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Updated: Feb 24, 2026
Investigating Aortic Valve Calcification via Isolation and Culture of T Lymphocytes using Feeder Cells from Irradiated Buffy Coat
Published on: February 4, 2021
Intermediate CD14++CD16+ monocytes decline after transcatheter aortic valve replacement and correlate with functional
Jonas Neuser1, Paolo Galuppo1, Daniela Fraccarollo1
1Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Insights
Intermediate monocyte levels decline after transcatheter aortic valve replacement (TAVR). Higher intermediate monocyte counts predict poorer cardiac function and limited improvement in NYHA class post-TAVR.
Area of Science:
- Cardiology
- Immunology
- Biomarker Discovery
Background:
- Transcatheter aortic valve replacement (TAVR) is a key treatment for severe aortic stenosis.
- Early re-hospitalization is a concern post-TAVR, necessitating outcome predictors.
- Monocyte subsets are implicated in cardiovascular disease and may offer prognostic insights.
Purpose of the Study:
- To investigate changes in monocyte subsets following TAVR.
- To determine if monocyte subsets can predict clinical outcomes after TAVR.
Main Methods:
- Peripheral blood samples were analyzed pre- and post-TAVR using flow cytometry to quantify monocyte subsets.
- Transthoracic echocardiography assessed cardiac function before and after TAVR.
- Clinical outcomes, including NYHA functional class, were evaluated at 3 months.
Main Results:
- A significant decrease in intermediate monocytes (CD14++CD16+) was observed early after TAVR.
- Higher pre-TAVR intermediate monocyte levels correlated with worse cardiac function and renal function.
- Intermediate monocyte levels predicted limited improvement in NYHA functional class at 3 months.
Conclusions:
- Intermediate monocyte populations significantly decline post-TAVR.
- Elevated intermediate monocyte levels are associated with poorer cardiac function and predict suboptimal functional recovery.
- Intermediate monocytes show potential as prognostic biomarkers for TAVR outcomes.
Background:
Transcatheter aortic valve replacement (TAVR) is the method of choice for patients with severe aortic valve stenosis, who are ineligible or at high risk for surgery. Though TAVR leads to a significant reduction in mortality, a notable amount of patients are re-hospitalized early after TAVR. Parameters or biomarkers predicting outcome are therefore needed to identify patients who benefit most. Specific monocyte subsets have been associated with cardiovascular diseases and were shown to possess prognostic value.
Methods:
Peripheral blood was drawn before and after transfemoral TAVR with the self-expanding CoreValve, Boston Lotus or the balloon-expanding Edwards Sapien prosthesis. Classical (CD14++CD16-), intermediate (CD14++CD16+) and non-classical (CD14+CD16++) monocyte subsets were determined by flow cytometry. Transthoracic echocardiography was performed before, early after as well as 3 months after the TAVR procedure.
Results:
No significant differences in the absolute monocyte counts were found after TAVR. A significant decline in the intermediate monocyte population was though observed early after TAVR (pre 4.01±0.38%, post 2.803±0.34%, p≤0.05). Creatinine levels stayed stable after TAVR procedure and intermediate monocytes were associated with worse renal function. Monocyte decline was not related to changes in CRP-, noradrenaline, cortisol or aldosterone-levels. The amount of intermediate monocytes correlated with worse cardiac function and predicted the possibility to reach an improvement in NYHA functional class at 3 months after TAVR.
Conclusions:
A significant decline of intermediate monocytes occurs shortly after TAVR. High levels of intermediate monocytes were associated with worse cardiac function and predicted poor functional capacity, hinting at a possible prognostic value.
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