosis scheduled for SAVR or TAVR. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Ang-1 and Ang-2 were measured using an enzyme-linked immunosorbent assay right before surgery (T0), at the end of surgery (T1), and at day one (T2). Sixty consecutive patients (SAVR group [n = 30] and TAVR group [n = 30]) were included between January and June 2017. Ang-1 decreased significantly after both TAVR (T0: 3,663 [2,602-4,262]; T1: 1,611 [981-2,409]; T2: 1,082 [652-1,589] ng/mL; p < 0.0001) and SAVR (T0: 1,603 [975-2,849]; T1: 783 [547-1,024]; T2: 828 [460-1,227] ng/mL; p = 0.0001). Ang-2 increased significantly after SAVR (T0: 2,472 [1,502-3,622]; T1: 2,997 [1,759-3,839]; T2: 5,421 [3,557-7,087] ng/mL; p < 0.0001) but did not change markedly after TAVR (T0: 3,343 [2,661-6,272]; T1: 3,788 [2,574-5,016]; T2: 3,446 [3,029-6,313] ng/mL; p = 0.066). Among patients with paravalvular leakage, the changes in the plasma Ang-2 level and the Ang-2/Ang-1 ratio were greater. CONCLUSION SAVR induces greater alterations of Ang homeostasis than TAVR, confirming a role for the use of cardiopulmonary bypass. Paravalvular leakage after TAVR is associated with Ang changes similar to those observed with SAVR.
- Subjects :
- Adult
medicine.medical_specialty
Transcatheter aortic
medicine.medical_treatment
030204 cardiovascular system & hematology
law.invention
Transcatheter Aortic Valve Replacement
Angiopoietin
03 medical and health sciences
0302 clinical medicine
Valve replacement
Aortic valve replacement
Risk Factors
030202 anesthesiology
law
Internal medicine
medicine
Cardiopulmonary bypass
Humans
Prospective Studies
Prospective cohort study
Heart Valve Prosthesis Implantation
business.industry
Aortic Valve Stenosis
medicine.disease
Cardiac surgery
Stenosis
Treatment Outcome
Anesthesiology and Pain Medicine
Aortic Valve
cardiovascular system
Cardiology
Cardiology and Cardiovascular Medicine
business
Angiopoietins
Subjects
Details
- ISSN :
- 10530770
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiothoracic and Vascular Anesthesia
- Accession number :
- edsair.doi.dedup.....d82b759051f3df290dffb9fe53265cf8