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Ongoing inflammation in children with rheumatic heart disease

Published online by Cambridge University Press:  08 February 2011

Nevin M. M. Habeeb  and
Iman S. Al Hadidi
Nevin M. M. Habeeb*
Affiliation:
Pediatric Cardiology Department and Clinical Pathology Department, Ain Shams University, Cairo, Egypt
Iman S. Al Hadidi
Affiliation:
Pediatric Cardiology Department and Clinical Pathology Department, Ain Shams University, Cairo, Egypt
*
Correspondence to: Dr N. M. M. Habeeb MD, 15 A Saraya Al Kobba Square, Cairo, Egypt. Tel: 00966 0508057325 ext: 0020101912490; Fax: 00202 (22597453); E-mail: nhabeeb69@yahoo.com
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Abstract

Aim of the work

To elucidate the hypothesis of ongoing inflammation in children with chronic rheumatic heart disease, and its possible consequences.

Subjects and methods

This study was conducted on 36 patients with a mean age of 12.63 years: six with acute rheumatic carditis, and 30 with chronic rheumatic heart disease. There were 15 age- and sex-matched children who served as a control group. All subjects underwent echocardiographic assessment of valvular involvement and left ventricular function. Laboratory investigations comprised lipid profile, high-sensitivity C-reactive protein, and homocysteine assay.

Results

High-sensitivity C-reactive protein was significantly elevated in patients with acute rheumatic carditis and in patients with chronic rheumatic heart disease (mean and standard deviation of 78.33, 156 micrograms per millilitre and 78.33, 23.17 micrograms per millilitre, respectively) as compared to the control group (mean and standard deviation of 5.83 and 2.79 micrograms per millilitre). High-sensitivity C-reactive protein correlated with the grade of mitral regurgitation (p less than 0.05). Homocysteine was significantly elevated in patients with acute carditis and patients with rheumatic heart disease as compared to the control group (their mean and standard deviation were 2.96, 0.476 nanograms per decilitre, 2.99, 1.48 nanograms per decilitre, and 1.717, 0.733 nanograms per decilitre, respectively), but did not show significant difference between the two studied groups of patients. Neither C-reactive protein nor homocysteine correlated with any of the studied parameters of lipid profile.

Conclusion

There is evidence of ongoing inflammation in children with rheumatic heart disease, which correlates with the degree of valvular involvement. This ongoing inflammation may put those children at risk for premature atherosclerosis.

Keywords

Rheumatic mitral regurgehighly sensitive C-reactive proteinhomocysteineatherosclerosis

Information

Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 3 , June 2011 , pp. 334 - 339
Copyright
Copyright © Cambridge University Press 2011

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