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The Presence of Ascending Aortic Dilatation in Patients Undergoing Transcatheter Aortic Valve Replacement Is Negatively Correlated with the Presence of Diabetes Mellitus and Does Not Impair Post-Procedural Outcomes

Both relevant aortic valve stenosis (AS) and aortic valve insufficiency significantly contribute to structural changes in the ascending aorta (AA) and thus to its dilatation. In patients with severe AS undergoing transcatheter aortic valve replacement (TAVR), survival data regarding aortic changes a...

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Autores principales: Boxhammer, Elke, Hecht, Stefan, Kaufmann, Reinhard, Kammler, Jürgen, Kellermair, Jörg, Reiter, Christian, Akbari, Kaveh, Blessberger, Hermann, Steinwender, Clemens, Lichtenauer, Michael, Hoppe, Uta C., Hergan, Klaus, Scharinger, Bernhard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914357/
https://www.ncbi.nlm.nih.gov/pubmed/36766463
http://dx.doi.org/10.3390/diagnostics13030358
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author Boxhammer, Elke
Hecht, Stefan
Kaufmann, Reinhard
Kammler, Jürgen
Kellermair, Jörg
Reiter, Christian
Akbari, Kaveh
Blessberger, Hermann
Steinwender, Clemens
Lichtenauer, Michael
Hoppe, Uta C.
Hergan, Klaus
Scharinger, Bernhard
author_facet Boxhammer, Elke
Hecht, Stefan
Kaufmann, Reinhard
Kammler, Jürgen
Kellermair, Jörg
Reiter, Christian
Akbari, Kaveh
Blessberger, Hermann
Steinwender, Clemens
Lichtenauer, Michael
Hoppe, Uta C.
Hergan, Klaus
Scharinger, Bernhard
author_sort Boxhammer, Elke
collection PubMed
description Both relevant aortic valve stenosis (AS) and aortic valve insufficiency significantly contribute to structural changes in the ascending aorta (AA) and thus to its dilatation. In patients with severe AS undergoing transcatheter aortic valve replacement (TAVR), survival data regarding aortic changes and laboratory biomarker analyses are scarce. Methods: A total of 179 patients with severe AS and an available computed tomography were included in this retrospective study. AA was measured, and dilatation was defined as a diameter ≥ 40 mm. Thirty-two patients had dilatation of the AA. A further 32 patients from the present population with a normal AA were matched to the aortic dilatation group with respect to gender, age, body mass index and body surface area, and the resulting study groups were compared with each other. In addition to echocardiographic and clinical characteristics, the expression of cardiovascular biomarkers such as brain natriuretic peptide (BNP), soluble suppression of tumorigenicity-2 (sST2), growth/differentiation of factor-15 (GDF-15), heart-type fatty-acid binding protein (H-FABP), insulin-like growth factor binding protein 2 (IGF-BP2) and soluble urokinase-type plasminogen activator receptor (suPAR) was analyzed. Kaplan–Meier curves for short- and long-term survival were obtained, and Pearson’s and Spearman’s correlations were calculated to identify the predictors between the diameter of the AA and clinical parameters. Results: A total of 19% of the total cohort had dilatation of the AA. The study group with an AA diameter ≥ 40 mm showed a significantly low comorbidity with respect to diabetes mellitus in contrast to the comparison cohort with an AA diameter < 40 mm (p = 0.010). This result continued in the correlation analyses performed, as the presence of diabetes mellitus correlated negatively not only with the diameter of the AA (r = −0.404; p = 0.001) but also with the presence of aortic dilatation (r = −0.320; p = 0.010). In addition, the presence of AA dilatation after TAVR was shown to have no differences in terms of patient survival at 1, 3 and 5 years. There were no relevant differences in the cardiovascular biomarkers studied between the patients with dilated and normal AAs. Conclusion: The presence of AA dilatation before successful TAVR was not associated with a survival disadvantage at the respective follow-up intervals of 1, 3 and 5 years. Diabetes mellitus in general seemed to have a protective effect against the development of AA dilatation or aneurysm in patients with severe AS.
