Περίληψη:
Background: Patients with mitral stenosis (MS) and heart failure (HF)
are characterized by changes in the left atrial (LA) function and
activation of the apoptotic process. The purpose of the present study
was the evaluation of the effect of mitral valve replacement on the LA
function, on inflammatory process and apoptotic markers in patients with
MS and HE Methods: We studied 30 patients with MS and HF (15 in NYHA
III-IV and 15 in NYHA IV) in sinus rhythm (mean age 56.2 +/- 4.6 years),
and 20 age and gender matched healthy volunteers. Blood samples were
obtained before and 6 months after surgical mitral valve replacement,
and plasma levels of soluble Fas/APO-1 receptor (sFas), tumor necrosis
factor-alpha (TNF-a) and interleukin-6 (IL-6) were measured.
Echocardiographically, LA volumes were measured at mitral valve opening
(Vmax), at the onset of left atria] systole (P wave of the
electrocardiogram, Vp) and at the mitral valve closure (Vmin). LA
contractile function was assessed by the LA active emptying fraction
(ACTEF). Results: After mitral valve replacement, TNF-a, IL-6 and sFas
levels, as well as the Vmax LA volume, were significantly reduced (p <
0.05). ACTEF showed a significant postoperative decrease (0.29 +/- 0.09
vs. 0.23 +/- 0.06,p < 0.01) and it was significantly correlated with
sFas (r = - 0.88,p = 0.001), TNF-a (r= - 0.81, p = 0.001) and IL-6 (r= -
0.74, p = 0.001) levels. Conclusion: The present findings indicate that
mitral valve replacement in patients with mitral valve stenosis, reduces
the size of the left atrium, improves left atrial contractile function
and depresses inflammatory and apoptotic process. (c) 2004 Elsevier
Ireland Ltd. All rights reserved.
Συγγραφείς:
Trikas, A
Papathanasiou, S
Tousoulis, D
Tentolouris, K and
Vasiliadou, K
Antoniades, C
Latsios, G
Stefanadis, C
