A New Biological stethoscope for heart diseases

28th july, 2016
A New Biological stethoscope for heart diseases:
Researchers from Lille have discovered a new and rapid method to test the successful
implantation of cardiac valves that are placed via percutaneous application.
Transcatheter Aortic Valve Implantation is a procedure performed in fragile patients suffering from
valvulopathy. A team of researchers from Lille has now identified a new blood-borne biomarker that
will significantly simplify this intervention. Their results have been published on July 28th 2016 in The
New England Journal of Medicine, one of the leading international scientific journals.
This major breakthrough is the result of a longstanding collaboration between the Institute of
Cardiology, the Institute of Hematology-Transfusion of the University Hospital of Lille and INSERM.
The original treatment of patients with severe aortic stenosis consisted of open heart surgery to
replace the affected aortic valves. Unfortunately, this type of intervention poses a heavy burden on
patients, and can therefore not be applied to fragile patients. Recently, an alternative technique has
been developed to perform a heart surgery without opening the heart: Transcatheter Aortic Valve
Implantation (TAVI). TAVI is an innovative and still expanding technology that is available for highrisk patients with severe aortic stenosis, who wouldn’t tolerate open heart surgery. Compared to
classical surgery, TAVI has major advantages. First, the burden for the patient is lower, thereby
making it available for the fragile patients. Secondly, hospitalization time is shorter, reducing costs of
treatment. Importantly, TAVI and surgical replacement are alike in bringing a complete correction of
the aortic stenosis, allowing the restoration of normal heart function. This results in improvement of
life expectancy and quality of life of the patients.
Despite its advantages, TAVI is not yet applied to all patients, because it is limited by the risk of a
particular complication that is difficult to detect. In nearly 15% of the interventions, a complication
called "aortic insufficiency" can occur caused by the bad positioning of the new valve. The presence
of aortic insufficiency is associated with a 2-3-fold increased risk of 1-year mortality. If aortic
insufficiency is identified, a correction can be performed during the intervention. However, this
identification process is until today a complex procedure that requires general anesthesia of the
patients, thereby undoing most of the benefits of the TAVI technique.
In search for a diagnostic marker that detects the risk of this complication, a clinical study has been
conducted in which nearly 400 patients from the university hospitals of Lille, Strasbourg and
Toulouse participated, orchestrated by researchers from the Lille University Hospital and INSERM.
This study identified a plasma protein named “von Willebrand factor” as a reliable diagnostic marker
to check the correct implantation of the new valve in the patient via the TAVI procedure. This
allowed the development of a simple test using 1-ml of the patient’s blood that will reveal within 15
min whether the valve is correctly placed, and aortic insufficiency is avoided. Thus, this test indicator
is a reliable approach to prove the effectiveness of treatment, and to predict mortality at 1 year.
A unique expertise concentrated in Lille
These findings represent a medical breakthrough that may simplify care practices in combination
with improved patient management and reduced health care costs, while maintaining the maximum
safety for the patient. This clinical program has been made possible by the combination of scientific
and clinical expertise present in existing specialized structures at Lille University Hospital, such as the
new Cardiopulmonary Institute & the French reference center for "Willebrand Disease" in Lille and
INSERM units in Lille (Unit 1101- Inserm, Institut Pasteur de Lille, Université Lille 2) and KremlinBicetre (Unit 1176-Inserm).
* Van Belle E, Rauch A, Vincent F, Robin E, Kibler M, Labreuche J, Jeanpierre E, Levade M, Hurt C,
Rousse N, Dally JB, Debry N, Dallongeville J, Vincentelli A, Delhaye C, Auffray JL, Juthier F, Schurtz
G, Lemesle G, Caspar T, Morel O, Dumonteil N, Duhamel A, Paris C, Dupont-Prado A, Legendre P,
Mouquet F, Marchant B, Hermoire S, Corseaux D, Moussa K, Manchuelle A, Bauchart JJ, Loobuyck
V, Caron C, Zawadzki C, Leroy F, Bodart JC, Staels B, Goudemand J, Lenting PJ, Susen S. Von
Willebrand Factor Multimers during Transcatheter. NEJM Med 2016;
Contacts PRESSE
Ségolène BINET
Institut Pasteur de Lille
03 20 87 78 08
[email protected]
Aurélie DELEGLISE
Inserm
03 20 29 86 72
Auré[email protected]
Vincent VOISIN
Université de Lille
03 20 96 52 66
[email protected]
Alexandra PREAU
CHRU de Lille
03 20 44 60 36
[email protected]