Neurohormonal Activation and Left Atrium Remodeling in Mitral Stenosis
AbstractMitral stenosis is closely related with the hemodynamic consequences of obstructed mitral leaflet. Definitive therapy in mitral stenosis is mechanical intervention. Late presentation of mitral stenosis patients to medical facilities due to limited health facilities and Indonesian’s demographic, often make patients’ condition deteriorates, in which intervention need to be delayed or even no longer suitable. Stretched left atrium and reduced cardiac output stimulate several neurohormonal activation; renin-angiotensin-aldosterone and symphatetic nervous system. Left atrial remodeling further worsen hemodynamic ststus. Renin-angiotensin-aldosterone and sympathetic blockage could improve mitral stenosis patients’ condition with close observation to hypotension status.
2. Data Stenosis Mitral 2010-2014. Unit Rekam Medis Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita; 2015.
3. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, 3rd, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2438-88.
4. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. The Lancet Infectious diseases 2005;5:685-94.
5. Carabello BA. Indications for mitral valve surgery. J Cardiovasc Surg (Torino) 2004;45:407-18.
6. Carabello BA. Is it ever too late to operate on the patient with valvular heart disease? J Am Coll Cardiol 2004;44:376-83.
7. Otto CM, Bonow RO. Rheumatic Miral Valve Disease. Valvular heart disease : a companion to Braunwald’s heart disease. 3rd ed. Philadelphia: Saunders Elsevier; 2004:221-42.
8. Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol 2006;47:2357-63.
9. Kennedy JW, Yarnall SR, Murray JA, Figley MM. Quantitative angiocardiography. IV. Relationships of left atrial and ventricular pressure and volume in mitral valve disease. Circulation 1970;41:817-24.
10. Rahimtoola SH, Durairaj A, Mehra A, Nuno I. Current evaluation and management of patients with mitral stenosis. Circulation 2002;106:1183-8.
11. Novo G, Guttilla D, Fazio G, Cooper D, Novo S. The role of the renin-angiotensin system in atrial fibrillation and the therapeutic effects of ACE-Is and ARBS. Br J Clin Pharmacol 2008;66:345-51.
12. Ehrlich JR, Hohnloser SH, Nattel S. Role of angiotensin system and effects of its inhibition in atrial fibrillation: clinical and experimental evidence. Eur Heart J 2006;27:512-8.
13. Chockalingam A, Venkatesan S, Dorairajan S, Chockalingam V, Subramaniam T, et al. Safety and efficacy of enalapril in multivalvular heart disease with significant mitral stenosis--SCOPE-MS. Angiology 2005;56:151-8.
14. Baumgartner H, Hung J, Bermejo J, Chambers JB, Evangelista A, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 2009;10:1-25.
15. Carabello BA. Modern management of mitral stenosis. Circulation 2005;112:432-7.
16. Gash AK, Carabello BA, Cepin D, Spann JF. Left ventricular ejection performance and systolic muscle function in patients with mitral stenosis. Circulation 1983;67:148-54.
17. Hoit BD. Left atrial size and function: role in prognosis. J Am Coll Cardiol 2014;63:493-505.
18. Rodriguez L, Gillinov A. Mitral Valve Disease. In: Topol EJ, ed. Textbook of Cardiovascular Medicine. 3rd ed: Lippincot Williams&Wilkins; 2007:347-65.
19. Dietz JR. Mechanisms of atrial natriuretic peptide secretion from the atrium. Cardiovascular research 2005;68:8-17.
20. Hayashi Y, Ohtani M, Sawa Y, Hiraishi T, Kobayashi Y, et al. Left atrial diameter is a simple indicator of a deficiency in atrial natriuretic peptide secretion in patients with mitral stenosis: efficacy of postoperative supplementation with synthetic human alpha-atrial natriuretic peptide. J Cardiovasc Pharmacol 2004;44:709-17.
21. Maeda K, Tsutamoto T, Wada A, Hisanaga T, Nishimura T, et al. Low dose synthetic human atrial natriuretic peptide infusion in a patient with mitral stenosis and severe pulmonary hypertension. Jpn Circ J 1999;63:816-8.
