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Microbubbles associated with mechanical heart valves: their relationwith serum lactic dehydrogenase levels

M Gencbay1, M Degertekin, Y Basaran

  • 1Kosuyolu Heart and Research Hospital, Istanbul, Turkey.

American Heart Journal
|February 27, 1999
PubMed
Abstract

Insights

Microbubbles are common in mechanical prosthetic heart valves (PHV), especially bileaflet types. Higher microbubble counts correlate with increased serum lactic dehydrogenase (LDH) levels, suggesting hemolysis may cause their formation.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Imaging

Background:

  • Prevalence and generation mechanisms of microbubbles in mechanical prosthetic heart valves (PHV) lack consensus.
  • This study investigated microbubble prevalence in PHV and their association with serum lactic dehydrogenase (LDH) levels.

Purpose of the Study:

  • To determine the prevalence of microbubbles in mechanical prosthetic heart valves.
  • To explore the relationship between microbubble presence and serum LDH levels in patients with PHV.

Main Methods:

  • Prospective study of 150 functioning mitral PHV (98 bileaflet, 52 monoleaflet) using transesophageal echocardiography.
  • Serum LDH levels were measured, excluding factors that could affect LDH other than PHV-related hemolysis.
  • A method was developed to quantify microbubbles in each PHV.

Main Results:

  • Microbubbles were detected in 79% of PHV (118/150), with 99% of bileaflet valves and 40% of monoleaflet valves showing microbubbles (P <.0001).
  • A strong positive correlation was observed between serum LDH levels and the amount of microbubbles (rs = 0.69, P <.001).
  • Intraobserver variability for microbubble quantification was not statistically significant.

Conclusions:

  • Microbubble detection in PHV is more prevalent than previously reported.
  • Bileaflet PHV showed a higher association with microbubbles compared to monoleaflet valves.
  • The correlation between microbubbles and LDH suggests a potential link to hemolysis in PHV.

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