Deoxyribonuclease is prognostic in patients undergoing transcatheter aortic valve replacement

• DOI: 10.1111/eci.13595
• Publication Date: 2021-06-09T11:21:54Z
• Authors: Andreas Mangold; Anna S. Ondracek; Thomas M. Hofbauer; Tyler Artner; Johanna Nechvile; Noel G. Panagiotides; Moritz Mirna²; Matthias Hammerer; Dzeneta Fejzic²; Uta Hoppe²; Bernhard Wernly²; Alexander Lauten; Brunilda Alushi; Marcus Franz; Paul C. Schulze; Evelyne Wohlschlä...; Irene M. Lang; Michael Lichtenauer²
• Keywords: Valve replacement; Deoxyribonucleases

Degenerative aortic valve stenosis is an inflammatory process that resembles atherosclerosis. Neutrophils release their DNA upon activation and form neutrophil extracellular traps (NETs), which are present on degenerated valves. NETs correlate with pressure gradients in severe stenosis. Transcatheter replacement (TAVR) established treatment option for Bioprosthetic deterioration promoted by inflammatory, fibrotic thrombotic processes limits outcome. Deoxyribonuclease a natural counter mechanism to degrade circulation. In the observational study, we investigated plasma levels of double-stranded DNA, deoxyribonuclease activity outcome after TAVR. 345 consecutive patients undergoing TAVR 100 healthy reference controls were studied. Double-stranded was measured fluorescence assays obtained at baseline using single radial enzyme diffusion assays. Follow-up performed 12 months, mean gradient survival evaluated. Receiver operating characteristic, Kaplan-Meier curves Cox regression models calculated. Baseline significantly higher compared controls, increased 3 7 days TAVR, declined thereafter. decreased controls. Interestingly, low correlated C-reactive protein transaortic months. Finally, strong independent predictor months potential biomarker risk stratification Pathomechanisms bioprosthetic involving merit investigation.