Elmadbouh Ibrahim, Ali Soliman Mahmoud, Abdallah Mostafa Ahmed, Ahmed Heneish Haitham
Biochemistry Department, Faculty of Medicine, Menoufia University, Egypt.
Cardiology Department, Faculty of Medicine, Menoufia University, Egypt.
Egypt Heart J. 2017 Jun;69(2):133-138. doi: 10.1016/j.ehj.2016.09.006. Epub 2016 Oct 7.
Rheumatic valve diseases are most common etiological valve diseases in developing countries. Urotensin II is cardiovascular autacoid/hormone and may be associated with patients of heart valve diseases. The present study was to measure plasma urotensin II concentrations in patients with left-sided rheumatic valve diseases such as mitral regurgitation (MR) and aortic regurgitation (AR), and to examine its correlation with severity of valve impairment, function (New York Heart association, NYHA) class and pulmonary artery pressure (PAP).
Sixty patients with moderate to severe rheumatic left-sided valve regurgitation and 20 healthy controls were selected after performing the echocardiography. Plasma urotensin II level was measured in all subjects. The patients with MR and AR were significantly increased of left ventricular end diastolic dimension (LVEDD), left ventricular end systolic dimension (LVESD), left atrial diameter, PAP, but decreased of EF% versus the controls. Urotensin II level was highly significant in patients with MR (1.83 ± 0.92 ng/ml, < 0001) and AR (0.79 ± 0.3 ng/ml, < 0.05) versus the controls (0.48 ± 0.13 ng/ml). Also, there was significant correlation between Urotensin II level and LVEDD (MR, = 0.318, = 003; AR, = 0.805, < 0.001), LVESD (MR, = -0.271, = 0115 AR, = 0.614, = 0.001), and PAP (MR, = 0.706, < 0.001; AR, = 0.129, = 0.538).
Urotensin II was elevated in patients with rheumatic left-sided valvular regurgitation, and positively correlated with increased LVEDD (in both MR and AR), LVESD (only AR) and pulmonary artery pressure (only MR). Therefore, urotensin II level may be used as diagnostic biomarker in patients with rheumatic valvular diseases for assessment of the severity in parallel with echocardiography.
风湿性瓣膜病是发展中国家最常见的病因性瓣膜病。尾加压素II是一种心血管自分泌物质/激素，可能与心脏瓣膜病患者有关。本研究旨在测量二尖瓣反流（MR）和主动脉瓣反流（AR）等左侧风湿性瓣膜病患者的血浆尾加压素II浓度，并研究其与瓣膜损害严重程度、心功能（纽约心脏协会，NYHA）分级和肺动脉压（PAP）的相关性。
经超声心动图检查后，选取60例中重度风湿性左侧瓣膜反流患者和20例健康对照者。测量所有受试者的血浆尾加压素II水平。与对照组相比，MR和AR患者的左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心房直径、PAP均显著增加，但射血分数（EF%）降低。与对照组（0.48±0.13 ng/ml）相比，MR患者（1.83±0.92 ng/ml，P<0.001）和AR患者（0.79±0.3 ng/ml，P<0.05）的尾加压素II水平显著升高。此外，尾加压素II水平与LVEDD（MR，r=0.318，P=0.03；AR，r=0.805，P<0.001）、LVESD（MR，r=-0.271，P=0.115；AR，r=0.614，P=0.001）和PAP（MR，r=0.706，P<0.001；AR，r=0.129，P=0.538）之间存在显著相关性。
风湿性左侧瓣膜反流患者的尾加压素II水平升高，且与LVEDD增加（MR和AR均如此）、LVESD增加（仅AR）和肺动脉压升高（仅MR）呈正相关。因此，尾加压素II水平可作为风湿性瓣膜病患者的诊断生物标志物，与超声心动图一起用于评估病情严重程度。
