1. Differences in metabolic profiles between bicuspid and tricuspid aortic stenosis in the setting of transcatheter aortic valve replacement.
- Author
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Xiong TY, Liu C, Liao YB, Zheng W, Li YJ, Li X, Ou Y, Wang ZJ, Wang X, Li CM, Zhao ZG, Feng Y, Liu XJ, and Chen M
- Subjects
- Aged, Aortic Valve physiopathology, Aortic Valve surgery, Aortic Valve Stenosis blood, Aortic Valve Stenosis etiology, Aortic Valve Stenosis physiopathology, Arachidonic Acid blood, Arginine blood, Bicuspid Aortic Valve Disease, Biomarkers blood, Female, Heart Valve Diseases blood, Heart Valve Diseases complications, Heart Valve Diseases physiopathology, Hemodynamics, Humans, Male, Proline blood, Prospective Studies, Recovery of Function, Treatment Outcome, Ventricular Function, Left, Ventricular Remodeling, Aortic Valve abnormalities, Aortic Valve Stenosis surgery, Energy Metabolism, Heart Valve Diseases surgery, Metabolomics, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Background: To explore why bicuspid aortic stenosis has certain clinical differences from the tricuspid morphology, we evaluated the metabolomics profile involved in bicuspid aortic valve (BAV) aortic stenosis prior to and after transcatheter aortic valve replacement (TAVR) in comparison with tricuspid aortic valve (TAV)., Methods: In this TAVR cohort with prospectively collected data, blood samples were obtained before TAVR valve deployment and at the 7th day after TAVR, which were then sent for liquid and gas chromatography-mass spectrometry detection. Besides comparisons between BAV and TAV, BAV patients were also divided in subgroups according to baseline hemodynamics (i.e. maximal transaortic velocity, V
max ) and post-procedural reverse left ventricular (LV) remodeling (i.e. the change in LV mass index from baseline, ∆LVMI) for further analysis. Metabolic differences between groups were identified by integrating univariate test, multivariate analysis and weighted correlation network analysis algorithm., Results: A total of 57 patients were enrolled including 33 BAV patients. The BAV group showed lower arginine and proline metabolism both before and post TAVR than TAV represented by decreased expression of L-Glutamine. In BAV subgroup analysis, patients with baseline Vmax > 5 m/s (n = 11) or the 4th quartile of change in ∆LVMI at one-year follow-up (i.e. poorly-recovered LV, n = 8) showed elevated arachidonic acid metabolism compared with Vmax < 4.5 m/s (n = 12) or the 1st quartile of ∆LVMI (i.e. well-recovered LV, n = 8) respectively., Conclusions: Difference in arginine and proline metabolism was identified between BAV and TAV in TAVR recipients. Elevated arachidonic acid metabolism may reflect more severe baseline hemodynamics and worse LV reserve remodeling after TAVR in BAV.- Published
- 2020
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