Inflammatory status in patients with rheumatic mitral stenosis: Guilty before and after balloon mitral valvuloplasty

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Aim: We studied the inflammatory status, suggested by high sensitivity C-reactive protein (hsCRP) in patients with rheumatic mitral stenosis (MS) before, immediately after, and 1-month after balloon mitral valvuloplasty (BMV). Methods and results: We studied 31 BMV candidates [35.6 ± 12.8 years, 20 (65%) females, and 9 (29%) had atrial fibrillation rhythm]. Mitral valve area (MVA) and hsCRP were measured before, immediately after BMV, and 1 month after BMV in 13 patients. In addition, hsCRP was measured in 15 controls. hsCRP was significantly higher in MS patients than control, significantly increased after BMV, and dropped 1 month after BMV to values comparable to basal but still higher than normal. hsCRP showed a trend for correlation with MVA after BMV (r = 0.384, p = 0.07), and the absolute increase in MVA (d-MVA) correlated significantly with the absolute increase in hsCRP (d-CRP) (r = 0.523, p = 0.01).21 patients had successful BMV and 10 patients had unsuccessful BMV. The increase in hsCRP post compared to pre-BMV was attenuated in patients with unsuccessful BMV, and receiver operator characteristic curve suggested that hsCRP > 3.6 before BMV and d-CRP <2.25 mg/dL can detect patients with unsuccessful BMV with good sensitivities and specificities. Conclusion: Inflammatory pathogenesis of rheumatic fever, suggested by hsCRP, seems fixed both before, and after BMV. A basal increase in hsCRP before BMV is related to BMV success and an acute increase immediately after BMV seems related to trauma of balloon dilatations.




Abdel Rahman, M. A., Omar, A. M. S., Amin, M., & Rifaie, O. (2016). Inflammatory status in patients with rheumatic mitral stenosis: Guilty before and after balloon mitral valvuloplasty. Egyptian Heart Journal, 68(2), 83–87.

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