Pre- and post-surgical evaluation of the inflammatory response in patients with aortic stenosis treated with different types of prosthesis

Autor: Jose Luis Salas, María Elena Soto, Verónica Guarner-Lans, Alejandra Rodriguez-Hernandez, Rafael Bojalil-Parra, Israel Pérez-Torres, Jesus Vargas-Barron, Ricardo Marquez
Rok vydání: 2016
Předmět:
Aortic valve
Male
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
medicine.medical_treatment
Hemodynamics
02 engineering and technology
030204 cardiovascular system & hematology
Doppler echocardiography
Prosthesis Design
Prosthesis
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Postoperative Period
Prospective Studies
Angiology
Bioprosthesis
Inflammation
medicine.diagnostic_test
business.industry
Aortic stenosis
Inflammatory response
Aortic Valve Stenosis
Middle Aged
021001 nanoscience & nanotechnology
medicine.disease
Echocardiography
Doppler
Cardiac surgery
Surgery
Heart surgery
Prothesis
Stenosis
medicine.anatomical_structure
lcsh:RC666-701
Heart Valve Prosthesis
Preoperative Period
Cardiology
Female
0210 nano-technology
Cardiology and Cardiovascular Medicine
business
Biomarkers
Follow-Up Studies
Research Article
Zdroj: BMC Cardiovascular Disorders
BMC Cardiovascular Disorders, Vol 17, Iss 1, Pp 1-8 (2017)
ISSN: 1471-2261
Popis: Background The inflammatory process in aortic valvular stenosis persists after surgery to replace the valve in almost half of the patients. No association has been found to its persistence. The main objective of this study was to evaluate the inflammatory response in patients with aortic stenosis through the determination of several biomarkers in plasma measured before and after the valvular replacement and to seek an association with the type of prosthesis used. Methods This is an observational study with a follow up of 6 months in subjects with severe aortic stenosis. Seric concentrations of TNFa, IL-1, IL-6 and ICAM and echocardiographic variables were quantified previous to the surgery and a week and 6 months after it. A group of control subjects paired by age and gender was included. Results Seventy-nine subjects were studied of which 57% were male; the average age was of 59 (± 11.4) years. Previous to surgery, the concentration of cytokines was higher in patients than in control subjects. A biological prosthesis was implanted in 48 patients and a mechanical prosthesis in 31. Both, types of prosthesis have components made of titanium. The echocardiograms 1 week and 6 months after the surgery showed a decrease in the mean aortic gradient and an increase in the valvular area (p = 0.001). Half of the patients still showed high proinflammatory cytokine levels. There were no differences according to the type of prosthesis implanted after adjustments for demographic variables, comorbidities and echocardiographic data. Conclusions The inflammatory response caused by both types of valvular prothesis at 6 months after implantation were similar. Both types of prosthesis are recommended, they had similarities in hemodynamic profiles registered with Doppler echocardiography. Age of the patient or the suitability use of anticoagulants determines the type of prosthesis to be used.
Databáze: OpenAIRE
Externí odkaz: