Oxidative Stress in Structural Valve Deterioration: A Longitudinal Clinical Study

Manuel Galiñanes*, Kelly Casós, Arnau Blasco-Lucas, Eduard Permanyer, Rafael Máñez, Thierry Le Tourneau, Jordi Barquinero, Simo Schwartz, Tomaso Bottio, Jean Christian Roussel, Imen Fellah-Hebia, Thomas Sénage, Arturo Evangelista, Luigi P. Badano, Alejandro Ruiz-Majoral, Cesare Galli, Vered Padler-Karavani, Jean Paul Soulillou, Xavier Vidal, Emanuele CozziCristina Costa

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


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.

Original languageEnglish
Article number1606
Issue number11
StatePublished - Nov 2022


FundersFunder number
Seventh Framework Programme603049
European Commission
Federación Española de Enfermedades Raras
Ministerio de Economía y CompetitividadPI15/00181, SLT002/16/00445
Departament de Salut, Generalitat de Catalunya


    • aortic valve
    • biological heart valves
    • lipid peroxidation
    • oxidative stress
    • protein nitration
    • structural valve deterioration
    • transcatheter aortic valve implantation


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