Key result
Intermediate monocyte shifts around TAVR predict early mortality and adverse clinical outcomes.
Why the study?
Postprocedural bleeding and thrombotic complications after TAVR involve poorly understood mechanisms, warranting an evaluation of TAVR's impact on monocyte phenotype and subset repartition and their link to clinical outcomes.
Does transcatheter aortic valve replacement modulate circulating monocyte subsets and affect clinical outcomes in patients with severe aortic valve stenosis?
Does transcatheter aortic valve replacement modulate circulating monocyte subsets and affect clinical outcomes in patients with severe aortic valve stenosis?
Monitoring monocyte subsets, particularly intermediate monocytes, could serve as a predictive biomarker for TAVR complications and guide future therapeutic strategies.
Monocyte monitoring may aid post-TAVR risk stratification; leaves open prospective validation before clinical use.
Transcatheter aortic valve replacement (TAVR), as an alternative to open heart surgery, has revolutionized the treatment of severe aortic valve stenosis (AVS), the most common valvular disorder in the elderly. AVS is now considered a form of atherosclerosis and, like the latter, partly of inflammatory origin. Patients with high-grade AVS have a highly disturbed blood flow associated with high levels of shear stress. The immediate reopening of the valve during TAVR leads to a sudden restoration of a normal blood flow hemodynamic. Despite its good prognosis for patients, TAVR remains associated with bleeding or thrombotic postprocedural complications, involving mechanisms that are still poorly understood. Many studies report the close link between blood coagulation and inflammation, termed thromboinflammation, including monocytes as a major actor. The TAVR procedure represents a unique opportunity to study the influence of shear stress on human monocytes, key mediators of inflammation and hemostasis processes. The purpose of this study was to conduct a review of the literature to provide a comprehensive overview of the impact of TAVR on monocyte phenotype and subset repartition and the association of these parameters with the clinical outcomes of patients with severe AVS who underwent TAVR.
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Lassalle et al. (2022) conducted a review in Severe aortic valve stenosis. Transcatheter aortic valve replacement (TAVR) was evaluated. Transcatheter aortic valve replacement alters intermediate monocyte levels, with pre- or post-procedural variations predicting early mortality and clinical outcomes.
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