Abstract
: 70 patients were enrolled in the present study, of which 40 were men and 30 women, aged between 27 and 81 years all of whom were to undergo surgical valvular restoration either mitral or aortic. The patients anthropometric data and personal medical history were Cardiovascular disease is the main cause of morbidity and mortality in western countries. Over the last 50 years the opinions on the cause of valvular disease have reversed, with a reduction on the consequences of valvular disease of rheumatic cause and a equivalent increase of the degenerative valvular disease. Primary and secondary prevention of this illness has been accorded a greater significance. Apart from the already known risk factors, research has been trying to uncover other markers that could help in the diagnosis and prognostic classification of the particular disease. Inflammation markers are in the center of attention. The purpose of this study was the presence of cytokines in the inflammatory process on the valv ...
: 70 patients were enrolled in the present study, of which 40 were men and 30 women, aged between 27 and 81 years all of whom were to undergo surgical valvular restoration either mitral or aortic. The patients anthropometric data and personal medical history were Cardiovascular disease is the main cause of morbidity and mortality in western countries. Over the last 50 years the opinions on the cause of valvular disease have reversed, with a reduction on the consequences of valvular disease of rheumatic cause and a equivalent increase of the degenerative valvular disease. Primary and secondary prevention of this illness has been accorded a greater significance. Apart from the already known risk factors, research has been trying to uncover other markers that could help in the diagnosis and prognostic classification of the particular disease. Inflammation markers are in the center of attention. The purpose of this study was the presence of cytokines in the inflammatory process on the valvular tissue, their relation with the particular type of tissue damage and finally the connection with the concentration of the particular molecules on the tissue damage and their correspondent concentration in the serumrecorded. For the majority of patients, a blood sample was used to define the lipidemic profile and the proinflammatory cytokine concentration (mainly the fibrinogen, TNFa, IL-10 and IL-6). A pathologic and immunoistohemic study was conducted on the preparation of the valves, to determine the specification of the damage and the degree of inflammation and calcification. Results: As was expected there is a connection between the subjects age and the amount of total cholesterol (p=0.004) and LDL (p=0.005). body weight was related to the fibrinogen (p=0.001) and the calcification degree of the valves (p=0.04). total cholesterol levels were related to the amount of LDL-ch (p<0.001) while its relation to the fibrinogen levels is significant. There is a negative relation between the HDL and the TG, while the relation between the HDL and the degree of inflammation is statistically significant (p=0,009). The relation between the amount of TG and the IL-10 levels is considerable (p=0.041) just like the IL-10 and the fibrinogen (p=0.011). however, a negative correlation wass found between the inflammatory factor TNFa in the serum and the calcification degree of the valves to a statistically significant degree (p=0.001 and p=0.002 respectively). A statistically significant correlation between the levels of TNFa in the serum and the calcification of the valves was also noticed (p=0.001). Furthermore the expression of TNFa on the valvular tissue is positively related to the tissue expression of IL-6 (p=0.019), also the expresion of both cytokines presents a considerable statistic relation to the degree of inflammation (p=0.001) on the damaged valvular tissue area. Conclusion: The production of TNFa on the valvular tissue is related to the local production of IL-6 and to the extent of the damage observed on the tissue, due to inflammation. The local production of proinflammatory factors is closely related to the extent of the damage. The pbservation that the levels of TNFa in the subjects serum is related to the calcification level of the valves offers the chance to use this factor and the one of IL-10 in the indirect assessment of the inflammation and calcification degree of the cardiac valves without the need of tissue test, bloodshed and surgical techniques. However we must point out that the diagnostic value of these parameters must be proven with absolute safety and confirmed through perspectives, clinical and experimental studies of a wider scale. The high cost of this measurement remains an obstacle for it to be used on a wide scale. It is probable that in future these markers will hold an important role as typical molecular determination in the non surgical diagnosis and observation of the process of valvular disease and its effective pharmaceutical management.
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