The effect of surgical versus transcatheter aortic valve replacement on endothelial function. An observational study

Marco Moscarelli; Fiorella Devito; Khalil Fattouch; Patrizio Lancellotti; Marco Matteo Ciccone; Paola Rizzo; Mario Gaudino; Alfredo Marchese; Gianni Angelini; Giuseppe Speziale

doi:10.1016/j.ijsu.2019.01.014

The effect of surgical versus transcatheter aortic valve replacement on endothelial function. An observational study

Marco Moscarelli^*, Fiorella Devito, Khalil Fattouch, Patrizio Lancellotti, Marco Matteo Ciccone, Paola Rizzo, Mario Gaudino, Alfredo Marchese, Gianni Angelini, Giuseppe Speziale

^*Corresponding author for this work

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Abstract

Background The effects of surgical aortic valve replacement versus transcatheter aortic valve replacement on endothelial function are unknown. We investigated the effects of surgical and transcatheter aortic valve replacement on early and 90-day endothelial function measured by brachial flow mediated dilation and apoptotic rate in the human umbilical vein endothelial cells in patients with significant aortic stenosis, intermediate risk of surgery, and no coronary artery disease. Methods We conducted a prospective observational case control single-blind study at a single tertiary center. Endothelial function was measured at baseline, early post-procedure (4 days), and follow-up (90 days). A blood pressure cuff was used to elicit reactive hyperemia for measuring brachial wall shear stress and flow mediated dilation. The apoptosis rate was observed in the human umbilical vein endothelial cells after 48-h incubation with 20% serum from patients. The rate of apoptosis was assessed by determining the number of annexin V and propidium iodide positive cells by flow cytometry. Results Early post-procedure flow dilation was significant lower in the surgical group (p < 0.003). At follow-up, both groups showed incremental increases in flow mediated dilation. Surgical group apoptotic rate did not significantly change, while transcatheter apoptotic rate steadily decreased, suggesting a trend toward improved endothelial function. Conclusions The data suggest that conventional surgical aortic valve replacement may be associated with an early and transient decrease in endothelial function, likely due to the use of cardio-pulmonary bypass.

Original language	English
Pages (from-to)	1-7
Number of pages	7
Journal	International Journal of Surgery
Volume	63
Early online date	28 Jan 2019
DOIs	https://doi.org/10.1016/j.ijsu.2019.01.014
Publication status	Published - 1 Mar 2019

Research Groups and Themes

Centre for Surgical Research

Keywords

Aortic valve
Endothelial function
flow-mediated dilation
Aortic valve replacement
transcatheter aortic valve replacement

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ijsu.2019.01.014

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title = "The effect of surgical versus transcatheter aortic valve replacement on endothelial function. An observational study",

abstract = "Background The effects of surgical aortic valve replacement versus transcatheter aortic valve replacement on endothelial function are unknown. We investigated the effects of surgical and transcatheter aortic valve replacement on early and 90-day endothelial function measured by brachial flow mediated dilation and apoptotic rate in the human umbilical vein endothelial cells in patients with significant aortic stenosis, intermediate risk of surgery, and no coronary artery disease. Methods We conducted a prospective observational case control single-blind study at a single tertiary center. Endothelial function was measured at baseline, early post-procedure (4 days), and follow-up (90 days). A blood pressure cuff was used to elicit reactive hyperemia for measuring brachial wall shear stress and flow mediated dilation. The apoptosis rate was observed in the human umbilical vein endothelial cells after 48-h incubation with 20% serum from patients. The rate of apoptosis was assessed by determining the number of annexin V and propidium iodide positive cells by flow cytometry. Results Early post-procedure flow dilation was significant lower in the surgical group (p < 0.003). At follow-up, both groups showed incremental increases in flow mediated dilation. Surgical group apoptotic rate did not significantly change, while transcatheter apoptotic rate steadily decreased, suggesting a trend toward improved endothelial function. Conclusions The data suggest that conventional surgical aortic valve replacement may be associated with an early and transient decrease in endothelial function, likely due to the use of cardio-pulmonary bypass.",

keywords = "Aortic valve, Endothelial function, flow-mediated dilation, Aortic valve replacement, transcatheter aortic valve replacement",

author = "Marco Moscarelli and Fiorella Devito and Khalil Fattouch and Patrizio Lancellotti and Ciccone, {Marco Matteo} and Paola Rizzo and Mario Gaudino and Alfredo Marchese and Gianni Angelini and Giuseppe Speziale",

