Selection of valve material and analysis of prognostic warning factors in patients with valvular heart disease undergoing aortic valve replacement

Liu Zheng; Abudusaimi Aini; Huo Qiang; Zhu Tao; Yu Guojun; Abudunaibi Maimaitiaili

doi:10.3760/j.issn.1673-4777.2025.07.005

Abstract：Objective To explore the selection of valve material and analysis of prognostic warning factors in patients with valvular heart disease(VHD)undergoing aortic valve replacement surgery(AVR).Methods A total of 300 patients with VHD who underwent AVR in the First Affiliated Hospital of Xinjiang Medical University from August 2022 to June 2024 were retrospectively selected as the research objects.The patients were divided into biological valve group(121 cases)and mechanical valve group(179 cases)according to the different materials of the valve.The clinical data of cardiac function,myocardial remodeling,myocardial injury and inflammatory indicators were analyzed,and the incidence of adverse events was compared between the two groups.The independent risk factors of poor prognosis were analyzed.Results On the day after surgery and 6 months post-surgery,the levels of left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left atrial diameter,brain natriuretic peptide(BNP),visfatin,matrix metalloproteinase 9(MMP-9),N-terminal pro-BNP(NT-proBNP),interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor α,cardiac troponin Ⅰ,and creatine kinase in the biological valve group were less than/lower than those in the mechanical valve group;the levels of left ventricular ejection fraction(LVEF),stroke volume,cardiac index and IL-10 in the biological valve group were higher/greater than those in the mechanical valve group(all P＜0.05).Compared with the mechanical valve group,the total risk of adverse events of patients in biological valve group was significantly reduced(relative risk=4.302,95％confidence interval:1.982-8.549,P＜0.05).NT-proBNP,valve material,BNP,CRP,MMP-9 and LVEF were independent risk factors for poor prognosis in patients with VHD(odds ratio=2.099,2.587,1.828,2.168,1.795,2.699,all P＜0.05).Conclusion NT-proBNP,valve material,BNP,CRP,MMP-9 and LVEF are independent risk factors for poor prognosis of VHD.Compared with mechanical valves,biological valves show more significant advantages in the improvement of cardiac function,optimization of myocardial remodeling,reduction of inflammatory stress response and myocardial injury,and can effectively reduce the incidence of adverse events.