Oxidative Stress in Structural Valve Deterioration: A Longitudinal Clinical Study

Biomolecules. 2022 Oct 31;12(11):1606. doi: 10.3390/biom12111606.


The cause of structural valve deterioration (SVD) is unclear. Therefore, we investigated oxidative stress markers in sera from patients with bioprosthetic heart valves (BHVs) and their association with SVD. Blood samples were taken from SVD (Phase A) and BHV patients during the first 24 (Phase B1) and >48 months (Phase B2) after BHV implantation to assess total antioxidant capacity (TAC), malondialdehyde (MDA), and nitrotyrosine (NT). The results show that MDA levels increased significantly 1 month after surgery in all groups but were higher at 6 months only in incipient SVD patients. NT levels increased gradually for the first 24 months after implantation in the BHV group. Patients with transcatheter aortic valve implantation (TAVI) showed even higher levels of stress markers. After >48 months, MDA and NT continued to increase in BHV patients with a further elevation after 60-72 months; however, these levels were significantly lower in the incipient and established SVD groups. In conclusion, oxidative stress may play a significant role in SVD, increasing early after BHV implantation, especially in TAVI cases, and also after 48 months' follow-up, but decreasing when SVD develops. Oxidative stress potentially represents a target of therapeutic intervention and a biomarker of BHV dysfunction.

Keywords: aortic valve; biological heart valves; lipid peroxidation; oxidative stress; protein nitration; structural valve deterioration; transcatheter aortic valve implantation.

Publication types

  • Clinical Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / surgery
  • Heart Valve Prosthesis*
  • Humans
  • Oxidative Stress
  • Prosthesis Design
  • Prosthesis Failure
  • Treatment Outcome

Grants and funding

The project was funded by the European Commission (FP7/2007–2013; Grant Agreement 603049: accessed on 1 September 2013; http://www.translinkproject.com/). This work was also supported by the Ministerio de Economía y Competitividad-ISCiii (PI15/00181); and PERIS SLT002/16/00445 funded by the Department of Health of the Generalitat de Catalunya, both granted to C.C., and cofunded by FEDER funds, a way to build Europe. IDIBELL benefits from the support of CERCA.