22. Weber M, Hamm C. Role of B-type natriuretic peptide (BNP) and NT-proBNP in clinical routine. Heart 2006;92:843-9.
23. Haug C, Metzele A, Kochs M, Hombach V, Grunert A. Plasma brain natriuretic peptide and atrial natriuretic peptide concentrations correlate with left ventricular end-diastolic pressure. Clin Cardiol 1993;16:553-7.
24. Iltumur K, Karabulut A, Yokus B, Yavuzkir M, Taskesen T, et al. N-terminal proBNP plasma levels correlate with severity of mitral stenosis. J Heart Valve Dis 2005;14:735-41.
25. Selcuk MT, Selcuk H, Maden O, Erbay AR, Temizhan A, et al. The effect of percutaneous balloon mitral valvuloplasty on N-terminal- pro B- type natriuretic peptide plasma levels in mitral stenosis. Int Heart J 2007;48:579-90.
26. Ranganayakulu KP RD, Vanajakshamma V, Santosh kumar C, Vasudeva Chetty P. N-Terminal-proBNP, a surrogate biomarker of combined clinical and hemodynamic outcomes following PTMC. Journal of the Saudi Heart Association2015.
27. Nattel S. Electrophysiologic remodeling: are ion channels static players or dynamic movers? J Cardiovasc Electrophysiol 1999;10:1553-6.
28. Goette A, Honeycutt C, Langberg JJ. Electrical remodeling in atrial fibrillation. Time course and mechanisms. Circulation 1996;94:2968-74.
29. Li D, Fareh S, Leung TK, Nattel S. Promotion of atrial fibrillation by heart failure in dogs: atrial remodeling of a different sort. Circulation 1999;100:87-95.
30. Colucci WS BE. Pathophysiology of Heart Failure. In: Zipes D LP, Bowon RO, Braunwald E, ed. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine 7th ed: Philadephia, PA: W.B. Saunders; 2005:305-38.
31. Khan A, Moe GW, Nili N, Rezaei E, Eskandarian M, et al. The cardiac atria are chambers of active remodeling and dynamic collagen turnover during evolving heart failure. J Am Coll Cardiol 2004;43:68-76.
32. Casaclang-Verzosa G, Gersh BJ, Tsang TS. Structural and functional remodeling of the left atrium: clinical and therapeutic implications for atrial fibrillation. J Am Coll Cardiol 2008;51:1-11.
33. Khan R, Sheppard R. Fibrosis in heart disease: understanding the role of transforming growth factor-beta in cardiomyopathy, valvular disease and arrhythmia. Immunology 2006;118:10-24.
34. Brown NJ, Vaughan DE. Prothrombotic effects of angiotensin. Advances in internal medicine 2000;45:419-29.
35. Goette A, Staack T, Rocken C, Arndt M, Geller JC, et al. Increased expression of extracellular signal-regulated kinase and angiotensin-converting enzyme in human atria during atrial fibrillation. J Am Coll Cardiol 2000;35:1669-77.
36. Rude MK, Duhaney TA, Kuster GM, Judge S, Heo J, et al. Aldosterone stimulates matrix metalloproteinases and reactive oxygen species in adult rat ventricular cardiomyocytes. Hypertension 2005;46:555-61.
37. Unger T, Li J. The role of the renin-angiotensin-aldosterone system in heart failure. J Renin Angiotensin Aldosterone Syst 2004;5 Suppl 1:S7-10.
38. Yongjun Q, Huanzhang S, Wenxia Z, Hong T, Xijun X. Histopathological characteristics and oxidative injury secondary to atrial fibrillation in the left atrial appendages of patients with different forms of mitral valve disease. Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology 2013;22:211-8.
39. Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Baron-Esquivias G, et al. Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg 2012;42:S1-44.
40. Chockalingam A, Venkatesan S, Subramaniam T, Jagannathan V, Elangovan S, et al. Safety and efficacy of angiotensin-converting enzyme inhibitors in symptomatic severe aortic stenosis: Symptomatic Cardiac Obstruction-Pilot Study of Enalapril in Aortic Stenosis (SCOPE-AS). Am Heart J 2004;147:E19.
PDF downloads: 64
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).