Circulating Progenitor Cells Are Associated With Bioprosthetic Aortic Valve Deterioration: A Preliminary Study
Background Mechanisms underlying bioprosthetic valve deterioration are multifactorial and incompletely elucidated. Reparative circulating progenitor cells, and conversely calcification‐associated osteocalcin expressing circulating progenitor cells, have been linked to native aortic valve deteriorati...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.027364 |
| _version_ | 1811170044826091520 |
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| author | Yoshihisa Kanaji Ilke Ozcan Takumi Toya Rajiv Gulati Melissa Young Tsunekazu Kakuta Lilach O. Lerman Amir Lerman |
| author_facet | Yoshihisa Kanaji Ilke Ozcan Takumi Toya Rajiv Gulati Melissa Young Tsunekazu Kakuta Lilach O. Lerman Amir Lerman |
| author_sort | Yoshihisa Kanaji |
| collection | DOAJ |
| description | Background Mechanisms underlying bioprosthetic valve deterioration are multifactorial and incompletely elucidated. Reparative circulating progenitor cells, and conversely calcification‐associated osteocalcin expressing circulating progenitor cells, have been linked to native aortic valve deterioration. However, their role in bioprosthetic valve deterioration remains elusive. This study sought to evaluate the contribution of different subpopulations of circulating progenitor cells in bioprosthetic valve deterioration. Methods and Results This single‐center prospective study enrolled 121 patients who had peripheral blood mononuclear cells isolated before bioprosthetic aortic valve replacement and had an echocardiographic follow‐up ≥2 years after the procedure. Using flow cytometry, fresh peripheral blood mononuclear cells were analyzed for the surface markers CD34, CD133, and osteocalcin. Bioprosthetic valve deterioration was evaluated by hemodynamic valve deterioration (HVD) using echocardiography, which was defined as an elevated mean transprosthetic gradient ≥30 mm Hg or at least moderate intraprosthetic regurgitation. Sixteen patients (13.2%) developed HVD during follow‐up for a median of 5.9 years. Patients with HVD showed significantly lower levels of reparative CD34+CD133+ cells and higher levels of osteocalcin‐positive cells than those without HVD (CD34+CD133+ cells: 125 [80, 210] versus 270 [130, 420], P=0.002; osteocalcin‐positive cells: 3060 [523, 5528] versus 670 [180, 1930], P=0.005 respectively). Decreased level of CD34+CD133+ cells was a significant predictor of HVD (hazard ratio, 0.995 [95% CI, 0.990%–0.999%]). Conclusions Circulating levels of CD34+CD133+ cells and osteocalcin‐positive cells were significantly associated with the subsequent occurrence of HVD in patients undergoing bioprosthetic aortic valve replacement. Circulating progenitor cells might play a vital role in the mechanism, risk stratification, and a potential therapeutic target for patients with bioprosthetic valve deterioration. |
| first_indexed | 2024-04-10T16:52:10Z |
| format | Article |
| id | doaj.art-88be1638d45b4728815cee9b25f9a59a |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T16:52:10Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-88be1638d45b4728815cee9b25f9a59a2023-02-07T16:01:10ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-01-0112210.1161/JAHA.122.027364Circulating Progenitor Cells Are Associated With Bioprosthetic Aortic Valve Deterioration: A Preliminary StudyYoshihisa Kanaji0Ilke Ozcan1Takumi Toya2Rajiv Gulati3Melissa Young4Tsunekazu Kakuta5Lilach O. Lerman6Amir Lerman7Department of Cardiovascular Medicine Rochester MNDepartment of Cardiovascular Medicine Rochester MNDepartment of Cardiovascular Medicine Rochester MNDepartment of Cardiovascular Medicine Rochester MNDepartment of Cardiovascular Medicine Rochester MNDivision of Cardiovascular Medicine Tsuchiura Kyodo General Hospital Ibaraki JapanDivision of Nephrology and Hypertension, Mayo Clinic Mayo Clinic Rochester MNDepartment of Cardiovascular Medicine Rochester MNBackground Mechanisms underlying bioprosthetic valve deterioration are multifactorial and incompletely elucidated. Reparative circulating progenitor cells, and conversely calcification‐associated osteocalcin expressing circulating progenitor cells, have been linked to native aortic valve deterioration. However, their role in bioprosthetic valve deterioration remains elusive. This study sought to evaluate the contribution of different subpopulations of circulating progenitor cells in bioprosthetic valve deterioration. Methods and Results This single‐center prospective study enrolled 121 patients who had peripheral blood mononuclear cells isolated before bioprosthetic aortic valve replacement and had an echocardiographic follow‐up ≥2 years after the procedure. Using flow cytometry, fresh peripheral blood mononuclear cells were analyzed for the surface markers CD34, CD133, and osteocalcin. Bioprosthetic valve deterioration was evaluated by hemodynamic valve deterioration (HVD) using echocardiography, which was defined as an elevated mean transprosthetic gradient ≥30 mm Hg or at least moderate intraprosthetic regurgitation. Sixteen patients (13.2%) developed HVD during follow‐up for a median of 5.9 years. Patients with HVD showed significantly lower levels of reparative CD34+CD133+ cells and higher levels of osteocalcin‐positive cells than those without HVD (CD34+CD133+ cells: 125 [80, 210] versus 270 [130, 420], P=0.002; osteocalcin‐positive cells: 3060 [523, 5528] versus 670 [180, 1930], P=0.005 respectively). Decreased level of CD34+CD133+ cells was a significant predictor of HVD (hazard ratio, 0.995 [95% CI, 0.990%–0.999%]). Conclusions Circulating levels of CD34+CD133+ cells and osteocalcin‐positive cells were significantly associated with the subsequent occurrence of HVD in patients undergoing bioprosthetic aortic valve replacement. Circulating progenitor cells might play a vital role in the mechanism, risk stratification, and a potential therapeutic target for patients with bioprosthetic valve deterioration.https://www.ahajournals.org/doi/10.1161/JAHA.122.027364aortic valve stenosisbioprosthetic valve deteriorationcirculating progenitor cellsstructural valve degenerationvalve replacement |
| spellingShingle | Yoshihisa Kanaji Ilke Ozcan Takumi Toya Rajiv Gulati Melissa Young Tsunekazu Kakuta Lilach O. Lerman Amir Lerman Circulating Progenitor Cells Are Associated With Bioprosthetic Aortic Valve Deterioration: A Preliminary Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease aortic valve stenosis bioprosthetic valve deterioration circulating progenitor cells structural valve degeneration valve replacement |
| title | Circulating Progenitor Cells Are Associated With Bioprosthetic Aortic Valve Deterioration: A Preliminary Study |
| title_full | Circulating Progenitor Cells Are Associated With Bioprosthetic Aortic Valve Deterioration: A Preliminary Study |
| title_fullStr | Circulating Progenitor Cells Are Associated With Bioprosthetic Aortic Valve Deterioration: A Preliminary Study |
| title_full_unstemmed | Circulating Progenitor Cells Are Associated With Bioprosthetic Aortic Valve Deterioration: A Preliminary Study |
| title_short | Circulating Progenitor Cells Are Associated With Bioprosthetic Aortic Valve Deterioration: A Preliminary Study |
| title_sort | circulating progenitor cells are associated with bioprosthetic aortic valve deterioration a preliminary study |
| topic | aortic valve stenosis bioprosthetic valve deterioration circulating progenitor cells structural valve degeneration valve replacement |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.027364 |
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