Severe autonomic failure in moderate to severe aortic stenosis: prevalence and association with hemodynamics and biomarkers

Zuern, Christine S.; Eick, Christian; Rizas, Konstantinos D.; Stoleriu, Cosmina; Barthel, Petra; Ståhl, Christian; Müller, Karin; Gawaz, Meinrad; Bauer, Axel

doi:10.1007/s00392-012-0427-3

Cited by 15 publications

(14 citation statements)

References 38 publications

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“…In the periphery, 5‐HT is mainly stored in platelet and released after platelet activation. These data suggest that the increase in plasma 5‐HT in severe AS could result, at least in part, from platelet activation induced by shear stress through aortic stenosis and release of dense granule content where 5‐HT is stored . It is interesting to note that the increase in arterial plasma 5‐HT was already detectable in arterial plasma from poststenotic aortic blood indicating that platelet activation and 5‐HT release occur at the aortic valve ostium.…”

Section: Discussionmentioning

confidence: 87%

Platelet activation and arterial peripheral serotonin turnover in cardiac remodeling associated to aortic stenosis

et al. 2014

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Peripheral serotonin (5-HT) has been involved in adverse cardiac remodeling and valve fibrosis. The peripheral levels of 5-HT mainly depend on its release from activated platelets and degradation by monoamine oxidase A (MAO-A). The SERAOPI study investigated the relationship between arterial serotoninergic system, degree of platelet activation and cardiac remodeling, in patients with aortic valve stenosis (AS). Thirty patients with severe AS and 15 control subjects underwent transthoracic echocardiography, radial, and aortic arterial blood sampling. Measurements of 5-HT and its MAO-Adependent degradation product, 5-HIAA, were performed by HPLC. Arterial platelet activation was assessed by flow cytometry analysis of platelet surface expression of P-selectin and activated integrin GPIIb/IIIa. Activated platelets and arterial plasma 5-HT increased in AS patients as compared to control subjects (P-selectin 1.08 6 0.2MFI vs. 0.49 6 0.1MFI, P 5 0.04; GPIIb/IIIa 0.71 6 0.1MFI vs. 0.35 6 0.1MFI; P 5 0.0015 and arterial plasma 5-HT 11.55 6 1.6 nM vs. 6.18 6 0.7 nM, P 5 0.028, respectively). Moreover, 5-HT was strongly correlated to left ventricular hypertrophy assessed by echocardiography. The correlation was independent of cardiovascular risk comorbidities and others echocardiographic AS parameters. Finally, plasma 5-HIAA increased in AS patients (74.64 6 9.7 nM vs. 37.16 6 4.1 nM; P 5 0.0002) indicating a higher 5-HT degradation rate by MAO-A. Platelet activation, arterial circulating serotonin, and serotonin degradation increased in patients with AS. These observations suggest that the serotoninergic system may contribute to the pathogenesis of AS including valve fibrosis and adverse ventricular remodeling.

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Section: Discussionmentioning

confidence: 87%

Platelet activation and arterial peripheral serotonin turnover in cardiac remodeling associated to aortic stenosis

et al. 2014

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“…8 Our study showed comparable results for the parameters of TO and TS for the 2 different groups with MCI and TAC. This, and the fact that HRT alterations have previously been found in a variety of cardiac diseases, [24][25][26][27] points out that not the disease itself, but its impact on cardiac strain, results in the variations of baroreceptor function.…”

Section: Discussionmentioning

confidence: 75%

“…Structural heart diseases lead to reductions in baroreceptor sensitivity . This phenomenon has been demonstrated using HRT parameters in various human cardiac diseases, including coronary artery disease, myocardial infarction, heart failure, and aortic stenosis . The reduction of baroreceptor function after myocardial infarction has been reproduced in several animal studies .…”

Section: Discussionmentioning

confidence: 88%

“…23 This phenomenon has been demonstrated using HRT parameters in various human cardiac diseases, including coronary artery disease, 24 myocardial infarction, 25 heart failure, 26 and aortic stenosis. 27 The reduction of baroreceptor function after myocardial infarction has been reproduced in several animal studies. 28 In the present study, we showed that myocardial cryoinfarction, as well as cardiac pressure overload by TAC, resulted in marked reductions of baroreceptor sensitivity, as indicated by abnormal TO values.…”

Section: Discussionmentioning

confidence: 99%

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Association of Heart Rate Turbulence With Arrhythmia Susceptibility and Heart Disease in Mice

Stöckigt

Jüngst

Linhart

et al. 2015

Cardiovasc electrophysiol

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“…Among different mechanism affected or modified by aortic-valve disease, the autonomic regulation, as assessed by heart rate variability (HRV), has been mainly examined in patients manifesting severe aortic-valve stenosis [7][8][9][10][11]. HRV refers to the interval fluctuations between consecutive heart beats [12,13].…”

Section: Introductionmentioning

confidence: 99%

Inflammation and Reduced Parasympathetic Cardiac Modulation in Aortic-Valve Sclerosis

et al. 2019

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Aortic-valve sclerosis increases cardiovascular mortality risk and precedes aortic-valve stenosis, but its mechanisms are not well understood. The purpose of this study was to compare the cardiac autonomic modulation and inflammation markers between subjects with aortic-valve normal leaflets and subjects with aortic-valve sclerosis. According to 2-D transthoracic echocardiograms, 61 middle-aged volunteers without chronic or acute illnesses were classified in two groups: with no aortic-valve sclerosis (NAVS, N = 16) and with aortic-valve sclerosis (AVS, N = 45). An electrocardiogram at the supine position and active standing was collected to estimate heart rate variability (HRV) indices. A blood sample was obtained to quantify markers of inflammation. Compared to NAVS, AVS subjects showed higher levels of IL-6 (1619 ± 650 vs. 1169 ± 676 pg/mL, p = 0.044) as well as TNFα (370.8 ± 182.0 vs. 247.3 ± 188.2 pg/mL, p = 0.032), and larger low-frequency (LF) to high-frequency (HF) ratio during supine position (Ln(LF/HF) = 0.85 ± 0.85 vs. 0.11 ± 0.69, p = 0.003). Multiple logistic regression analysis showed that AVS was independently associated with LF/HF, TNFα and left ventricle mass index (p < 0.05). In conclusion, a significant reduction of the parasympathetic-driven cardiac modulation and low-grade inflammation occurs in aortic-valve sclerosis.

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Severe autonomic failure in moderate to severe aortic stenosis: prevalence and association with hemodynamics and biomarkers

Abstract: In patients with moderate to severe AS prevalence of SAF is high. SAF correlates with hemodynamic and biochemical markers indicating increased risk. Future studies should evaluate the prognostic value of SAF in patients with AS.

Cited by 15 publications

References 38 publications

Platelet activation and arterial peripheral serotonin turnover in cardiac remodeling associated to aortic stenosis

Platelet activation and arterial peripheral serotonin turnover in cardiac remodeling associated to aortic stenosis

Association of Heart Rate Turbulence With Arrhythmia Susceptibility and Heart Disease in Mice

Inflammation and Reduced Parasympathetic Cardiac Modulation in Aortic-Valve Sclerosis

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