Frailty is associated with chronic inflammation and pro-inflammatory monocyte subpopulations

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Maria Cybularz - , TUD Dresden University of Technology (Author)
  • Sandy Wydra - , TUD Dresden University of Technology (Author)
  • Katharina Berndt - , Leipzig University (Author)
  • David M. Poitz - , Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus Dresden, TUD Dresden University of Technology (Author)
  • Peggy Barthel - , TUD Dresden University of Technology (Author)
  • Ahmad Alkouri - , TUD Dresden University of Technology (Author)
  • Felix M. Heidrich - , TUD Dresden University of Technology (Author)
  • Karim Ibrahim - , TUD Dresden University of Technology (Author)
  • Stefanie Jellinghaus - , TUD Dresden University of Technology (Author)
  • Uwe Speiser - , TUD Dresden University of Technology (Author)
  • Axel Linke - , Department of internal Medicine with focus on Cardiology (at Herzzentrum Dresden), TUD Dresden University of Technology (Author)
  • Marian Christoph - , TUD Dresden University of Technology (Author)
  • Christian Pfluecke - , TUD Dresden University of Technology (Author)

Abstract

Aim of the study: Frail patients with high grade aortic valve stenosis (AS) undergoing Transcatheter Aortic Valve Implantation (TAVI) have an increased mortality. A connection between frailty and inflammation has been suggested. Monocyte subpopulations are associated with both cardiovascular diseases and chronic inflammatory diseases. This study investigates the association of frailty with monocyte subpopulations and systemic inflammatory parameters in elderly patients undergoing TAVI. Methods: A total of 120 patients with symptomatic AS was examined. Before TAVI implantation, frailty was assessed by a bedside evaluation (eyeball test). In all patients a flow cytometry analysis has been performed. Monocyte subpopulations were defined as follows: classical (CD14++CD16), intermediate (CD14++CD16+) and non-classical (CD14+CD16++). Expression of CD11b was measured as a marker for monocyte activation. Pro-inflammatory cytokines such as interleukin IL-8, as well as CRP were measured with Cytometric Bead Array or standard laboratory methods. Results: 28 out of 120 patients were frail. These patients showed both, signs of elevated chronic systemic inflammation reflected by elevated CRP (3.7 (1.4–5.4) vs. 5.9 (3.7–29.1), p = 0.001) and an elevated level of intermediate monocytes (37 (24–54) vs. 53 (47–63), p = 0.001). At 6 months after TAVI, 19 of 120 patients died, primarily without relevant dysfunction of the implanted aortic valve. Mortality was significantly higher in the frail as compared with non-frail patients (9 of 28 frail patients vs. 10 of 92 non frail patients, p < 0.001). A binary logistic regression analysis validated frailty and intermediate monocytes as independent predictors for early mortality after TAVI. Conclusion: Chronic systemic inflammation and increased levels of intermediate monocytes are associated with frailty in old patients with severe aortic valve stenosis. Both the syndrome of frailty and elevated intermediate monocytes showed an association with early mortality after TAVI.

Details

Original languageEnglish
Article number111317
JournalExperimental Gerontology
Volume149
Publication statusPublished - 1 Jul 2021
Peer-reviewedYes

External IDs

PubMed 33744391
ORCID /0000-0001-7803-1972/work/142235087

Keywords

Sustainable Development Goals

Keywords

  • Chronic inflammation, Frailty, Tavi