scholarly journals Effect of cardiac rhythm on serum levels of the inflammatory mediators; Interleukin-6 and C-Reactive Protein in patients with chronic rheumatic heart disease

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Y Mohammad ◽  
O A Rifaie ◽  
M A Hamza ◽  
S A Amin

Abstract Background Rheumatic fever has a marked tendency to recur leading to high risk of chronic heart lesions or worsening lesions in patients with previous rheumatic heart disease. For secondary prevention of RF, long acting penicillin can be used. Some rheumatic heart disease patients suffer from atrial fibrillation. Cardiac rhythm may affect the response of the body to the long acting penicillin, so it would be helpful to study the effect of cardiac rhythm on serum levels of inflammatory mediators in patients with chronic rheumatic heart disease. Objectives Our study is a prospective cross-sectional controlled study that aims to study the effect of cardiac rhythm on serum levels of the inflammatory mediators; C-Reactive Protein and Interleukin-6 in patients with chronic rheumatic heart disease. Methods The study included 70 rheumatic heart disease patients on regular long acting penicillin. Patients were divided into to 2 groups: Group A; 56 patients with rheumatic heart disease who have sinus rhythm, and Group B; 14 patients with rheumatic heart disease who have atrial fibrillation (AF) and Group C; control group of 10 healthy individuals. Results There was no significant difference between sinus patients and AF patients in CRP and IL-6 levels (p = 0.3050 and 0.6758, respectively). Also, there was no significant difference between 15, 21 and 30 days regimens of penicillin in CRP and IL-6 levels (p = 0.9467and 0.0795, respectively). IL6 values were significantly correlated with CRP values (r = 0.5435, p < 0.0001). There was a significant difference in CRP and IL-6 levels between compliant and non-compliant patients (p = 0.0053 and 0.0308). Conclusion Our study results disprove that cardiac rhythm has an effect on the serum levels of the inflammatory mediators C-Reactive Protein and Interleukin-6 in chronic rheumatic heart disease. Our study also disproves the preference of any regimen of long acting penicillin (15 days, 21 days and 30 days) over each other for secondary prevention of chronic rheumatic heart disease. Our study results emphasized that chronic rheumatic heart disease is an inflammatory process mediated with some mediators as CRP and IL-6 that are strongly correlated with each other.

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Ahmad M. Yousef ◽  
Osama A. Rifaie ◽  
Mohamed A. Hamza ◽  
Sameh A. Amin

Abstract Background There is an evidence of a chronic inflammatory state in patients with chronic rheumatic valvular heart disease (RHD) as shown by high serum levels of high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL6). Despite the efficacy of long-acting penicillin (LAP) in secondary prevention of rheumatic fever, its effect on this inflammatory state is still unknown. So, we sought to study the effect of LAP on the inflammatory markers, CRP and IL-6, in patients with chronic rheumatic heart disease. Results Eighty RHD patients coming to our hospital’s outpatient clinic for rheumatic fever secondary prophylaxis by regular administration of LAP were enrolled in the study. Patients were divided into 3 groups: group A, 70 patients with RHD already on prophylactic LAP, group B, 10 patients with RHD who have not yet started prophylactic LAP, and group C, control group of 10 healthy individuals not known to have RHD. Serum levels of LAP, IL-6, and CRP were measured for the three groups. Group A had significantly lower IL-6 levels than group B (25.22 ± 33.50 vs. 126.1 ± 33.76nng/ml, respectively, p < 0.0001). IL-6 levels were significantly lower in control subjects compared to patients in group B (3.600 ± 2.319, 25.22 ± 33.50 ng/ml, respectively, p < 0.0001). However, IL-6 levels in the control group were lower but non-significantly different compared to group A. CRP level was lower in group A than group B (8419 ± 4935 vs. 14400 ± 3375 mg/dl, respectively, p = 0.0002). CRP levels were significantly lower in control subjects compared to patients in group A and group B. IL-6 values were positively correlated with CRP values (r = 0.6387, p < 0.0001). CRP values were negatively correlated with LAP values (r = -0.5277, p < 0.0001). IL-6 values were negatively correlated with LAP values (r = − 0.4401, p < 0.0001). There was a highly significant difference between LAP level in compliant and non-compliant patients (1.045 ± 1.270 vs. 0.0785 ± 0.1057 ng/ml, respectively, p value < 0.0001). There was also a highly significant difference between CRP level in compliant and non-compliant patients (7640 ± 4558 vs. 13090 ± 4717 mg/dl, respectively, p = 0.005). Moreover, there was a significant difference between IL-6 levels in compliant and non-compliant patients (21.53 ± 32.70 vs. 47.40 ± 30.91 ng/ml, respectively, p value 0.03). Conclusion Serum LAP has a strong negative correlation with IL-6 and CRP levels. Regular administration of LAP strongly ameliorates the inflammatory state seen in patients with RHD.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mahmoud Saied Mahmoud Badr ◽  
Haitham Galal Mohammed ◽  
Ahmed Abdel Sallam ◽  
Osama Abdel Aziz Rifaie

