Preliminary clinical experience of the novel transcatheter aortic valve system Prizvalve® for the treatment of severe aortic stenosis / 中华心血管病杂志

Objective: To evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) with the novel Prizvalve® system in treating severe aortic stenosis. Methods: This is a single-center, prospective, single-arm, observational study. A total of 11 patients with severe aortic stenosis with high risk or inappropriate for conventional surgical aortic valve replacement (SAVR) were included, and TAVI was achieved with the Prizvalve® system between March 2021 and May 2021 in West China Hospital. Transthoracic echocardiography (TTE) was performed immediately after prosthesis implantation to evaluate mean transaortic gradient and maximal transaortic velocity. The device success rate was calculated, which was defined as (1) the device being delivered via the access, deployed, implanted and withdrawn, (2) mean transaortic gradient<20 mmHg (1 mmHg=0.133 kPa) or a maximal transaortic velocity<3 m/s post TAVI, and without severe aortic regurgitation or paravalvular leak post TAVI. TTE was performed at 30 days after the surgery, and all-cause mortality as well as the major cardiovascular adverse events (including acute myocardial infarction, disabling hemorrhagic or ischemic stroke) up to 30 days post TAVI were analyzed. Results: The age of 11 included patients were (78.1±6.3) years, with 8 males. A total of 10 patients were with NYHA functional class Ⅲ or Ⅳ. Devices were delivered via the access, deployed, implanted and withdrawn successfully in all patients. Post-implant mean transaortic gradient was (7.55±4.08) mmHg and maximal transaortic velocity was (1.78±0.44) m/s, and both decreased significantly as compared to baseline levels (both P<0.05). No severe aortic regurgitation or paravalvular leak was observed post TAVI. Device success was achieved in all the 11 patients. No patient died or experienced major cardiovascular adverse events up to 30 days post TAVI. Mean transaortic gradient was (9.45±5.07) mmHg and maximal transaortic velocity was (2.05±0.42) m/s at 30 days post TAVI, which were similar as the values measured immediately post TAVI (both P>0.05). Conclusions: TAVI with the Prizvalve® system is a feasible and relatively safe procedure for patients with severe aortic stenosis and at high risk or inappropriate for SAVR. Further clinical studies could be launched to obtain more clinical experience with Prizvalve® system.

Plasma levels of miRNA-145 and miRNA-19b in patients with acute heart failure and its clinical signifi-cance / 心血管康复医学杂志

Objective :To explore plasma levels of microRNA (miRNA)-145 and miRNA-19b in patients with acute heart failure (AHF) and its clinical significance .Methods : A total of 150 AHF patients ,who were treated in our hospital from Jan 2015 to Dec 2016 ,were selected as AHF group .Another 100 healthy subjects were regarded as healthy control group .According to NYHA classification ,AHF group was further divided into class III group (n＝67) and class IV group (n＝ 83 ).Left ventricular ejection fraction (LVEF) ,pulmonary arterial pressure (PAP) , plasma levels of brain natriuretic peptide (BNP) ,miRNA-145 and miRNA-19b were measured and compared among all groups.Results : Compared with healthy control group ,there were significant reductions in LVEF [ (78-57 ± 5-12)% vs.(49-32 ± 8-17)%] and PAP [(74-16 ± 10-82) mmHg vs.(28-35 ± 8-11) mmHg] ,and significant rise in plasma levels of BNP [ (51-84 ± 3-08) pg／ml vs .(204-15 ± 30-46) pg／ml] ,miRNA-145 [ (1-04 ± 0-27) vs. (2-42 ± 1-18)] and miRNA-19b [ (1-06 ± 0-25) vs.(4-53 ± 1-47)] in AHF group , P＝0-001 all.Compared with NYHA class III group ,there were significant rise in plasma levels of miRNA-145 [(1-47 ± 0-32) vs.(2-52 ± 0-46)] and miRNA-19b [(2-08 ± 0-56) vs.(4-62 ± 0-76)] in class IV group ,P＝0-001 both .Conclusion : Plasma levels of miRNA-145 and miRNA-19b increase in AHF patients along with heart failure aggravates ,which can be used as pre-dictive indexes for severity of heart failure .