Oxidative Stress in Structural Valve Deterioration: A Longitudinal Clinical Study

Galiñanes, Manuel; Casós, Kelly; Blasco-Lucas, Arnau; Permanyer, Eduard; Máñez, Rafael; Tourneau, Thierry Le; Barquinero, Jordi; Bottio, Tomaso; Roussel, J; Fellah-Hebia, Imen; Sénage, Thomas; Evangelista, Arturo; Badano, Luigi P.; Ruiz-Majoral, Alejandro; Galli, Cesare; Padler‐Karavani, Vered; Soulillou, Jean‐Paul; Vidal, Xavier; Cozzi, Emanuele; Costa, Cristina

doi:10.3390/biom12111606

Cited by 3 publications

(4 citation statements)

References 54 publications

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“…Notably, macrophages and lymphocytes have also been observed in BHV retrieved from patients [34,35]. The mechanisms responsible for the immune infiltrates in SVD are not fully understood, but various pathways have been proposed, including the release of proteolytic enzymes and reactive oxygen species [12][13][14][15]35,36]. In the present study, the samples that displayed a prominent and penetrating cellular immune infiltrate were associated with more severe structural alterations.…”

Section: Discussionmentioning

confidence: 53%

“…The pathogenesis of SVD is not fully elucidated, but it is known to be multifactorial [4,11,12]. Recently, the role of the immune response has gained much attention as a mediator for SVD and a potential target for intervention [4,[12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…The most common tissues used for BHVs are of animal origin, basically from bovine and porcine pericardium, pig valves, and occasionally from equine pericardium [4,15,16]. Many are commercialized by large companies that produce BHVs following not-fully disclosed procedures that modify their structure and function.…”

Section: Introductionmentioning

confidence: 99%

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Differential Immune Response to Bioprosthetic Heart Valve Tissues in the α1,3Galactosyltransferase-Knockout Mouse Model

et al. 2023

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Structural valve deterioration (SVD) of bioprosthetic heart valves (BHVs) has great clinical and economic consequences. Notably, immunity against BHVs plays a major role in SVD, especially when implanted in young and middle-aged patients. However, the complex pathogenesis of SVD remains to be fully characterized, and analyses of commercial BHVs in standardized-preclinical settings are needed for further advancement. Here, we studied the immune response to commercial BHV tissue of bovine, porcine, and equine origin after subcutaneous implantation into adult α1,3-galactosyltransferase-knockout (Gal KO) mice. The levels of serum anti-galactose α1,3-galactose (Gal) and -non-Gal IgM and IgG antibodies were determined up to 2 months post-implantation. Based on histological analyses, all BHV tissues studied triggered distinct infiltrating cellular immune responses that related to tissue degeneration. Increased anti-Gal antibody levels were found in serum after ATS 3f and Freedom/Solo implantation but not for Crown or Hancock II grafts. Overall, there were no correlations between cellular-immunity scores and post-implantation antibodies, suggesting these are independent factors differentially affecting the outcome of distinct commercial BHVs. These findings provide further insights into the understanding of SVD immunopathogenesis and highlight the need to evaluate immune responses as a confounding factor.

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Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

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Differential Immune Response to Bioprosthetic Heart Valve Tissues in the α1,3Galactosyltransferase-Knockout Mouse Model

et al. 2023

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“…Currently, the value of total antioxidant capacity appears to be a valid indicator in the context of alimentary supplementation [55,56]. In addition, the TAC value allows us to find a correlation with dietary TAC (DTAC is considered more in recent studies), thus, associating the patient's nutritional status (BMI) with the vascular damage possibly associated with the change in oxidative stress [56].…”

