Differential systemic inflammatory responses after TAVI: The role of self versus balloon expandable devices.

<h4>Objective</h4>Transcatheter aortic valve implantation (TAVI) provokes early injury response, represented in part by dynamic changes in the inflammatory markers. The association of self-expanding valves (SEVs) and balloon-expandable valves (BEVs) with the consequent inflammatory respo...

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Autores principales: Haitham Abu Khadija, Gera Gandelman, Omar Ayyad, Mustafa Jaber, Lion Poles, Michael Jonas, Offir Paz, Firas Abu Sbaih, Gal Sella, Sara Shimoni, Jacob George, Alex Blatt
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:da06e82c7f7c4d4c9ed34347d53049a42021-12-02T20:13:31ZDifferential systemic inflammatory responses after TAVI: The role of self versus balloon expandable devices.1932-620310.1371/journal.pone.0258963https://doaj.org/article/da06e82c7f7c4d4c9ed34347d53049a42021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258963https://doaj.org/toc/1932-6203<h4>Objective</h4>Transcatheter aortic valve implantation (TAVI) provokes early injury response, represented in part by dynamic changes in the inflammatory markers. The association of self-expanding valves (SEVs) and balloon-expandable valves (BEVs) with the consequent inflammatory response remains uncertain.<h4>Materials and methods</h4>Patients with severe symptomatic aortic stenosis who underwent transfemoral TAVI: SEVs or BEVs, from January 2010 to December 2019 were enrolled. Whole white blood cells (WBC) and subpopulation dynamics as well the neutrophil to lymphocyte ratio (NLR) were evaluated.<h4>Results</h4>Three-hundred seventy consecutive patients (mean age 81.75 ± 6.8 years, 199 women's) were enrolled. In the entire population, significant kinetic changes in the WBC response (p <0.0001) between admission and first 24 hours post procedure, with a significant increase in total WBC (7.46 ± 2.26 to 10.08 ± 3.55) and absolute neutrophil count (4.97 ± 2.06 to 8.19 ± 3.43), NL ratio (3.72 ± 2.8 to 9.76 ± 7.29), and a meaningful decrease in absolute lymphocytes count (1.67 ± 1.1 to 1.1 ± 0.76). When compared between the types of valves, SEVs were associated with a more pronounced inflammatory response than BEVs, with total WBC (10.44 ± 3.86 vs. 9.45 ± 3.19) neutrophils (8.56 ± 3.75 vs. 7.55 ± 3.06) with p 0.016 and 0.012 respectively.<h4>Conclusion</h4>This is the first description of a differential inflammatory response between the two leading delivery systems. SEV appears to trigger a more robust inflammatory response as compared to BEV. Clinical studies are warranted to assess the long term effect of our findings.Haitham Abu KhadijaGera GandelmanOmar AyyadMustafa JaberLion PolesMichael JonasOffir PazFiras Abu SbaihGal SellaSara ShimoniJacob GeorgeAlex BlattPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258963 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Haitham Abu Khadija
Gera Gandelman
Omar Ayyad
Mustafa Jaber
Lion Poles
Michael Jonas
Offir Paz
Firas Abu Sbaih
Gal Sella
Sara Shimoni
Jacob George
Alex Blatt
Differential systemic inflammatory responses after TAVI: The role of self versus balloon expandable devices.
description <h4>Objective</h4>Transcatheter aortic valve implantation (TAVI) provokes early injury response, represented in part by dynamic changes in the inflammatory markers. The association of self-expanding valves (SEVs) and balloon-expandable valves (BEVs) with the consequent inflammatory response remains uncertain.<h4>Materials and methods</h4>Patients with severe symptomatic aortic stenosis who underwent transfemoral TAVI: SEVs or BEVs, from January 2010 to December 2019 were enrolled. Whole white blood cells (WBC) and subpopulation dynamics as well the neutrophil to lymphocyte ratio (NLR) were evaluated.<h4>Results</h4>Three-hundred seventy consecutive patients (mean age 81.75 ± 6.8 years, 199 women's) were enrolled. In the entire population, significant kinetic changes in the WBC response (p <0.0001) between admission and first 24 hours post procedure, with a significant increase in total WBC (7.46 ± 2.26 to 10.08 ± 3.55) and absolute neutrophil count (4.97 ± 2.06 to 8.19 ± 3.43), NL ratio (3.72 ± 2.8 to 9.76 ± 7.29), and a meaningful decrease in absolute lymphocytes count (1.67 ± 1.1 to 1.1 ± 0.76). When compared between the types of valves, SEVs were associated with a more pronounced inflammatory response than BEVs, with total WBC (10.44 ± 3.86 vs. 9.45 ± 3.19) neutrophils (8.56 ± 3.75 vs. 7.55 ± 3.06) with p 0.016 and 0.012 respectively.<h4>Conclusion</h4>This is the first description of a differential inflammatory response between the two leading delivery systems. SEV appears to trigger a more robust inflammatory response as compared to BEV. Clinical studies are warranted to assess the long term effect of our findings.
format article
author Haitham Abu Khadija
Gera Gandelman
Omar Ayyad
Mustafa Jaber
Lion Poles
Michael Jonas
Offir Paz
Firas Abu Sbaih
Gal Sella
Sara Shimoni
Jacob George
Alex Blatt
author_facet Haitham Abu Khadija
Gera Gandelman
Omar Ayyad
Mustafa Jaber
Lion Poles
Michael Jonas
Offir Paz
Firas Abu Sbaih
Gal Sella
Sara Shimoni
Jacob George
Alex Blatt
author_sort Haitham Abu Khadija
title Differential systemic inflammatory responses after TAVI: The role of self versus balloon expandable devices.
title_short Differential systemic inflammatory responses after TAVI: The role of self versus balloon expandable devices.
title_full Differential systemic inflammatory responses after TAVI: The role of self versus balloon expandable devices.
title_fullStr Differential systemic inflammatory responses after TAVI: The role of self versus balloon expandable devices.
title_full_unstemmed Differential systemic inflammatory responses after TAVI: The role of self versus balloon expandable devices.
title_sort differential systemic inflammatory responses after tavi: the role of self versus balloon expandable devices.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/da06e82c7f7c4d4c9ed34347d53049a4
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