{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:49:15Z","timestamp":1790225355094,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:00:00Z","timestamp":1623110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011852","name":"Paracelsus Medizinische Privatuniversit\u00e4t","doi-asserted-by":"publisher","award":["R\u201019\/05\/125\u2010FEJ"],"award-info":[{"award-number":["R\u201019\/05\/125\u2010FEJ"]}],"id":[{"id":"10.13039\/501100011852","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002428","name":"Austrian Science Fund","doi-asserted-by":"publisher","award":["F54"],"award-info":[{"award-number":["F54"]}],"id":[{"id":"10.13039\/501100002428","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Degenerative aortic valve stenosis is an inflammatory process that resembles atherosclerosis. Neutrophils release their DNA upon activation and form neutrophil extracellular traps (NETs), which are present on degenerated aortic valves. NETs correlate with pressure gradients in severe aortic stenosis. Transcatheter aortic valve replacement (TAVR) is an established treatment option for aortic valve stenosis. Bioprosthetic valve deterioration promoted by inflammatory, fibrotic and thrombotic processes limits outcome. Deoxyribonuclease is a natural counter mechanism to degrade DNA in circulation. In the present observational study, we investigated plasma levels of double\u2010stranded DNA, deoxyribonuclease activity and outcome after TAVR.<\/jats:p><jats:p>345 consecutive patients undergoing TAVR and 100 healthy reference controls were studied. Double\u2010stranded DNA was measured by fluorescence assays in plasma obtained at baseline and after TAVR. Deoxyribonuclease activity was measured at baseline using single radial enzyme diffusion assays. Follow\u2010up was performed at 12\u00a0months, and mean aortic pressure gradient and survival were evaluated. Receiver operating characteristic, Kaplan\u2010Meier curves and Cox regression models were calculated.<\/jats:p><jats:p>Baseline double\u2010stranded DNA in plasma was significantly higher compared to healthy controls, was increased at 3 and 7\u00a0days after TAVR, and declined thereafter. Baseline deoxyribonuclease activity was decreased compared to healthy controls. Interestingly, low deoxyribonuclease activity correlated with higher C\u2010reactive protein and higher mean transaortic gradient after 12\u00a0months. Finally, deoxyribonuclease activity was a strong independent predictor of outcome 12\u00a0months after TAVR.<\/jats:p><jats:p>Deoxyribonuclease activity is a potential biomarker for risk stratification after TAVR. Pathomechanisms of bioprosthetic valve deterioration involving extracellular DNA and deoxyribonuclease merit investigation.<\/jats:p>","DOI":"10.1111\/eci.13595","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T11:21:54Z","timestamp":1623237714000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Deoxyribonuclease is prognostic in patients undergoing transcatheter aortic valve replacement"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0029-6852","authenticated-orcid":false,"given":"Andreas","family":"Mangold","sequence":"first","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7625-3651","authenticated-orcid":false,"given":"Anna S.","family":"Ondracek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Hofbauer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Artner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Nechvile","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel G.","family":"Panagiotides","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Mirna\u00b2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Hammerer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Paracelsus Medical University of Salzburg  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dzeneta","family":"Fejzic\u00b2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uta","family":"Hoppe\u00b2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Wernly\u00b2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Lauten","sequence":"additional","affiliation":[{"name":"Department of Cardiology Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0937-9999","authenticated-orcid":false,"given":"Brunilda","family":"Alushi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6543-4684","authenticated-orcid":false,"given":"Marcus","family":"Franz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Cardiology Pneumology, and Intensive Medical Care Friedrich\u2010Schiller\u2010University  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Schulze","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Cardiology Pneumology, and Intensive Medical Care Friedrich\u2010Schiller\u2010University  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyne","family":"Wohlschl\u00e4ger\u2010Krenn","sequence":"additional","affiliation":[{"name":"Center of Prevention and Health Sanatorium Hera  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene M.","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lichtenauer\u00b2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2014.02.006"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx391"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.07.715"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2014.06.025"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.11.015"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/500135"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri.2017.105"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0909927107"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aam8897"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.304944"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2020.03.006"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20160530"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2016.05.029"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2019.03.047"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2009.02234.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00395-019-0740-3"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.11.056"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-020-01436-w"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1042\/BJ20042124"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2016.05.034"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.2174\/0929867324666170727110241"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.recesp.2018.08.022"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.12719"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-019-0163-2"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-52671-y"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1185395"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms11138"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mtbio.2019.100038"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carpath.2011.05.003"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.12534"}],"container-title":["European Journal of Clinical Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.13595","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/eci.13595","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.13595","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T19:39:17Z","timestamp":1692819557000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eci.13595"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,8]]},"references-count":31,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1111\/eci.13595"],"URL":"https:\/\/doi.org\/10.1111\/eci.13595","archive":["Portico"],"relation":{},"ISSN":["0014-2972","1365-2362"],"issn-type":[{"value":"0014-2972","type":"print"},{"value":"1365-2362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,8]]},"assertion":[{"value":"2021-03-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13595"}}