Key result
Patients with rheumatic heart disease who underwent mitral valve replacement had significantly higher plasma levels of IL-6 (53.42 vs 9.57 pg/mL) and poorer cardiac function compared to healthy controls.
Why the study?
Do patients with rheumatic mitral lesions who underwent valve replacement have higher inflammatory markers and decreased cardiac function compared to healthy controls?
Case-Control (n=49)
No
Do patients with rheumatic mitral lesions who underwent valve replacement have higher inflammatory markers and decreased cardiac function compared to healthy controls?
Absolute Event Rate: 53.42% vs 9.57%
p-value: p=<0.001
Patients with rheumatic heart disease who underwent mitral valve replacement continue to have elevated inflammatory markers and decreased cardiac function compared to healthy controls, suggesting an ongoing autoimmune response.
Purpose: To explore the effect of autoimmune response on the decreased cardiac function in patients with rheumatic mitral lesion following valve replacement.Methods: In this case-controlled study, 29 patients who had undergone valve replacement as a result of mitral lesion were enrolled (mean age = 48.7 years). Twenty healthy volunteers were selected as control (mean age = 47.5 years). Plasma levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), high –sensitivity C-reactive protein (hs-CRP) and echocardiographic indices of heart function in the two groups were investigated, respectively. Body mass index (BMI) was also calculated.Results: TNF-α, IL-6 and hs-CRP levels in plasma were significantly higher than those in controls (p < 0.05; 22.23 pg/mL vs. 13.24 pg/mL, 53.42 pg/mL vs. 9.57 pg/mL, and 2.12 μg/mL vs. 0.97 μg/mL, respectively). The indices of left atrial diameter (LAD), left ventricular end-diastolic diameter (LDD) and isovolumetric contraction time (ICT) were significantly higher (p < 0.05; 4.72 cm vs. 3.78 cm, 4.85 cm vs. 4.37 cm, and 76.38 ms vs. 66.24 ms, respectively), but those of early diastolic velocity (Ea), late diastolic velocities (Aa) and ejection time (ET) were significantly lower (p < 0.05; 7.65 cm/s vs. 16.8 cm/s, 5.56 cm/s vs. 12.9 cm/s, and 261.54 ms vs. 276.14 ms, respectively). Two-dimensional echocardiography obtained the same results.Conclusion: Valve replacement in patients with rheumatic heart disease (RHD) does not attenuate inflammatory response; rather, autoimmune response would keep affecting decreased heart function in RHD patients who have received mitral valve replacement.
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Zhou et al. (2016) conducted a case-control in Rheumatic mitral lesion following valve replacement (n=49). Rheumatic heart disease with mitral valve replacement vs. Healthy volunteers was evaluated on Plasma IL-6 levels (pg/mL) (p=<0.001). Patients with rheumatic heart disease who underwent mitral valve replacement had significantly higher plasma levels of IL-6 (53.42 vs 9.57 pg/mL) and poorer cardiac function compared to healthy controls.
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