Evaluation of the endothelial functions in patients with prosthetic heart valves who had paravalvular leakage detected in the early postoperative period

Macit Kalçık, Ahmet Güner, Mahmut Yesin, Emrah Bayam, Semih Kalkan, Mehmet Özkan
2018 Journal of Integrative Cardiology  
Minimal paravalvular leaks (PVLs) through microdefects around the annulus have been demonstrated immediately after valvular replacement surgery and usually disappear after regional tissue healing. It has been recognized that endothelium takes place in some pathological process during wound healing. In this study we aimed to investigate the role of endothelial functions in patients with persistent PVLs detected in the early postoperative period. Methods: This study enrolled a total of 33
more » ... total of 33 patients (14 female, mean age: 47.9±10.4 years) who had PVL detected by means of transesophageal echocardiography (TEE) within 3 months after prosthetic valve replacements, and 40 control subjects (19 female, mean age: 49.9 ± 13.0 years) without PVL in the early postoperative period. Endothelial functions were evaluated by measurement of endothelium-dependent flow-mediated dilation (FMD) secondary to reactive hyperemia. Results: The demographic, echocardiographic and laboratory parameters did not differ between the groups except for lactate dehydrogenase levels which were higher in PVL group. Calculated FMD values were found to be significantly lower in PVL group than the control group (12.9 ± 1.8 vs 13.8 ± 1.6 %; p=0.022). In the receiver operating characteristic curve analysis, FMD values below 12.8% predicted PVL formation with a sensitivity of 55%, and a specificity of 31% (area under curve= 0.355, p=0.034). There was a weak and negative correlation between FMD values and the number of paravalvular defects (r= -0.246 ; p=0.036). Conclusion: Endothelial dysfunction in patients with prosthetic heart valves may play an important role in the development of PVLs during the early postoperative period. Kalçık M (2018) Evaluation of the endothelial functions in patients with prosthetic heart valves who had paravalvular leakage detected in the early postoperative period Volume 4(6): 3-5 Kalçık M (2018) Evaluation of the endothelial functions in patients with prosthetic heart valves who had paravalvular leakage detected in the early postoperative period
doi:10.15761/jic.1000261 fatcat:f4pbdfcza5hlzfayd7wifvhrxe