Can percutaneous mitral balloon valvuloplasty reduce ongoing inflammation in patients with rheumatic mitral stenosis?

Yıl 2015, Cilt: 42 Sayı: 3, 305 - 309, 24.10.2015

Fatih Uzun , İsmail Bıyık Mohammad Toib Mehmet Erturk Derya Öztürk Ali Kalkan Ahmet Yalcin İbrahim Akturk Özgür Surgit Aydın Tosu Ali Birand

https://doi.org/10.5798/diclemedj.0921.2015.03.0579

Öz

Objective: In the pathophysiology of rheumatic heart valve disease, chronic systemic inflammatory process plays an important role. In this study, we aimed to investigate whether the percutaneous transluminal mitral balloon valvuloplasty (PTMV) has any effect on the chronic systemic inflammatory response in patients with rheumatic mitral stenosis (RMS).

Methods: In this study, we used neutrophil to lymphocyte ratio (NLR), which is a simply available and inexpensive biomarker of systemic inflammatory response, to evaluate the level of inflammation. A total of 41 consecutive patients with severe RMS undergoing successful PTMV were included in the study. Laboratory assessments of all patients by the measuring of NLR before and after the PTMV procedure were performed.

Results: Before and after the PTMV, the mean lymphocyte counts were found 2.1±0.6 x10³ /µL and 1.9±0.6 x10³ / µL (p=0.01), and the mean leukocyte counts were 4.8±1.4 x10³ /µL and 4.4±1.3 x10³ /µL (p=0.069) respectively. NLR values were determined as 2.7 ± 1.0 and 2.2 ± 0.8. After the PTMV, there was a significant decrease in NLR in patients with rheumatic mitral stenosis patients (p=0.001). In the correlation analysis, there was significant negative correlation between the mitral valve area and NLR (p= 0.004- r=0.440), and there was significant positive correlation between left atrial diameter and NLR (p=0.028 r=0.344).

Conclusion: This study showed significant decrease in NLR after PTMV in patients with RMS, which means reduced inflammation after PTMV. Larger studies are needed to confirm the results.

Key words: Rheumatic mitral stenosis, neutrophil-to-lymphocyte ratio, percutaneous mitral valvuloplasty, inflammation

Anahtar Kelimeler

Rheumatic mitral stenosis, neutrophil-to-lymphocyte ratio, percutaneous mitral valvuloplasty, inflammation

Perkütan mitral balon valvüloplasti romatizmal mitral darlığı olan hastalardaki inflamasyonu azaltabilir mi?

Öz

Amaç: Romatizmal kalp kapağı hastalığı patofizyolojisinde kronik sistemik inflamatuar süreç önemli bir rol oynar. Biz bu çalışmada perkütan translüminal mitral balon valvüloplastinin (PTMV) romatizmal mitral darlığı olan hastalarda kronik sistemik inflamatuar yanıt üzerinde etkisinin olup olmadığını araştırdık.Yöntemler: Biz bu çalışmada sistemik inflamatuar yanıtın derecesini değerlendirmek için kolay ulaşılan ve ucuz bir belirteç olan nötrofil lenfosit oranını (NLR) kullandık. Çalışmaya ciddi mitral darlığı olup başarılı PTMV yapılan toplam 41 hasta dahil edildi. Tüm hastaların NLR’si PTMV işlemi öncesinde ve sonrasında değerlendirildi. Bulgular: PTMV öncesinde ve sonrasında ortalama lenfosit sayısı, 2,1±0,6 x103 /µL; 1,9±0,6 x103 / µL (p=0,01), ve ortalama lökosit sayısı 4,8±1,4 x103 /µL; 4,4±1,3 x103 /µL (p=0.069) bulundu. Romatizmal mitral darlığı olan hastalarda PTMV sonrası NLR değerlerinde anlamlı düşüş saptandı. (2,7±1,0 ve 2,2± ,8, p = 0.001). Korelasyon analizinde mitral kapak alanı ve NLR arasında anlamlı negatif korelasyon (p= 0,004- r=0,440), ve sol atrial çap ile NLR arasında anlamlı pozitif korelasyon saptandı. (p=0,028 r=0,344). Sonuç: Bu çalışma romatizmal mitral darlığı olan hastalarda PTMV sonrası NLR değerlerinde anlamlı düşüş göstermiştir. Bu PTMV sonrası inflamasyonun azalması anlamına gelebilir. Bu sonuçların desteklenmesi için daha büyük çalışmalara ihtiyaç vardır

Anahtar Kelimeler

Romatizmal mitral darlık, nötrofil lenfosit oranı, perkütan mitral valvüloplasti, inflamasyon

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