Abstract Corrsponding author: Mahmoud Saied Mahmoud Badr. E-mail: [email protected]


1958 ◽  
Vol 17 (3) ◽  
pp. 314-318 ◽  
Author(s):  
R. D. Eastham ◽  
P. Szekely ◽  
K. Davison

2011 ◽  
Vol 21 (3) ◽  
pp. 334-339 ◽  
Author(s):  
Nevin M. M. Habeeb ◽  
Iman S. Al Hadidi

AbstractAim of the workTo elucidate the hypothesis of ongoing inflammation in children with chronic rheumatic heart disease, and its possible consequences.Subjects and methodsThis 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.ResultsHigh-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.ConclusionThere 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.


2009 ◽  
Vol 1 (2) ◽  
pp. 51 ◽  
Author(s):  
Marissa Arifin ◽  
Marsetio Donosepoetro ◽  
Sutomo Kasiman

BACKGROUND: Recent clinical studies have suggested that γ-glutamyltransferase (γ-GT) can trigger oxidative stress within the plaque. This study aimed to investigate whether serum γ-GT might be as a risk factor of coronary heart disease (CHD), and measure the associations of serum γ-GT with high sensitive C-Reactive Protein (hs-CRP), Oxidized LDL (Ox-LDL) and Glutathione Peroxidase (GPx).METHODS: This study recruited 48 patients aged 30-70 year who underwent coronary angiography at Haji Adam Malik Medical Center at Medan between February and April 2008 and who presented at least one coronary stenosis of > 50% of the luminar diameter. The sample subjects were consecutively selected.RESULTS: γ-Glutamyltransferase was positively associated (r = 0.546) with hs-CRP as a marker of chronic inflammation after careful adjustment for other established risk factors in CHD patient. But, there was no significant difference between γ-GT in male and female patients. Further, there were no correlations between γ-GT and Ox-LDL and GPx. Ratio of γ-GT/GPx was measured as well, and it was associated with hs-CRP.CONCLUSIONS: Ratio of γ-GT/GPx was associated with inflammation process in coronary heart disease patients.KEYWORDS: γ-glutamyltransferase (γ-GT), inflammation, oxidative stress, coronary heart disease


2020 ◽  
Vol 30 (5) ◽  
pp. 717-721
Author(s):  
Dilek Giray ◽  
Olgu Hallioglu

AbstractObjective:The aim of this study was to investigate the relationship between C-reactive protein and erythrocyte sedimentation rate and neutrophil-to-lymphocyte, platelet-to-lymphocyte, and monocyte-to-lymphocyte ratios in acute rheumatic fever in children.Method:In this retrospective study, 182 patients with acute rheumatic fever and 173 controls were included. Complete blood count parameters, and neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were recorded for all the patients underwent transthoracic echocardiography.Results:Neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were significantly higher in patients with rheumatic heart disease than patients without cardiac involvement (p < 0.05). C-reactive protein and erythrocyte sedimentation rate levels were found to have a positive correlation with neutrophil-to-lymphocyte (r = 0.228, p = 0.001; r = 0.355, p = 0.001), platelet-to-lymphocyte (r = 0.227, p = 0.01; r = 0.149, p = 0.005), and monocyte-to-lymphocyte ratios (r = 0.117, p = 0.005; r = 0.107, p = 0.044). Cardiac involvement was present in 152 (83.5%) of the patients. Neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were significantly higher in patients with rheumatic heart disease than patients without cardiac involvement (p < 0.05). Patients with carditis were grouped according to mitral, aortic, or both valve involvement but there was no significant difference between the groups with respect to neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios. In addition, neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios were significantly higher in patients with Sydenham’s chorea than without chorea (p < 0.05).Conclusion:Neutrophil-to-lymphocyte, platelet-to-lymphocyte, and monocyte-to-lymphocyte ratios may help make the diagnosis of acute rheumatic fever and its prognosis by serial measurements in follow-up but none of them tell us the severity of carditis. Also, this is the first study showing the positive correlation between Sydenham’s chorea and neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios. Further studies are needed to confirm this hypothesis, as this is the first study in the literature on this topic.


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