title: Improved endothelial function and decreased levels of endothelium-derived microparticles after transcatheter aortic valve implantation.
abstract: OBJECTIVE
  Degenerative aortic valve stenosis (AVS) is independently associated with endothelial dysfunction and increased levels of circulating endothelium-derived microparticles (EMPs) as a marker of compromised endothelial integrity. The aim of this study was to investigate whether therapy for severe AVS by transcatheter aortic valve implantation (TAVI) improves endothelial function and decreases EMPs.
  
  
  RESULTS
  Fifty-six patients with indication for TAVI due to symptomatic severe AVS were prospectively enrolled. Brachial wall shear stress (WSS), endothelial function and circulating microparticles (MPs) were measured before and three months following TAVI. Endothelial function was assessed as flow-mediated dilation (FMD) using ultrasound. MP subpopulations were discriminated by flow cytometry according to the expression of established surface antigens: CD31+/CD41-, CD144+ and CD62E+ as EMPs and CD41+ as platelet-derived MPs (PMPs). In patients with severe AVS, decreased brachial WSS was an independent predictor of low FMD. At three-month follow-up after TAVI, WSS and FMD increased along with decreased levels of EMPs as compared to pre TAVI. Decrease of CD31+/CD41-, CD144+ and CD62E+ EMP levels correlated with the increase of FMD.
  
  
  CONCLUSIONS
  Therapy for AVS by TAVI was associated with improved endothelial function and integrity indicating beneficial effects of TAVI on systemic arterial function.
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Horn
authors.forename: Daniel
authors.initials: D
authors.lastname: Stern
authors.forename: Verena
authors.initials: V
authors.lastname: Veulemans
authors.forename: Christian
authors.initials: C
authors.lastname: Heiss
authors.forename: Tobias
authors.initials: T
authors.lastname: Zeus
authors.forename: Marc W
authors.initials: MW
authors.lastname: Merx
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
authors.forename: Ralf
authors.initials: R
authors.lastname: Westenfeld
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D015820:Cadherins / Q000378:metabolism; D055252:Cell-Derived Microparticles / Q000378:metabolism*; D019040:E-Selectin / Q000378:metabolism; D042783:Endothelial Cells / Q000378:metabolism*; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D040201:Platelet Membrane Glycoprotein IIb / Q000378:metabolism; D011446:Prospective Studies; D065467:Transcatheter Aortic Valve Replacement; D016896:Treatment Outcome; D014664:Vasodilation / Q000502:physiology; D000099152:Cadherin 5
chemical_list: D015703:Antigens, CD; D015820:Cadherins; D019040:E-Selectin; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D040201:Platelet Membrane Glycoprotein IIb; D000099152:Cadherin 5