Roth, Nastasia and Heidel, Carolin and Xu, Congde and Hubauer, Ute and Wallner, Stefan and Meindl, Christine and Holzamer, Andreas and Hilker, Michael and Creutzenberg, Marcus and Sossalla, Samuel and Maier, Lars and Jungbauer, Carsten and Debl, Kurt (2022) The impact of bicuspid aortic valve morphology on von Willebrand factor function in patients with severe aortic stenosis and its change after TAVI. CLINICAL RESEARCH IN CARDIOLOGY, 111 (12). pp. 1348-1357. ISSN 1861-0684, 1861-0692
Full text not available from this repository. (Request a copy)Abstract
Background Aortic stenosis (AS) can cause acquired von Willebrand syndrome (AVWS) and valve replacement has been shown to lead to von Willebrand factor (vWF) recovery. The aim of the current study was to investigate the prevalence of AVWS in different severe AS phenotypes and its course after transcatheter aortic valve implantation (TAVI). Methods 143 patients with severe AS undergoing TAVI were included in the study. vWF function was assessed at baseline, 6 and 24 h after TAVI. AVWS was defined as a reduced vWF:Ac/Ag ratio <= 0.7. Phenotypes were classified by tricuspid (TAV) and bicuspid (BAV) valve morphology, mean transvalvular gradient (P-mean), stroke volume index (SVI), ejection fraction (EF) and indexed effective orifice area (iEOA). Results AVWS was present in 36 (25.2%) patients before TAVI. vWF:Ac/Ag ratio was significantly lower in high gradient compared to low-gradient severe AS [0.78 (IQR 0.67-0.86) vs. 0.83 (IQR 0.74-0.93), p< 0.05] and in patients with BAV compared to TAV [0.70 (IQR 0.63-0.78) vs. 0.81 (IQR 0.71-0.89), p < 0.05]. Normalization of vWF:Ac/Ag ratio was achieved in 61% patients 24 h after TAVI. As in the overall study cohort, vWF:Ac/Ag ratio increased significantly in all severe AS subgroups 6 h after TAVI (each p < 0.05). Regarding binary logistic regression analysis, BAV was the only significant predictor for AVWS. Conclusions BAV morphology is a strong predictor for AVWS in severe AS. TAVI restores vWF function in most patients with severe AS independently of AS phenotype and valve morphology. [GRAPHICS] .
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EUROPEAN ASSOCIATION; AMERICAN SOCIETY; DISEASE; IMPLANTATION; GUIDELINES; REPLACEMENT; MANAGEMENT; UPDATE; von Willebrand factor; Acquired von Willebrand syndrome; Bicuspid aortic valve; Aortic stenosis; Transcatheter aortic valve implantation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II Medicine > Lehrstuhl für Klinische Chemie und Laboratoriumsmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Jan 2024 08:16 |
| Last Modified: | 09 Jan 2024 08:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/57088 |
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