Correlation between P-Selectin Level and Left Atrial Function in Rheumatic Mitral Stenosis
AbstractBackground. Mitral stenosis (MS) prevalence remains significant in developing countries because of the prevalence of Rheumatic Heart Disease (RHD). In moderate-severe MS patients, enormous increase in turbulent region and shear stress cause vascular endothelial dysfunction, and as the consequence, it increases the risk of thromboembolic complications. P-selectin is an adhesion molecule that play a role in the inflammation process, where it is expressed rapidly in mere minutes. Left Atrial Volume Index (LAVI) is a superior parameter compared with other two-dimensional echocardiography method to assess left atrial function.Methods. This was a cross-sectional study involving 20 MS moderate-severe patients with mitral valve area (MVA) < 1.5 cm2, to whom successful Percutaneous transvenous Balloon Mitral Valvulotomy (PBMV) was performed. Samples were taken consecutively from May-October 2013 at the National Cardiovascular Center Harapan Kita, Jakarta. Blood samples of P-selectin were collected pre and post-PBMV. The result was statistically analyzed with echocardiography data of LAVI prior PBMV to describe any association between expression of P-selectin and atrial function.Result.We found no association between LAVI and P-selectin level pre and post-PBMV in MS patients. That is described in the value of pre PBMV ?=-0.103 (95% CI -0.251-0.045) with p=0.16 and post-PBMV ?= 0.009 (95% CI -0.155-0.172) with p=0.91 We then performed linear regression test with adjusted confounding variable including sex, age, and atrial fibrillation, still we found no association between LAVI and P-selectin level, with the value of pre PBMV ?= -0.154 (95% CI -0.340-0.032) p=0.09 and post PBMV ?= -0.049 (95% CI -0.250-0.152) p=0.61.Conclusion. There is no difference in P-selectin level pre and post PBMV. There is no association between poor LAVI value and expression of P-selectin pre and post PBMV in MS.
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