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Relationship between inflammation and atrial fibrillation in patients with isolated rheumatic mitral stenosis.
J Heart Valve Dis. 2007 Sep; 16(5):468-74.JH

Abstract

BACKGROUND AND AIM OF THE STUDY

Atrial fibrillation (AF) is the most common arrhythmia in patients with rheumatic mitral stenosis (MS), with an increased risk of mortality and morbidity. Although recent data have suggested that the inflammatory process is associated with non-valvular AF, the relationship between inflammation and AF occurrence in MS patients remains unknown. The study aim was to determine whether plasma levels of high-sensitivity C-reactive protein (hs-CRP), as a marker of inflammation, are elevated in patients with isolated rheumatic MS and AF compared to patients with MS but without AF.

METHODS

The study population comprised 89 patients with isolated rheumatic MS (57 patients in sinus rhythm and 32 in AF) and 35 healthy controls. Patients with MS were categorized into subgroups in terms of their mitral valve area (MVA). Mean transmitral diastolic gradients and pulmonary artery pressure were monitored, and morphologic features of the mitral valve classified using an echocardiographic scoring system. Plasma levels of hs-CRP were monitored in all patients and control subjects, using a commercially available analytical kit.

RESULTS

Patients with AF were shown to have significantly higher plasma levels of hs-CRP compared to those in sinus rhythm and controls (p < 0.001). In general, patients with AF were older (p < 0.001) and had a larger left atrial diameter (LAD) (p < 0.001). Plasma levels of hs-CRP were associated with LAD only in the AF group (rho = 0.437; p = 0.012). Multivariate logistic regression analysis revealed a significant independent relationship between AF and hs-CRP plasma level (odds ratio (OR) 3.57; 95% confidence interval (CI) 1.2-10.5; p = 0.021), age (OR 1.08; 95% CI 1.03-1.14; p = 0.003), and LAD (OR 1.2; 95% CI 1.02-1.4; p = 0.023).

CONCLUSION

The study results indicated that hs-CRP plasma levels are associated with the presence of AF in patients with MS. This finding may have important implications for the development of new therapeutic and preventive approaches of AF in the setting of MS.

Authors+Show Affiliations

Department of Cardiology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey. timurselcuk@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17944117

Citation

Selcuk, M Timur, et al. "Relationship Between Inflammation and Atrial Fibrillation in Patients With Isolated Rheumatic Mitral Stenosis." The Journal of Heart Valve Disease, vol. 16, no. 5, 2007, pp. 468-74.
Selcuk MT, Selcuk H, Maden O, et al. Relationship between inflammation and atrial fibrillation in patients with isolated rheumatic mitral stenosis. J Heart Valve Dis. 2007;16(5):468-74.
Selcuk, M. T., Selcuk, H., Maden, O., Temizhan, A., Aksu, T., Dogan, M., & Sasmaz, A. (2007). Relationship between inflammation and atrial fibrillation in patients with isolated rheumatic mitral stenosis. The Journal of Heart Valve Disease, 16(5), 468-74.
Selcuk MT, et al. Relationship Between Inflammation and Atrial Fibrillation in Patients With Isolated Rheumatic Mitral Stenosis. J Heart Valve Dis. 2007;16(5):468-74. PubMed PMID: 17944117.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between inflammation and atrial fibrillation in patients with isolated rheumatic mitral stenosis. AU - Selcuk,M Timur, AU - Selcuk,Hatice, AU - Maden,Orhan, AU - Temizhan,Ahmet, AU - Aksu,Tolga, AU - Dogan,Mehmet, AU - Sasmaz,Ali, PY - 2007/10/20/pubmed PY - 2008/2/15/medline PY - 2007/10/20/entrez SP - 468 EP - 74 JF - The Journal of heart valve disease JO - J Heart Valve Dis VL - 16 IS - 5 N2 - BACKGROUND AND AIM OF THE STUDY: Atrial fibrillation (AF) is the most common arrhythmia in patients with rheumatic mitral stenosis (MS), with an increased risk of mortality and morbidity. Although recent data have suggested that the inflammatory process is associated with non-valvular AF, the relationship between inflammation and AF occurrence in MS patients remains unknown. The study aim was to determine whether plasma levels of high-sensitivity C-reactive protein (hs-CRP), as a marker of inflammation, are elevated in patients with isolated rheumatic MS and AF compared to patients with MS but without AF. METHODS: The study population comprised 89 patients with isolated rheumatic MS (57 patients in sinus rhythm and 32 in AF) and 35 healthy controls. Patients with MS were categorized into subgroups in terms of their mitral valve area (MVA). Mean transmitral diastolic gradients and pulmonary artery pressure were monitored, and morphologic features of the mitral valve classified using an echocardiographic scoring system. Plasma levels of hs-CRP were monitored in all patients and control subjects, using a commercially available analytical kit. RESULTS: Patients with AF were shown to have significantly higher plasma levels of hs-CRP compared to those in sinus rhythm and controls (p < 0.001). In general, patients with AF were older (p < 0.001) and had a larger left atrial diameter (LAD) (p < 0.001). Plasma levels of hs-CRP were associated with LAD only in the AF group (rho = 0.437; p = 0.012). Multivariate logistic regression analysis revealed a significant independent relationship between AF and hs-CRP plasma level (odds ratio (OR) 3.57; 95% confidence interval (CI) 1.2-10.5; p = 0.021), age (OR 1.08; 95% CI 1.03-1.14; p = 0.003), and LAD (OR 1.2; 95% CI 1.02-1.4; p = 0.023). CONCLUSION: The study results indicated that hs-CRP plasma levels are associated with the presence of AF in patients with MS. This finding may have important implications for the development of new therapeutic and preventive approaches of AF in the setting of MS. SN - 0966-8519 UR - https://www.unboundmedicine.com/medline/citation/17944117/Relationship_between_inflammation_and_atrial_fibrillation_in_patients_with_isolated_rheumatic_mitral_stenosis_ L2 - https://medlineplus.gov/atrialfibrillation.html DB - PRIME DP - Unbound Medicine ER -