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Bioprosthesis in aortic valve replacement: long-term inflammatory response and functionality.

Authors:
Huitzilihuitl Saucedo-Orozco Jesus Vargas-Barron Ricardo Márquez-Velazco Julio Iván Farjat-Pasos Karla Susana Martinez-Zavala Valentin Jiménez-Rojas Sergio Andres Criales-Vera Jose Antonio Arias-Godínez Giovanni Fuentevilla-Alvarez Veronica Guarner-Lans Israel Perez-Torres Gabriela Melendez-Ramirez Tomas Efrain Sanchez Perez Maria Elena Soto

Open Heart 2022 08;9(2)

Immunology, Instituto Nacional de Cardiologia Ignacio Chavez, CDMX, Mexico

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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http://dx.doi.org/10.1136/openhrt-2022-002065DOI Listing
August 2022

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