Plasma levels of tumor necrosis factor-α and its receptors in patients with mitral stenosis and sinus rhythm undergoing percutaneous balloon valvuloplasty

• Published in: Heart and vessels Vol. 25; no. 2; pp. 131 - 137
• Main Authors: Cagli, Kumral Ergun, Aras, Dursun, Topaloglu, Serkan, Geyik, Bilal, Ayaz, Selime, Cagirci, Goksel, Kisacik, Halil Lutfi, Korkmaz, Sule
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01-03-2010
• Subjects: Adult; Biomarkers - blood; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Case-Control Studies; Catheterization; Echocardiography, Doppler, Color; Echocardiography, Transesophageal; Female; Heart Conduction System - physiopathology; Hemodynamics; Humans; Inflammation Mediators - blood; Male; Medicine; Medicine & Public Health; Mitral Valve Stenosis - diagnostic imaging; Mitral Valve Stenosis - immunology; Mitral Valve Stenosis - physiopathology; Mitral Valve Stenosis - therapy; Original Article; Receptors, Tumor Necrosis Factor - blood; Rheumatic Heart Disease - diagnostic imaging; Rheumatic Heart Disease - immunology; Rheumatic Heart Disease - physiopathology; Rheumatic Heart Disease - therapy; Time Factors; Treatment Outcome; Tumor Necrosis Factor-alpha - blood; Vascular Surgery; Valvuloplasty; Tumor necrosis factor-α; Mitral stenosis
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-009-1175-9

This study aimed to determine whether plasma levels of tumor necrosis factor-α (TNF-α) and soluble TNF receptor (sTNF-R) increases in rheumatic mitral stenosis (MS) patients with sinus rhythm and to examine the effect of percutaneous mitral balloon valvuloplasty (PMBV) on these parameters. Twenty-six patients with MS and sinus rhythm (study group, 20 female, mean age 33 ± 8 years), who were scheduled for PMBV, and a well-matched control group consisting of 21 healthy volunteers (15 female, mean age 35 ± 6 years) were enrolled in the study. Tumor necrosis factor-α and sTNF-R levels were compared between study patients and controls, and between peripheral and left atrium (LA) blood. Changes in TNF α and sTNF-R levels 24 h and 4 weeks after PMBV were analyzed. Significantly higher baseline TNF-α and sTNF-R levels were noted in the study group. In the study group, TNF-α and its receptors were also found to be higher in LA blood than in baseline peripheral blood. After PMBV, mitral valve area (MVA) increased and transmitral pressure gradient decreased significantly. At the 24th hour after PMBV, the TNF-α level decreased from 29.61 ± 12.22 pg/ml to 22.42 ± 8.81 pg/ml (
P
< 0.0001) and at the 4th week, from 22.42 ± 8.81 pg/ml to 18.92 ± 7.37 pg/ml (
P
< 0.0001). Similar reductions were observed in the sTNF-R level. Regression analysis between the difference in sTNF-R level measured 24 h after and before PMBV and the difference in MVA measured 24 h after and before PMBV showed a significant direct relationship between these variables. This study suggests that isolated rheumatic MS without atrial fibrillation is accompanied by increased TNF-α and sTNF-R level. The successful PMBV establishes a significant reduction in TNF-α and its receptors, probably due to improved postprocedural hemodynamic parameters.