Oury Cécile, Nchimi Alain, Lancellotti Patrizio, Bergler-Klein Jutta
Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.
Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy.
Front Cardiovasc Med. 2018 Mar 28;5:31. doi: 10.3389/fcvm.2018.00031. eCollection 2018.
Transcatheter aortic valve implantation (TAVI) has become the method of choice for patients with severe aortic valve stenosis, who are ineligible or at high risk for surgery. In this high risk patient population, early and late mortality and rehospitalization rates after TAVI are still relatively high. In spite of recent improvements in procedural TAVI, and establishment of risk models for poor outcome, determining individual risk remains challenging. In this context, current data from several small studies strongly suggest that blood biomarkers of myocardial injury, cardiac mechanical stretch, inflammation, and hemostasis imbalance might play an important role by providing informations on patient risk at baseline, and postprocedural progression of patient clinical conditions from days up to years post-TAVI. Although the role of biomarkers for predicting survival post-TAVI remains to be validated in large randomized studies, implementing biomarkers in clinical practice might improve risk stratification, thereby further reducing TAVI-associated morbidity and mortality.
经导管主动脉瓣植入术（TAVI）已成为严重主动脉瓣狭窄患者的首选治疗方法，这些患者不适合手术或手术风险很高。在这个高风险患者群体中，TAVI术后的早期和晚期死亡率以及再住院率仍然相对较高。尽管最近TAVI手术有所改进，并且建立了预后不良的风险模型，但确定个体风险仍然具有挑战性。在这种情况下，几项小型研究的当前数据强烈表明，心肌损伤、心脏机械拉伸、炎症和止血失衡的血液生物标志物可能通过提供基线时患者风险以及TAVI术后数天至数年患者临床状况的术后进展信息发挥重要作用。尽管生物标志物在预测TAVI术后生存率方面的作用仍有待大型随机研究验证，但在临床实践中应用生物标志物可能会改善风险分层，从而进一步降低TAVI相关的发病率和死亡率。
