经导管主动脉瓣植入术后预测结局的细胞外囊泡：一项前瞻性、多中心队列研究。

Extracellular Vesicles to Predict Outcomes After Transcatheter Aortic Valve Implantation - a Prospective, Multicenter Cohort Study.

机构信息

Department of Cardiac Surgery, Medical University of Warsaw, Warsaw, Poland.

Club 30", Polish Cardiac Society, Warsaw, Poland.

出版信息

J Cardiovasc Transl Res. 2024 Oct;17(5):992-1003. doi: 10.1007/s12265-024-10521-x. Epub 2024 May 28.

INTRODUCTION

Transcatheter aortic valve implantation (TAVI) is an established treatment for aortic stenosis (AS) in patients at intermediate and high surgical risk. Circulating extracellular vesicles (EVs) are nanoparticles involved in cardiovascular diseases. We aimed to (i) determine the effect of TAVI on plasma concentrations of five EV subtypes and (ii) evaluate the predictive value of EVs for post-TAVI outcomes.

METHODS

Blood samples were collected 1 day before TAVI and at hospital discharge. Concentrations of EVs were evaluated using flow cytometry.

RESULTS

Concentration of leukocytes EVs decreased after TAVI, compared to the measurement before (p = 0.008). Among 123 patients discharged from the hospital, 19.5% experienced MACCE during the median of 10.3 months. Increased pre-TAVI concentration of phosphatidylserine-exposing EVs was an independent predictor of MACCE in multivariable analysis (OR 5.313, 95% CI 1.164-24.258, p = 0.031).

CONCLUSIONS

Patients with increased pre-TAVI concentration of procoagulant, PS-exposing EVs have over fivefold higher odds of adverse outcomes.

简介

经导管主动脉瓣植入术（TAVI）是一种治疗中高危手术风险的主动脉瓣狭窄（AS）的成熟方法。循环细胞外囊泡（EVs）是参与心血管疾病的纳米颗粒。我们旨在：（i）确定 TAVI 对五种 EV 亚型血浆浓度的影响；（ii）评估 EVs 对 TAVI 后结局的预测价值。

方法

在 TAVI 前 1 天和出院时采集血样。使用流式细胞术评估 EVs 的浓度。

结果

与 TAVI 前的测量值相比，TAVI 后白细胞 EVs 的浓度降低（p=0.008）。在出院的 123 名患者中，19.5%在中位数为 10.3 个月的时间内发生 MACCE。多变量分析显示，术前 PS 暴露 EVs 浓度升高是 MACCE 的独立预测因子（OR 5.313，95%CI 1.164-24.258，p=0.031）。