Giovanna Paliares Monteiro, Carolina Carotenuto Ramos1, Livia Airoldi Broekman, Aldrei Costa Araujo and Jean Marcos de Souza*
Volume5-Issue1
Dates: Received: 2023-12-28 | Accepted: 2024-01-13 | Published: 2024-01-17
Pages: 044-051
Abstract
Background: Rheumatic Fever (RF) is an immunological disorder related to exposure to group a streptococcus and rheumatic heart disease is an important cause of valve replacement. Bioprosthetic valves tend to degenerate faster in rheumatic patients, presumably due to immune mechanisms.
Objectives: The study sought to assess whether classic risk factors for cardiovascular disease are related to Early Valve Degeneration (EVD) in patients with RF.
Design: Case-control study.
Methods: Patients with RF and EVD or Late Valve Degeneration (LVD) were selected. The cutoff point was 9 years for a second valve surgery. Data regarding cardiovascular risk of the two groups were obtained and compared. A data imputation analysis was used to deal with missing data.
Results: Twenty valves were included in the primary outcome analysis and 33 were used for data imputation. The mean age for the first valve replacement was 40.6 (±6.2) years for the EVD group and 31.1 (±12.3) years for the LVD group, (p = 0.03), which remained significant after data imputation. For blood pressure, there was a non-statistically significant trend towards higher diastolic pressure in patients with EVD in relation to LVD (86.8 (±7.2) and 79 (±10.9) mmHg, respectively, p = 0.08), which after data imputation was statistically higher than that of the LVD group (88 [85.4-88.8] and 77 [73-84.5] mmHg, respectively, p = 0.001). Lipid profile was also worse on the EVD group.
Conclusions: The data suggest that EVD may result more from aging and cardiovascular factors than from immunological mechanisms, suggesting stricter targets for cardiovascular disease in these patients.
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DOI: 10.37871/jbres1870
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© 2024 Monteir GP, et al. Distributed under Creative Commons CC-BY 4.0 
How to cite this article
Monteir GP, Ramos CC, Broekman LA, Araujo AC, de Souza JM. Risk Factors for Early Bioprosthetic Heart Valve Degeneration in Patients with Rheumatic Fever. J Biomed Res Environ Sci. 2024 Jan 17; 5(1): 044-051. doi: 10.37871/jbres1870, Article ID: JBRES1870, Available at: https://www.jelsciences.com/articles/jbres1870.pdf
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