Role of Lymphocyte Subsets in Pathogenesis of Chronic Rheumatic Heart Disease

Analyses of lymphocyte subsets using flow cytometry were conducted to determine the significance of these cells in the pathogenesis of chronic rheumatic heart disease. Lymphocytes (B cells, T cells, CD4 cells, CD8 suppressor or cytotoxic T cells, activated T cells, and natural killer cells) were measured in blood and left atrial appendage samples of 30 patients with rheumatic heart disease and 10 patients with acyanotic congenital heart disease. Monoclonal fluorescent-labeled antibodies were used to identify various cells by flow cytometry. There was a significant increase in CD4 cells and activated T cells with a significant decrease in B cells in the left atrial appendage tissue of patients with rheumatic heart disease compared to those in the control group. There was no significant difference between the two groups in the distribution pattern of T lymphocytes in peripheral blood. These changes in rheumatic heart disease reflect an abnormal immunoregulatory mechanism with an ongoing enhanced immunological process continuing into the chronic phase of the disease. In our opinion, this persistent T cell response may lead to fresh damage to the myocardium and deformation of the heart valves.

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Light and electron microscopic features of surgically excised left atrial appendage in rheumatic heart disease patients with atrial fibrillation and sinus rhythm

Cardiovascular Pathology ◽

10.1016/j.carpath.2014.07.008 ◽

2014 ◽

Vol 23 (6) ◽

pp. 319-326 ◽

Cited By ~ 15

Author(s):

Shruti Sharma ◽

Gautam Sharma ◽

Milind Hote ◽

V Devagourou ◽

Vikas Kesari ◽

...

Keyword(s):

Atrial Fibrillation ◽

Heart Disease ◽

Sinus Rhythm ◽

Rheumatic Heart Disease ◽

Left Atrial ◽

Left Atrial Appendage ◽

Atrial Appendage ◽

Electron Microscopic ◽

Microscopic Features ◽

Rheumatic Heart

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The significance of the left atrial appendage in rheumatic heart disease.

Circulation ◽

10.1161/01.cir.54.1.146 ◽

1976 ◽

Vol 54 (1) ◽

pp. 146-153 ◽

Cited By ~ 3

Author(s):

M J Kelley ◽

L P Elliott ◽

S T Shulman ◽

E M Ayoub ◽

B E Victorica ◽

...

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

Left Atrial ◽

Left Atrial Appendage ◽

Atrial Appendage ◽

Rheumatic Heart

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Increase in Activated T Cells and Reduction in Suppressor/Cytotoxic T Cells in Acute Rheumatic Fever and Active Rheumatic Heart Disease: A Longitudinal Study

The Journal of Infectious Diseases ◽

10.1093/infdis/167.4.979 ◽

1993 ◽

Vol 167 (4) ◽

pp. 979-983 ◽

Cited By ~ 15

Author(s):

K. Morris ◽

C. Mohan ◽

P. L. Wahi ◽

I. S. Anand ◽

N. K. Ganguly

Keyword(s):

T Cells ◽

Heart Disease ◽

Longitudinal Study ◽

Rheumatic Fever ◽

Rheumatic Heart Disease ◽

Acute Rheumatic Fever ◽

Cytotoxic T Cells ◽

Activated T Cells ◽

Rheumatic Heart

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Altered left atrial appendage function associated with cardioembolic stroke in patients with rheumatic heart disease

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20213243 ◽

2021 ◽

Vol 8 (9) ◽

pp. 1395

Author(s):

Zeeshan H. Mansuri ◽

Jit H. Brahmbhatt ◽

Roopesh R. Singhal ◽

Karthik Natarajan

Keyword(s):

Heart Disease ◽

Flow Velocity ◽

Rheumatic Heart Disease ◽

Left Atrial ◽

Left Atrial Appendage ◽

Peak Flow ◽

Thrombus Formation ◽

Cardioembolic Stroke ◽

Peak Flow Velocity ◽

Rheumatic Heart

Background: Left atrial appendage (LAA) is usually the first site for thrombus formation in rheumatic heart disease (RHD). LAA function is altered in RHD which may predispose it to thrombus formation. The aim of this study was to determine an association between function of LAA and cardioembolic stroke.Methods:Total 132 patients with RHD were studied by means of transthoracic echocardiography and/or transesophageal echocardiography and left atrial (LA) size, LAA ejection fraction (EF) and peak flow velocities were measured. These patients were followed up for 18 months with reference to development of cardioembolic stroke.Results: Seventy nine patients had atrial fibrillation (AF), of which 34 had thrombus in LAA. Out of 53 patients with sinus rhythm, 5 had LAA thrombus. Mean LAA EF was significantly lower in patients with thrombus in LAA, so was the peak flow velocity (both variables p<0.0001). Saw tooth LAA outflow velocity pattern was visible in 30 (80%) patients with LAA thrombus versus 20 (28%) patients without LAA thrombus. Total 14 patients experienced cardioembolic stroke. Patients with cardioembolic stroke had lower mean LAA EF and peak flow velocity as compared to patients without cardioembolic stroke.Conclusions:Increased LAA size, reduced LAA EF and reduced peak flow velocity are associated with increased risk of cardioembolic stroke. LAA evaluation should be mandatory in deciding treatment strategies in patients with RHD and AF.

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