Changes in Plasma Angiopoietin Levels After Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement: A Prospective Cohort Study.
J Cardiothorac Vasc Anesth
; 35(11): 3215-3222, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-33867234
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 MAINRESULTS:
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 [nâ¯=â¯30] and TAVR group [nâ¯=â¯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; pâ¯=â¯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; pâ¯=â¯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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
/
Implante de Prótese de Valva Cardíaca
/
Angiopoietinas
/
Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Assunto da revista:
ANESTESIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article