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Original Article Changes in Plasma Angiopoietin Levels After Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement: A Prospective Cohort Study

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. I nterventions: 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. Para-valvular leakage after TAVR is associated with Ang changes similar to those observed with SAVR. (c) 2021 Elsevier Inc. All rights reserved.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03565098
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Soumis le : jeudi 10 février 2022 - 17:58:42
Dernière modification le : mercredi 4 mai 2022 - 16:48:02

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Osama Abou-Arab, Saïd Kamel, Stephane Bar, Christophe Beyls, Pierre Huette, et al.. Original Article Changes in Plasma Angiopoietin Levels After Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement: A Prospective Cohort Study. Journal of cardiothoracic and vascular anesthesia, 2021, 35 (11), pp.3215-3222. ⟨10.1053/j.jvca.2021.03.025⟩. ⟨hal-03565098⟩

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