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

Osama Abou-Arab (1, 2) , Saïd Kamel (2) , Stephane Bar (1, 3) , Christophe Beyls (1) , Pierre Huette (4) , Cathy Gomila (5) , Carine Avondo (2) , Gilles Touati (6) , Christophe Tribouilloy (2, 1) , Herve Dupont (1, 2) , Emmanuel Lorne (7) , Pierre-Gregoire Guinot (8, 9, 10)

1 CHU Amiens-Picardie
2 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517
3 SSPC - Simplification des soins chez les patients complexes - UR UPJV 7518
4 Département d'anesthésiologie [CHU Caen]
5 HEMATIM - HEMATIM - Hématopoïèse et immunologie - UR UPJV 4666
6 Service de Cardiologie [Amiens]
7 Clinique du Millénaire - Oc Santé [Montpellier]
8 Service d'anesthésie - réanimation chirurgicale [CHU de Dijon]
9 LNC - Lipides - Nutrition - Cancer [Dijon - U1231]
10 LabEx LipSTIC - Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer

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.

Domains: Life Sciences [q-bio]

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⟩