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Risk Factors for Early Bioprosthetic Heart Valve Degeneration in Patients with Rheumatic Fever

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Open Access
Article Type Research Article
Subject Medicine Group
OCLC JBRES Record
Giovanna Paliares Monteiro, Carolina Carotenuto Ramos1, Livia Airoldi Broekman, Aldrei Costa Araujo and Jean Marcos de Souza*
Issue: Volume5-Issue1
Pages: 044-051
Received: 2023-12-28
Accepted: 2024-01-13
Published: 2024-01-17

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.

FullText HTML FullText PDF DOI: 10.37871/jbres1870 Crossmark

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Copyright

© 2024 Monteir GP, et al. Distributed under Creative Commons CC-BY 4.0 Creative CommonsAttribution

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

Subject area(s)

RheumatologyCardiovascular DiseasesClinical Cardiology

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