Reduced plasma level of basic fibroblast growth factor is associated with incomplete device endothelialization at six months following left atrial appendage closure

Xu, Jing; Gong, Xin; Chen, Chuanzhi; Xing, Jun; Wang, Qi; Shi, Weifeng; Zhang, Qi

doi:10.1186/s12872-021-02059-6

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…Regarding the exploration of additional biomarkers capable of identifying incomplete device endothelialization (IDE) and potential peri-device leakage (PDL), Xu et al [31] conducted a study involving 55 patients. Their investigation delved into inflammatory and growth factors (IGFs), encompassing plasma levels of specific IGFs, including basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), stromal cell-derived factor (SDF)-1a, transforming growth factor (TGF)-β1, vascular growth factor receptor-1 (VEGF-R1), and von Willebrand factor (vWF).…”

Section: Discussionmentioning

confidence: 99%

“…Among these six IGFs, solely the plasma level of bFGF exhibited a significant decrease in patients exhibiting IDE. Notably, employing a cut-off value of 440.52 pg/mL (with a sensitivity of 76.5% and a specificity of 78.9%), Xu et al [31] identified lower bFGF levels as an independent factor associated with IDE. This finding was substantiated by a multivariate logistic regression model [31].…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage

Haertel,

Lustermann,

Hamadanchi

et al. 2023

IJMS

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Echocardiographic detection of residual peri-device leakage (PDL) after percutaneous left atrial appendage occlusion (LAAO) is crucial for managing anticoagulation. Galectin-3, a protein involved in tissue–foreign body interactions, may hold significance in understanding PDL and cardiac tissue remodeling after LAAO. This study aimed to analyze galectin-3 serum levels in relation to PDL using a novel echo-morphological classification. LAAO eligible patients were included in the study. Galectin-3 serum levels were measured before LAAO, at 45 days (45D), and at 6 months (6M) after the procedure. Transesophageal echocardiography was used to assess LAAO success. A new echo-morphological classification categorized the degree of LAAO into three different types (A: homogenous echodensity, indicating completely thrombosed device; B: inhomogeneous echolucencies (<50% of device); and C: partially thrombosed device with echolucencies > 50%). Among 47 patients, complete LAAO was achieved in 60% after 45D and in 74% after 6M. We observed a significant increase and distribution of serum levels of galectin-3 [ng/mL] after 45D among the three types (baseline: 13.1 ± 5.8 ng/mL; 45D: 16.3 ± 7.2 ng/mL (Type A) vs. 19.2 ± 8.6 ng/mL (Type B) vs. 25.8 ± 9.4 ng/mL (Type C); p = 0.031), followed by a drop in galectin-3 for Types A and B after 6M toward and below the baseline levels (6M: 8.9 ± 3.1 ng/mL (Type A) vs. 12.4 ± 5.5 ng/mL (Type B)), whereas Type C persisted in showing elevated galectin-3 levels compared to all other types (6M: 17.5 ± 4.5 ng/mL (Type C); p < 0.01). Increased galectin-3 serum levels after LAAO likely reflect the transition from thrombus formation to fibrotic scar development in the LAA lumen. Successful occlusion is associated with a time-restricted decrease in galectin-3 levels after 6 months, while relevant PDL leads to persistently elevated levels, making galectin-3 a potential predictor of occlusion success.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage

Haertel,

Lustermann,

Hamadanchi

et al. 2023

IJMS

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“…LAAC procedure and anticoagulation regimen LAAC procedure was performed under uoroscopy and trans-esophageal echocardiography guidance by the standard technique described previously [19]. In brief, intravenous heparin was administered following transseptal puncture and introduction of delivery system to the left atrial appendage.…”

Section: Study Populationmentioning

confidence: 99%

Clinical relevance of incomplete device endothelialization after left atrial appendage closure

Chen

Xing

et al. 2022

Int J Cardiovasc Imaging

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This study aimed to assess the incidence, potential risk factors and clinical impact of incomplete device endothelialization (IDE) after left atrial appendage closure (LAAC). MethodsA total of 101 consecutive patients with nonvalvular atrial brillation (AF) who underwent successful LAAC and received antithrombotic treatment using a standard regimen were prospectively followed up to 6 months after the procedure. The status of device endothelialization and device-related thrombus (DRT) were evaluated using cardiac computed tomography (CT). Major adverse cardio-cerebral events (MACCE) including all-cause death, heart failure(HF) hospitalization, acute ischemic stroke, transient ischemic attack(TIA), peripheral vascular embolism, and major bleeding were recorded. ResultsIDE was detected in 65 (64.4%) patients. Patients with IDE or complete device endothelialization (CDE) did not signi cantly differ with respect to baseline clinical characteristics and interventional procedure features. Multivariate analysis model revealed that persistent AF, left atrial appendage ostial diameter and left atrial size were independent risk factors for IDE. During 6-month follow-up, the incidence of DRT was 4.6% in patients with IDE and 2.8% in those with CDE, respectively (p > 0.05), and the overall rate of MACCE was non-signi cantly higher in the IDE group (7.7% vs. 2.8%, p = 0.32). ConclusionsIDE is common after LAAC, especially in patients with persistent AF, higher left atrial appendage ostial diameter and left atrial size. IDE confers an increased risk for DRT, but may be not necessarily associated with thromboembolic events and poor clinical outcome, providing careful monitoring and continued antithrombotic therapy are given.

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Clinical Relevance of Incomplete Device Endothelialization After Left Atrial Appendage Closure

Chen

Xing

et al. 2022

Preprint

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Purpose This study aimed to assess the incidence, potential risk factors and clinical impact of incomplete device endothelialization (IDE) after left atrial appendage closure (LAAC). Methods A total of 101 consecutive patients with nonvalvular atrial fibrillation (AF) who underwent successful LAAC and received antithrombotic treatment using a standard regimen were prospectively followed up to 6 months after the procedure. The status of device endothelialization and device-related thrombus (DRT) were evaluated using cardiac computed tomography (CT). Major adverse cardio-cerebral events (MACCE) including all-cause death, heart failure(HF) hospitalization, acute ischemic stroke, transient ischemic attack(TIA), peripheral vascular embolism, and major bleeding were recorded. Results IDE was detected in 65 (64.4%) patients. Patients with IDE or complete device endothelialization (CDE) did not significantly differ with respect to baseline clinical characteristics and interventional procedure features. Multivariate analysis model revealed that persistent AF, left atrial appendage ostial diameter and left atrial size were independent risk factors for IDE. During 6-month follow-up, the incidence of DRT was 4.6% in patients with IDE and 2.8% in those with CDE, respectively (p > 0.05), and the overall rate of MACCE was non-significantly higher in the IDE group (7.7% vs. 2.8%, p = 0.32). Conclusions IDE is common after LAAC, especially in patients with persistent AF, higher left atrial appendage ostial diameter and left atrial size. IDE confers an increased risk for DRT, but may be not necessarily associated with thromboembolic events and poor clinical outcome, providing careful monitoring and continued antithrombotic therapy are given.

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Reduced plasma level of basic fibroblast growth factor is associated with incomplete device endothelialization at six months following left atrial appendage closure

Cited by 3 publications

References 35 publications

Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage

Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage

Clinical relevance of incomplete device endothelialization after left atrial appendage closure

Clinical Relevance of Incomplete Device Endothelialization After Left Atrial Appendage Closure

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