Postoperative Plasma Mitochondrial DNA and Cytokine Profiles of Elderly Patients Undergoing Minimally Invasive Aortic Valve Replacement
| Autor: | Maria E. Serrano-Teruel, José J. Cuenca-Castillo, Victor Bautista-Hernandez, Francisco Estévez-Cid, Alberto Bouzas-Mosquera, Paula Dieguez-Garcia, Fernando Fernandez-Rodriguez, Mercedes Fernandez-Moreno |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors medicine.medical_treatment Operative Time Inflammation Context (language use) DNA Mitochondrial Severity of Illness Index law.invention Aortic valve replacement law Internal medicine Severity of illness Cardiopulmonary bypass Humans Medicine Prospective Studies Prospective cohort study Aged 80 and over Bioprosthesis Heart Valve Prosthesis Implantation business.industry Age Factors Aortic Valve Stenosis medicine.disease Sternotomy Sutureless Surgical Procedures Stenosis Treatment Outcome Cytokine Aortic Valve Heart Valve Prosthesis Cardiology Cytokines Female Surgery Inflammation Mediators medicine.symptom Cardiology and Cardiovascular Medicine business Cell-Free Nucleic Acids Biomarkers |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 69:034-042 |
| ISSN: | 1439-1902 0171-6425 |
| Popis: | Introduction Mitochondrial DNA (mtDNA) is gaining increasing interest as a marker of cellular damage and could also act as an inflammatory mediator in cardiopulmonary bypass induced postoperative inflammatory response. Although minimally invasive heart valve surgery reportedly reduces inflammation, the mtDNA and cytokine profile in this context remains unclear.Materials and Methods Here, we report a prospective series of 40 elderly patients with aortic stenosis who underwent bioprosthetic aortic valve replacement (AVR) through upper ministernotomy with either a sutureless (n = 20) or a conventional (n = 20) valve. Primary end points included serial plasma levels of mtDNA (T1: at baseline; T2: 4 hours after surgery; and T3: 24s hour after surgery), cytokines (interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α]), and myocardial necrosis biomarkers (MNBs), whereas secondary end points included clinical and echocardiographic data.Results Significant increases in the postoperative plasma levels (T2) of mtDNA, cytokines, and MNBs were observed in all patients. The postoperative plasma levels of mtDNA, TNF-α, and MNBs showed no significant differences between the treatment groups, although there was a trend toward lower levels in the sutureless group. The decreases in aortic cross-clamp and cardiopulmonary bypass times seen in the sutureless group were associated with significant lower postoperative levels (T2 and T3) of IL-6.Conclusion AVR through upper ministernotomy was associated with a significant increase in postoperative plasma levels of mtDNA and cytokines. There was no difference in the mtDNA levels between the sutureless and conventional valve groups, suggesting a similar level of inflammation in both groups. However, the shorter operation time observed in the sutureless valve group was associated with significantly lower postoperative levels of IL-6, indicating potential clinical benefits. |
| Databáze: | OpenAIRE |
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