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T1 - The effect of surgical versus transcatheter aortic valve replacement on endothelial function. An observational study

AU - Moscarelli, Marco

AU - Devito, Fiorella

AU - Fattouch, Khalil

AU - Lancellotti, Patrizio

AU - Ciccone, Marco Matteo

AU - Rizzo, Paola

AU - Gaudino, Mario

AU - Marchese, Alfredo

AU - Angelini, Gianni

AU - Speziale, Giuseppe

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background The effects of surgical aortic valve replacement versus transcatheter aortic valve replacement on endothelial function are unknown. We investigated the effects of surgical and transcatheter aortic valve replacement on early and 90-day endothelial function measured by brachial flow mediated dilation and apoptotic rate in the human umbilical vein endothelial cells in patients with significant aortic stenosis, intermediate risk of surgery, and no coronary artery disease. Methods We conducted a prospective observational case control single-blind study at a single tertiary center. Endothelial function was measured at baseline, early post-procedure (4 days), and follow-up (90 days). A blood pressure cuff was used to elicit reactive hyperemia for measuring brachial wall shear stress and flow mediated dilation. The apoptosis rate was observed in the human umbilical vein endothelial cells after 48-h incubation with 20% serum from patients. The rate of apoptosis was assessed by determining the number of annexin V and propidium iodide positive cells by flow cytometry. Results Early post-procedure flow dilation was significant lower in the surgical group (p < 0.003). At follow-up, both groups showed incremental increases in flow mediated dilation. Surgical group apoptotic rate did not significantly change, while transcatheter apoptotic rate steadily decreased, suggesting a trend toward improved endothelial function. Conclusions The data suggest that conventional surgical aortic valve replacement may be associated with an early and transient decrease in endothelial function, likely due to the use of cardio-pulmonary bypass.

AB - Background The effects of surgical aortic valve replacement versus transcatheter aortic valve replacement on endothelial function are unknown. We investigated the effects of surgical and transcatheter aortic valve replacement on early and 90-day endothelial function measured by brachial flow mediated dilation and apoptotic rate in the human umbilical vein endothelial cells in patients with significant aortic stenosis, intermediate risk of surgery, and no coronary artery disease. Methods We conducted a prospective observational case control single-blind study at a single tertiary center. Endothelial function was measured at baseline, early post-procedure (4 days), and follow-up (90 days). A blood pressure cuff was used to elicit reactive hyperemia for measuring brachial wall shear stress and flow mediated dilation. The apoptosis rate was observed in the human umbilical vein endothelial cells after 48-h incubation with 20% serum from patients. The rate of apoptosis was assessed by determining the number of annexin V and propidium iodide positive cells by flow cytometry. Results Early post-procedure flow dilation was significant lower in the surgical group (p < 0.003). At follow-up, both groups showed incremental increases in flow mediated dilation. Surgical group apoptotic rate did not significantly change, while transcatheter apoptotic rate steadily decreased, suggesting a trend toward improved endothelial function. Conclusions The data suggest that conventional surgical aortic valve replacement may be associated with an early and transient decrease in endothelial function, likely due to the use of cardio-pulmonary bypass.

KW - Aortic valve

KW - Endothelial function

KW - flow-mediated dilation

KW - Aortic valve replacement

KW - transcatheter aortic valve replacement

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JO - International Journal of Surgery

JF - International Journal of Surgery

ER -

The effect of surgical versus transcatheter aortic valve replacement on endothelial function. An observational study

Abstract

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Keywords

UN SDGs

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