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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
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Myocardial apoptosis predicts postoperative course after aortic valve replacement in patients with severe left

Mario Gaudino1, Amedeo Anselmi, Antonio Abbate

  • 1Department of Cardiac Surgery, Catholic University of the Sacred Heart, Rome, Italy.

The Journal of Heart Valve Disease
|August 19, 2007
PubMed

Insights

Myocardial apoptosis in patients undergoing aortic valve replacement (AVR) for severe aortic stenosis is linked to worse postoperative outcomes, including longer intensive care unit (ICU) stays and renal issues. Identifying these patients may improve surgical risk assessment.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Cellular Biology

Background:

  • Myocardial apoptosis is implicated in heart failure and post-infarct remodeling.
  • Delayed aortic valve replacement in severe aortic stenosis correlates with poor outcomes.
  • The study investigates cardiomyocyte apoptosis in patients undergoing aortic valve replacement (AVR).

Purpose of the Study:

  • To evaluate the impact of cardiomyocyte apoptosis on the postoperative course after AVR for severe aortic stenosis.
  • To identify predictors of adverse outcomes in patients with severe left ventricular hypertrophy (LVH) undergoing AVR.

Main Methods:

  • Myocardial biopsies were obtained from the left ventricle of 11 patients with severe LVH during elective AVR.
  • Apoptosis rates in myocardial samples were analyzed.

Main Results:

  • The mean apoptotic rate was 10.4 +/- 3.7 per thousand.
  • Apoptotic rate correlated with NYHA class, ICU stay, renal insufficiency, and troponin T levels.
  • Apoptotic rate and LVH were independent predictors of prolonged ICU stay.
  • Apoptotic rate predicted duration of postoperative renal insufficiency.

Conclusions:

  • Myocardial apoptosis is associated with poorer postoperative outcomes in patients with severe LVH undergoing AVR.
  • Non-invasive correlates of apoptosis could identify high-risk patients.
  • Anti-apoptotic strategies may improve surgical results for AVR.
Abstract

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