Bioprosthetic heart valve structural degeneration associated with metabolic syndrome: Mitigation with polyoxazoline modification

A Abramov, Y Xue, A Zakharchenko… - Proceedings of the …, 2023 - National Acad Sciences
A Abramov, Y Xue, A Zakharchenko, M Kurade, RK Soni, RJ Levy, G Ferrari
Proceedings of the National Academy of Sciences, 2023National Acad Sciences
Bioprosthetic heart valves (BHV), made from glutaraldehyde-fixed xenografts, are widely
used for surgical and transcatheter valve interventions but suffer from limited durability due
to structural valve degeneration (SVD). We focused on metabolic syndrome (MetS), a risk
factor for SVD and a highly prevalent phenotype in patients affected by valvular heart
disease with a well-recognized cluster of comorbidities. Multicenter patient data (N= 251)
revealed that patients with MetS were at significantly higher risk of accelerated SVD and …
Bioprosthetic heart valves (BHV), made from glutaraldehyde-fixed xenografts, are widely used for surgical and transcatheter valve interventions but suffer from limited durability due to structural valve degeneration (SVD). We focused on metabolic syndrome (MetS), a risk factor for SVD and a highly prevalent phenotype in patients affected by valvular heart disease with a well-recognized cluster of comorbidities. Multicenter patient data (N = 251) revealed that patients with MetS were at significantly higher risk of accelerated SVD and required BHV replacement sooner. Using a next-generation proteomics approach, we identified significantly differential proteomes from leaflets of explanted BHV from MetS and non-MetS patients (N = 24). Given the significance of protein infiltration in MetS-induced SVD, we then demonstrated the protective effects of polyoxazoline modification of BHV leaflets to mitigate MetS-induced BHV biomaterial degeneration (calcification, tissue cross-linking, and microstructural changes) in an ex vivo serum model and an in vivo with MetS rat subcutaneous implants.
National Acad Sciences
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