Extracellular Vesicles to Predict Outcomes After Transcatheter Aortic Valve Implantation - a Prospective, Multicenter Cohort Study.

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Translational Research Pub Date : 2024-10-01 Epub Date: 2024-05-28 DOI:10.1007/s12265-024-10521-x

Radosław Wilimski, Jan Budzianowski, Michał Łomiak, Anna Olasińska-Wiśniewska, Katarzyna Pieniak, Szymon Jędrzejczyk, Olaf Domaszk, Magdalena Chudzik, Krzysztof J Filipiak, Jarosław Hiczkiewicz, Wojciech Faron, Tomasz Urbanowicz, Marek Jemielity, Marek Grygier, Marcin Grabowski, Mariusz Kuśmierczyk, Bartosz Rymuza, Zenon Huczek, Janusz Kochman, Edwin van der Pol, Rienk Nieuwland, Aleksandra Gąsecka

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Abstract

Introduction: Transcatheter aortic valve implantation (TAVI) is an established treatment for aortic stenosis (AS) in patients at intermediate and high surgical risk. Circulating extracellular vesicles (EVs) are nanoparticles involved in cardiovascular diseases. We aimed to (i) determine the effect of TAVI on plasma concentrations of five EV subtypes and (ii) evaluate the predictive value of EVs for post-TAVI outcomes.

Methods: Blood samples were collected 1 day before TAVI and at hospital discharge. Concentrations of EVs were evaluated using flow cytometry.

Results: Concentration of leukocytes EVs decreased after TAVI, compared to the measurement before (p = 0.008). Among 123 patients discharged from the hospital, 19.5% experienced MACCE during the median of 10.3 months. Increased pre-TAVI concentration of phosphatidylserine-exposing EVs was an independent predictor of MACCE in multivariable analysis (OR 5.313, 95% CI 1.164-24.258, p = 0.031).

Conclusions: Patients with increased pre-TAVI concentration of procoagulant, PS-exposing EVs have over fivefold higher odds of adverse outcomes.

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预测经导管主动脉瓣植入术后预后的细胞外小泡--一项前瞻性多中心队列研究。

导言：经导管主动脉瓣植入术（TAVI）是一种治疗主动脉瓣狭窄（AS）的成熟疗法，适用于中高手术风险患者。循环中的细胞外囊泡（EVs）是与心血管疾病有关的纳米颗粒。我们的目的是：(i) 确定 TAVI 对血浆中五种 EV 亚型浓度的影响；(ii) 评估 EV 对 TAVI 术后结果的预测价值：方法：在 TAVI 术前 1 天和出院时采集血样。方法：分别在 TAVI 术前 1 天和出院时采集血液样本，使用流式细胞术评估 EV 的浓度：结果：与测量前相比，TAVI 术后白细胞 EVs 浓度下降（p = 0.008）。在 123 名出院患者中，19.5% 的患者在 10.3 个月的中位数期间出现了 MACCE。在多变量分析中，TAVI前磷脂酰丝氨酸暴露的EVs浓度增加是MACCE的独立预测因素（OR 5.313，95% CI 1.164-24.258，p = 0.031）：结论：TAVI术前促凝物、PS暴露EVs浓度升高的患者出现不良预后的几率高出5倍以上。

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来源期刊

Journal of Cardiovascular Translational Research CARDIAC & CARDIOVASCULAR SYSTEMS-MEDICINE, RESEARCH & EXPERIMENTAL

CiteScore

6.10

自引率

2.90%

发文量

148

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Translational Research (JCTR) is a premier journal in cardiovascular translational research. JCTR is the journal of choice for authors seeking the broadest audience for emerging technologies, therapies and diagnostics, pre-clinical research, and first-in-man clinical trials. JCTR''s intent is to provide a forum for critical evaluation of the novel cardiovascular science, to showcase important and clinically relevant aspects of the new research, as well as to discuss the impediments that may need to be overcome during the translation to patient care.