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Saucedo-Orozco H, Vargas-Barron J, Márquez-Velazco R, Farjat-Pasos JI, Martinez-Zavala KS, Jiménez-Rojas V, Criales-Vera SA, Arias-Godínez JA, Fuentevilla-Alvarez G, Guarner-Lans V, Perez-Torres I, Melendez-Ramirez G, Sanchez Perez TE, Soto ME. Bioprosthesis in aortic valve replacement: long-term inflammatory response and functionality. Open Heart 2022; 9:openhrt-2022-002065. [PMID: 35926961 PMCID: PMC9358956 DOI: 10.1136/openhrt-2022-002065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background The evaluation of long-term inflammatory response and function in postoperative patients with aortic valve replacement (AVR) deserves special analysis because it is important to try to prevent reoperation and improve durability and functionality of the prostheses. It is our objective Methods In this study, we included a cohort of patients with aortic valve damage treated by AVR with mechanical prosthesis, bio prosthesis and we included a control group. Results We found that IL-4 and osteopontin levels were higher in patients with mechanical vs biological prostheses (p=0.01 and p=0.04, respectively), osteoprotegerin (OPG) levels were decreased (p=0.01), women had lower levels of ET-1 and IL-6, (p=0.02) (p=0.04), respectively. Patients older than 60 years had decreased levels of IL-1ß p<0.001) and a higher concentration of IL-4 p<0.05). IL-1ß, OPG and TNFα were higher in patients with less than 5 years of evolution vs more than 10 years (p=0.004, p=0.02 and p=0.03, respectively). Factors such as age, gender, prosthetic and elevated IL-1B and ET-1 levels are associated with valve dysfunction prosthetic. These results indicate that the inflammatory involvement present prior to valve replacement may be perpetuated by various factors in the long term. Conclusions The findings provide us with the opportunity to effectively treat patients with AVR in the postoperative period, which could prolong the functionality of the bio prostheses. Trial registration number NCT04557345.
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Affiliation(s)
- Huitzilihuitl Saucedo-Orozco
- Cardioneumology, Instituto Nacional de Cardiologia Ignacio Chavez, Ciudad de Mexico, Mexico.,Speciality Hospital, National Medical Center "La Raza", Cardioneumology, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico
| | - Jesus Vargas-Barron
- Pharmacology, Instituto Nacional de Cardiologia Ignacio Chavez, CDMX, Mexico
| | - Ricardo Márquez-Velazco
- Department of Immunology, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico
| | - Julio Iván Farjat-Pasos
- Interventional Cardiology, Instituto Nacional de Cardiologia Ignacio Chavez, Tlalpan, Mexico
| | | | | | | | | | | | | | - Israel Perez-Torres
- Cardiovascular Biomedicine, Instituto Nacional de Cardiologia Ignacio Chavez, CDMX, Mexico
| | | | | | - Maria Elena Soto
- Immunology, Instituto Nacional de Cardiologia Ignacio Chavez, CDMX, Mexico .,Cardiovascular Line, Hospital ABC, Mexico City, Mexico
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De Palma R, Sotto I, Wood EG, Khan NQ, Butler J, Johnston A, Rothman MT, Corder R. Cocoa flavanols reduce N-terminal pro-B-type natriuretic peptide in patients with chronic heart failure. ESC Heart Fail 2016; 3:97-106. [PMID: 27588209 PMCID: PMC4985700 DOI: 10.1002/ehf2.12077] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 06/18/2015] [Accepted: 10/16/2015] [Indexed: 01/09/2023] Open
Abstract
AIMS Poor prognosis in chronic heart failure (HF) is linked to endothelial dysfunction for which there is no specific treatment currently available. Previous studies have shown reproducible improvements in endothelial function with cocoa flavanols, but the clinical benefit of this effect in chronic HF has yet to be determined. Therefore, the aim of this study was to assess the potential therapeutic value of a high dose of cocoa flavanols in patients with chronic HF, by using reductions in N-terminal pro-B-type natriuretic peptide (NT-proBNP) as an index of improved cardiac function. METHODS AND RESULTS Thirty-two patients with chronic HF, stable on guideline-directed medical therapy, were randomized to consume 50 g/day of high-flavanol dark chocolate (HFDC; 1064 mg of flavanols/day) or low-flavanol dark chocolate (LFDC; 88 mg of flavanols/day) for 4 weeks and then crossed over to consume the alternative dark chocolate for a further 4 weeks. Twenty-four patients completed the study. After 4 weeks of HFDC, NT-proBNP (mean decrease % ± standard deviation) was significantly reduced compared with baseline (-44 ± 69%), LFDC (-33 ± 72%), and follow-up (-41 ± 77%) values. HFDC also reduced diastolic blood pressure compared with values after LFDC (-6.7 ± 10.1 mmHg). CONCLUSIONS Reductions in blood pressure and NT-proBNP after HFDC indicate decreased vascular resistance resulting in reduced left ventricular afterload. These effects warrant further investigation in patients with chronic HF.