Section: Circulating Total Antioxidant Capacity Levelsmentioning

confidence: 99%

Essential Hypertension and Oxidative Stress: Novel Future Perspectives

Franco

Sciatti

Favero

et al. 2022

IJMS

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Among cardiovascular diseases, hypertension is one of the main risk factors predisposing to fatal complications. Oxidative stress and chronic inflammation have been identified as potentially responsible for the development of endothelial damage and vascular stiffness, two of the primum movens of hypertension and cardiovascular diseases. Based on these data, we conducted an open-label randomized study, first, to evaluate the endothelial damage and vascular stiffness in hypertense patients; second, to test the effect of supplementation with a physiological antioxidant (melatonin 1 mg/day for 1 year) in patients with essential hypertension vs. hypertensive controls. Twenty-three patients of either gender were enrolled and randomized 1:1 in two groups (control and supplemented group). The plasmatic total antioxidant capacity (as a marker of oxidative stress), blood pressure, arterial stiffness, and peripheral endothelial function were evaluated at the beginning of the study and after 1 year in both groups. Our results showed that arterial stiffness improved significantly (p = 0.022) in supplemented patients. The endothelial function increased too, even if not significantly (p = 0.688), after 1 year of melatonin administration. Moreover, the supplemented group showed a significative reduction in TAC levels (p = 0.041) correlated with the improvement of arterial stiffness. These data suggest that melatonin may play an important role in reducing the serum levels of TAC and, consequently, in improving arterial stiffness.

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Calcification of surgical aortic bioprostheses and its impact on clinical outcome

Guimbretière,

Sénage,

Boureau

et al. 2024

European Heart Journal - Cardiovascular Imaging

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Aims Aortic valve calcification (AVC) of surgical valve bioprostheses (BP) has been poorly explored. We aimed to evaluate in-vivo and ex-vivo BP AVC and its prognosis value. Methods and results Between 2011 and 2019, AVC was assessed using in-vivo computed tomography (CT) in 361 patients who had undergone surgical valve replacement 6.4±4.3 years earlier. Ex-vivo CT scans were performed for 37 explanted BP. The in-vivo CT scans were interpretable for 342 patients (19 patients [5.2%], were excluded). These patients were 77.2±9.1 years old and 64.3% were male. Mean in-vivo AVC was 307±500 Agatston unit (AU). The AVC was 562±570 AU for the 183 (53.5%) patients with structural valve degeneration (SVD) and 13±43 AU for those without SVD (p<0.0001). In-vivo and ex-vivo AVC were strongly correlated (r=0.88, p<0.0001). An in-vivo AVC>100 AU (n=147, 43%) had a specificity of 96% for diagnosing Stage 2-3 SVD (area under the curve=0.92). Patients with AVC>100 AU had a worse outcome compared with those with AVC≤100 AU (n=195). In multivariable analysis, AVC was a predictor of overall mortality (hazard ratio [HR] and 95% confidence interval=1.16[1.04-1.29]; p=0.006), cardiovascular mortality (HR=1.22[1.04-1.43]; p=0.013), cardiovascular events (HR=1.28 [1.16-1.41]; p<0.0001), and re-intervention (HR=1.15 [1.06-1.25]; p<0.0001). After adjustment for Stage 2-3 SVD diagnosis, AVC remained a predictor of overall mortality (HR=1.20 [1.04-1.39]; p=0.015) and cardiovascular events (HR=1.25 [1.09-1.43]; p=0.001). Conclusion CT scan is a reliable tool to assess BP leaflet calcification. An AVC>100 AU is tightly associated with SVD and it is a strong predictor of overall mortality and cardiovascular events.

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Oxidative Stress in Structural Valve Deterioration: A Longitudinal Clinical Study

Cited by 3 publications

References 54 publications

Differential Immune Response to Bioprosthetic Heart Valve Tissues in the α1,3Galactosyltransferase-Knockout Mouse Model

Differential Immune Response to Bioprosthetic Heart Valve Tissues in the α1,3Galactosyltransferase-Knockout Mouse Model

Essential Hypertension and Oxidative Stress: Novel Future Perspectives

Calcification of surgical aortic bioprostheses and its impact on clinical outcome

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