Objectives
Inflammation and oxidative stress play an important role in the pathogenesis of heart valve diseases (especially rheumatic valves). It is also known that matrix metalloproteinase is associated with myxomatous mitral valve disease. The study aims to investigate the inflammation, oxidative stress and collagen turnover parameter levels in patients with ischemic and non ischemic mitral regurgitation (MR).
Material and Methods
The 112 consecutive MR patients who had coronary angiography were divided into ischemic (62 with coronary artery stenosis) and nonischemic groups (50 without coronary stenosis). 30 healthy people were also included in the study as control group. The classifications of MR were carried out according to the findings based on the echocardiography. Inflammation markers such as ceruloplasmin and high sensitive C-reactive protein (HsCRP); oxidative stress parameters such as oxidant including total oxidant status (TOS) and lipid hydroperoxide (LOOH), along with antioxidant ones including catalase, total antioxidant capacity (TAC), thiol, arylesterase and paraoxonase; oxidative stress index (OSI) and collagen turnover parameter (prolidase activity) were measured in all study population.
Material and Methods
The 112 consecutive MR patients who had coronary angiography were divided into ischemic (62 with coronary artery stenosis) and nonischemic groups (50 without coronary stenosis). 30 healthy people were also included in the study as control group. The classifications of MR were carried out according to the findings based on the echocardiography. Inflammation markers such as ceruloplasmin and high sensitive C-reactive protein (HsCRP); oxidative stress parameters such as oxidant including total oxidant status (TOS) and lipid hydroperoxide (LOOH), along with antioxidant ones including catalase, total antioxidant capacity (TAC), thiol, arylesterase and paraoxonase; oxidative stress index (OSI) and collagen turnover parameter (prolidase activity) were measured in all study population.
Results
The comparison of the parameters of these three Groups is shown in table-1, -2 and -3. Age, male, systolic blood pressure, history of dyslipidemia, smoking, medications, creatinine, left ventricle diameters and ejection fraction were different among the groups (all of p<0.05). Prolidase activity was similar in all groups. Except for the catalase, all the antioxidant parameters were lower, but oxidant parameters, HsCRP, ceruloplasmin and OSI were higher in patients with MR than control. The ceruloplasmin levels according to severity and etiologies of MR were shown in figure-1. Pearson correlation indicated that ceruloplasmin levels were significantly correlated with MR (p<0.001). ROC-curve analysis revealed that serum ceruloplasmin levels over 571 mg/L may predict an MR with 81% sensitivity and 82% specificity (area under the curve = 0.900; %95 CI: 0.851-0.950).
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