Scalable Uncertainty Management Third International Conference, SUM
This volume contains the papers presented at the Third International Conference on Scalable Uncertainty Management, SUM 2009, in Washington, DC, September 28-30, 2009. It contains 21 technical papers which were selected out of 30 submitted papers in a rig
- PDF / 290,579 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 93 Downloads / 210 Views
ORIGINAL ARTICLE
Prediction of Residual Valvular Lesions in Rheumatic Heart Disease: Role of Adhesion Molecules Mona Hafez • Sohier Yahia • Waleed Eldars • Heba Eldegla • Mohamed Matter • Gehan Attia Samia Hawas
•
Received: 3 June 2012 / Accepted: 26 August 2012 Ó Springer Science+Business Media, LLC 2012
Abstract Rheumatic heart disease (RHD) is a chronic condition characterized by fibrosis and scarring of the cardiac valves and damage to the heart muscle, leading to congestive heart failure and death. This prospective cohort study was conducted to investigate the possible relation between the levels of serum adhesion molecules and acute rheumatic fever (ARF) carditis, valvular insult severity, and residual valvular lesion after improvement of rheumatic activity. Serum levels of intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin were assayed by enzyme-linked immunoassay (ELISA) for 50 children with ARF carditis during activity and after improvement and for 50 healthy children as control subjects. After the acute attack, patients were followed up regularly to detect residual valvular lesion. The serum levels of these adhesion molecules were significantly higher in the patients than in the control group (p \ 0.001). In addition, the levels of serum adhesion molecules were significantly higher in the patients with severe carditis than in the patients with mild to moderate carditis (p \ 0.001). Among the severe carditis group, the level of serum adhesion molecules was significantly higher among the patients with heart failure than among the patients without heart failure (p \ 0.001). Furthermore, the pretreatment serum levels of ICAM-1 and VCAM-1 were significantly higher among the patients with residual valve lesion (p = 0.002) than among those without the lesion (p \ 0.001). The cutoff values were M. Hafez S. Yahia M. Matter (&) G. Attia Pediatric Department, Faculty of Medicine, Mansoura University Children’s Hospital, Mansoura 35516, Egypt e-mail: [email protected] W. Eldars H. Eldegla S. Hawas Medical Microbiology and Immunology Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
obtained for the prediction of residual valvular lesion (ICAM-1, [1,032.3 lg/ml; VCAM-1, [3,662.3 lg/ml; E-selectin, [104.8 lg/ml). Finally, by combining the three adhesion molecules in a single prediction model, the highest area under the curve (AUC) ± standard error (SE) was obtained (0.869 ± 0.052), and the positive likelihood ratio for having a residual valvular lesion was increased (17.33). Levels of serum adhesion molecules could predict residual valvular lesions in RHD patients. The authors recommend that the serum level of adhesion molecules be measured in all cases of ARF carditis. Keywords Adhesion molecule Rheumatic heart disease Valvular lesion
Introduction Rheumatic heart disease (RHD) is a chronic condition characterized by fibrosis and scarring of the cardiac valves and damage to the heart muscle. It arises from an episode
Data Loading...