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Affiliation(s)
- Rodney De Palma
- Department of Cardiology, The London Chest HospitalBarts Health NHS TrustBonner RoadLondonE2 9JXUK
| | - Imelda Sotto
- Department of Cardiology, The London Chest HospitalBarts Health NHS TrustBonner RoadLondonE2 9JXUK
| | - Elizabeth G. Wood
- William Harvey Research Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonCharterhouse SquareLondonEC1M 6BQUK
| | - Noorafza Q. Khan
- William Harvey Research Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonCharterhouse SquareLondonEC1M 6BQUK
| | - Jane Butler
- Department of Cardiology, The London Chest HospitalBarts Health NHS TrustBonner RoadLondonE2 9JXUK
| | - Atholl Johnston
- William Harvey Research Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonCharterhouse SquareLondonEC1M 6BQUK
| | - Martin T. Rothman
- Department of Cardiology, The London Chest HospitalBarts Health NHS TrustBonner RoadLondonE2 9JXUK
| | - Roger Corder
- William Harvey Research Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonCharterhouse SquareLondonEC1M 6BQUK
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Kendler M, Kratzsch J, Schmidt R, Wetzig T, Simon J. Serum endothelin 1 levels before, during and after mechanochemical endovenous ablation with foam and surgical correction of incompetent great saphenous veins. J Eur Acad Dermatol Venereol 2015; 30:546-7. [DOI: 10.1111/jdv.12944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. Kendler
- Department of Dermatology, Venereology and Allergology; Leipzig University; Ph.-Rosenthal-Str. 23 Leipzig 04103 Germany
| | - J. Kratzsch
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics; Leipzig University; Paul-List-Str.13-15 Leipzig 04103 Germany
| | - R. Schmidt
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics; Leipzig University; Paul-List-Str.13-15 Leipzig 04103 Germany
| | - T. Wetzig
- Department of Dermatology, Venereology and Allergology; Leipzig University; Ph.-Rosenthal-Str. 23 Leipzig 04103 Germany
| | - J.C. Simon
- Department of Dermatology, Venereology and Allergology; Leipzig University; Ph.-Rosenthal-Str. 23 Leipzig 04103 Germany
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Miragoli M, Yacoub MH, El-Hamamsy I, Sanchez-Alonso JL, Moshkov A, Mongkoldhumrongkul N, Padala M, Paramagurunathan S, Sarathchandra P, Korchev YE, Gorelik J, Chester AH. Side-specific mechanical properties of valve endothelial cells. Am J Physiol Heart Circ Physiol 2014; 307:H15-24. [DOI: 10.1152/ajpheart.00228.2013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aortic valve endothelial cells (ECs) function in vastly different levels of shear stress. The biomechanical characteristics of cells on each side of valve have not been investigated. We assessed the morphology and mechanical properties of cultured or native valve ECs on intact porcine aortic valve cusps using a scanning ion conductance microscope (SICM). The autocrine influence of several endothelial-derived mediators on cell compliance and the expression of actin were also examined. Cells on the aortic side of the valve are characterized by a more elongated shape and were aligned along a single axis. Measurement of EC membrane compliance using the SICM showed that the cells on the aortic side of intact valves were significantly softer than those on the ventricular side. A similar pattern was seen in cultured cells. Addition of 10−6 M of the nitric oxide donor sodium nitroprusside caused a significant reduction in the compliance of ventricular ECs but had no effect on cells on the aortic side of the valve. Conversely, endothelin-1 (10−10-10−8 M) caused an increase in the compliance of aortic cells but had no effect on cells on the ventricular side of the valve. Aortic side EC compliance was also increased by 10−4 M of the nitric oxide synthase inhibitor NG-nitro-l-arginine methyl ester. Immunofluorescent staining of actin filaments revealed a great density of staining in ECs on the ventricular surface. The expression of actin and the relative membrane compliance of ECs on both side of the valve were not affected by ventricular and aortic patterns of flow. This study has shown side-specific differences in the biomechanics of aortic valve ECs. These differences can have important implications for valve function.
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Affiliation(s)
- Michele Miragoli
- Imperial College, National Heart and Lung Institute, Department of Cardiac Medicine, Imperial Centre for Translational and Experimental Medicine, Hammersmith Campus, London, United Kingdom
- Humanitas Clinical and Research Center, Rozzano (Milan), Italy
| | - Magdi H. Yacoub
- Imperial College, National Heart and Lung Institute, Heart Science Centre, Harefield, Middlesex, United Kingdom
- Qatar Cardiovascular Research Centre, Qatar Foundation, Doha, Qatar
| | - Ismail El-Hamamsy
- Imperial College, National Heart and Lung Institute, Heart Science Centre, Harefield, Middlesex, United Kingdom
| | - Jose L. Sanchez-Alonso
- Imperial College, National Heart and Lung Institute, Department of Cardiac Medicine, Imperial Centre for Translational and Experimental Medicine, Hammersmith Campus, London, United Kingdom
| | - Alexey Moshkov
- Imperial College, National Heart and Lung Institute, Department of Cardiac Medicine, Imperial Centre for Translational and Experimental Medicine, Hammersmith Campus, London, United Kingdom
| | | | - Muralindar Padala
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia; and
| | - Saravanan Paramagurunathan
- Imperial College, National Heart and Lung Institute, Heart Science Centre, Harefield, Middlesex, United Kingdom
| | - Padmini Sarathchandra
- Imperial College, National Heart and Lung Institute, Heart Science Centre, Harefield, Middlesex, United Kingdom
| | - Yuri E. Korchev
- Division of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom
| | - Julia Gorelik
- Imperial College, National Heart and Lung Institute, Department of Cardiac Medicine, Imperial Centre for Translational and Experimental Medicine, Hammersmith Campus, London, United Kingdom
| | - Adrian H. Chester
- Imperial College, National Heart and Lung Institute, Heart Science Centre, Harefield, Middlesex, United Kingdom
- Qatar Cardiovascular Research Centre, Qatar Foundation, Doha, Qatar
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