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spelling pubmed-99143572023-02-11 The Presence of Ascending Aortic Dilatation in Patients Undergoing Transcatheter Aortic Valve Replacement Is Negatively Correlated with the Presence of Diabetes Mellitus and Does Not Impair Post-Procedural Outcomes Boxhammer, Elke Hecht, Stefan Kaufmann, Reinhard Kammler, Jürgen Kellermair, Jörg Reiter, Christian Akbari, Kaveh Blessberger, Hermann Steinwender, Clemens Lichtenauer, Michael Hoppe, Uta C. Hergan, Klaus Scharinger, Bernhard Diagnostics (Basel) Article Both relevant aortic valve stenosis (AS) and aortic valve insufficiency significantly contribute to structural changes in the ascending aorta (AA) and thus to its dilatation. In patients with severe AS undergoing transcatheter aortic valve replacement (TAVR), survival data regarding aortic changes and laboratory biomarker analyses are scarce. Methods: A total of 179 patients with severe AS and an available computed tomography were included in this retrospective study. AA was measured, and dilatation was defined as a diameter ≥ 40 mm. Thirty-two patients had dilatation of the AA. A further 32 patients from the present population with a normal AA were matched to the aortic dilatation group with respect to gender, age, body mass index and body surface area, and the resulting study groups were compared with each other. In addition to echocardiographic and clinical characteristics, the expression of cardiovascular biomarkers such as brain natriuretic peptide (BNP), soluble suppression of tumorigenicity-2 (sST2), growth/differentiation of factor-15 (GDF-15), heart-type fatty-acid binding protein (H-FABP), insulin-like growth factor binding protein 2 (IGF-BP2) and soluble urokinase-type plasminogen activator receptor (suPAR) was analyzed. Kaplan–Meier curves for short- and long-term survival were obtained, and Pearson’s and Spearman’s correlations were calculated to identify the predictors between the diameter of the AA and clinical parameters. Results: A total of 19% of the total cohort had dilatation of the AA. The study group with an AA diameter ≥ 40 mm showed a significantly low comorbidity with respect to diabetes mellitus in contrast to the comparison cohort with an AA diameter < 40 mm (p = 0.010). This result continued in the correlation analyses performed, as the presence of diabetes mellitus correlated negatively not only with the diameter of the AA (r = −0.404; p = 0.001) but also with the presence of aortic dilatation (r = −0.320; p = 0.010). In addition, the presence of AA dilatation after TAVR was shown to have no differences in terms of patient survival at 1, 3 and 5 years. There were no relevant differences in the cardiovascular biomarkers studied between the patients with dilated and normal AAs. Conclusion: The presence of AA dilatation before successful TAVR was not associated with a survival disadvantage at the respective follow-up intervals of 1, 3 and 5 years. Diabetes mellitus in general seemed to have a protective effect against the development of AA dilatation or aneurysm in patients with severe AS. MDPI 2023-01-18 /pmc/articles/PMC9914357/ /pubmed/36766463 http://dx.doi.org/10.3390/diagnostics13030358 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Boxhammer, Elke
Hecht, Stefan
Kaufmann, Reinhard
Kammler, Jürgen
Kellermair, Jörg
Reiter, Christian
Akbari, Kaveh
Blessberger, Hermann
Steinwender, Clemens
Lichtenauer, Michael
Hoppe, Uta C.
Hergan, Klaus
Scharinger, Bernhard
The Presence of Ascending Aortic Dilatation in Patients Undergoing Transcatheter Aortic Valve Replacement Is Negatively Correlated with the Presence of Diabetes Mellitus and Does Not Impair Post-Procedural Outcomes
title The Presence of Ascending Aortic Dilatation in Patients Undergoing Transcatheter Aortic Valve Replacement Is Negatively Correlated with the Presence of Diabetes Mellitus and Does Not Impair Post-Procedural Outcomes
title_full The Presence of Ascending Aortic Dilatation in Patients Undergoing Transcatheter Aortic Valve Replacement Is Negatively Correlated with the Presence of Diabetes Mellitus and Does Not Impair Post-Procedural Outcomes
title_fullStr The Presence of Ascending Aortic Dilatation in Patients Undergoing Transcatheter Aortic Valve Replacement Is Negatively Correlated with the Presence of Diabetes Mellitus and Does Not Impair Post-Procedural Outcomes
title_full_unstemmed The Presence of Ascending Aortic Dilatation in Patients Undergoing Transcatheter Aortic Valve Replacement Is Negatively Correlated with the Presence of Diabetes Mellitus and Does Not Impair Post-Procedural Outcomes
title_short The Presence of Ascending Aortic Dilatation in Patients Undergoing Transcatheter Aortic Valve Replacement Is Negatively Correlated with the Presence of Diabetes Mellitus and Does Not Impair Post-Procedural Outcomes
title_sort presence of ascending aortic dilatation in patients undergoing transcatheter aortic valve replacement is negatively correlated with the presence of diabetes mellitus and does not impair post-procedural outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914357/
https://www.ncbi.nlm.nih.gov/pubmed/36766463
http://dx.doi.org/10.3390/diagnostics13030358
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