PhD Scientific Days 2025

Poster Session III. - V: Cardiovascular Medicine and Research

Temporal changes in serpinA3 and periostin levels during transcatheter aortic valve replacement

Name of the presenter

Bálint Tímea

Institute/workplace of the presenter

Semmelweis University Heart and Vascular Center, Budapest, Hungary

Authors

Tímea Bálint¹, Dávid Nagy¹, Zsuzsanna Ladányi¹, Bálint Károly Lakatos¹, Petra Kocsis-Balogh¹, Zoltán Horváth¹, Bálint András Barta¹, Attila Oláh¹, Alex Ali Sayour¹, Éva Straub¹, Endre Zima¹, Levente Molnár¹, Béla Merkely¹, Tamás Radovits¹, Mihály Ruppert¹

1: Semmelweis University Heart and Vascular Center, Budapest, Hungary

Text of the abstract

Introduction: Emerging evidence suggests that cardiac diseases, including aortic stenosis (AS), may contribute to cancer development via chronic inflammation, oxidative stress, and pro-fibrotic signalling. Proteins such as serpinA3 and periostin have been implicated in both pressure overload-induced heart failure and cancer progression. It is hypothesized that these proteins, released from the remodelled myocardium, may foster a tumour-promoting microenvironment. This study explores whether reverse remodelling after transcatheter aortic valve replacement (TAVR) affects their circulating levels.
Aims: This study aimed to investigate the dynamic changes in circulating serpinA3 and periostin levels in patients with AS undergoing TAVR.
Methods: Twenty-one patients (age: 81±1 years, 52% female) with severe AS underwent TAVR. Echocardiographic assessments and blood samples were obtained at three time points: within 24 hours preoperatively (preop), within 24 hours postoperatively (postop), and at the six-month follow-up (6MFU). Serum serpinA3 and periostin levels were measured using ELISA. NT-proBNP levels were assessed preoperatively and at 6MFU as part of routine clinical laboratory testing.
Results: Baseline left ventricular (LV) ejection fraction was 55±4%. At 6MFU, significant reverse remodelling was observed, including reduced global work index (2395±150 vs. 1947±117 mmHg%, p<0.05) and LV end-diastolic diameter (50.4±2 vs. 44.9±1 mm, p<0.05). NT-proBNP levels tended to decrease (2304±552 vs. 993±146 pg/mL, p=0.057). SerpinA3 levels rose significantly after TAVR (262.6±27 to 457.7±50 µg/mL, p<0.001), then declined at 6MFU (457.7±50 to 291±50 µg/mL, p<0.001), yet remained above baseline. Periostin levels were unchanged postoperatively (104.7±6 vs. 100.4±8 ng/mL, p=0.06) but significantly increased at 6MFU (100.4±8 to 128.5±11 ng/mL, p<0.001).
Conclusion: Contrary to expectations, reverse remodelling induced by TAVI in patients with AS was not associated with a reduction in circulating serpinA3 and periostin levels.
Funding: EKÖP-2024-213 (T.B.), STARTING 150923 (M.R.)
balint.timea09@gmail.com
Semmelweis University,
Supervisors: Mihály Ruppert, MD, PhD and Prof. Tamás Radovits, MD, PhD