Circulating endothelial cells and vascular cell adhesion molecule-1 correlates with severity of regurgitation lesion and heart failure in rheumatic heart disease

Wulan Sasmeita, R. Suwarniaty, L. Fitri, M. Rohman, S. L. Kawuryan
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Abstract

Objective: This study aims to determine the correlation of vascular cell adhesion molecule-1 (VCAM-1) and circulating endothelial cells (CEC) with cardiac valves lesion severity and heart failure (HF) in rheumatic heart disease (RHD). Methods: A cross-sectional observational study using human peripheral blood samples of 36 children aged 6 to14 years old, divided into two groups: 18 RHD patients and 18 healthy controls group. The expression of CECs and VCAM-1 on CECs was investigated by using flow-cytometry method while the levels of soluble VCAM-1 (sVCAM-1) were obtained by using ELISA method. The severity of valve lesions was determined in a qualitative manner. Results: The average of CECs expression, VCAM-1 on CECs expression, and sVCAM-1 levels were significantly higher in the patient group than those of the healthy group. The expression of VCAM-1 on CECs was significantly different among mild, moderate, and severe regurgitation. Correlation analysis showed that the CECs expression had a significant correlation with HF. Moreover, correlation was found between expression of VCAM-1 on CECs and the severity of valve lesions. However, sVCAM-1 in plasma had no correlation either with HF or with valve lesion. Conclusion: The expression of VCAM-1 on CECs is associated with severe regurgitation while CECs level was correlated with HF. VCAM-1 on CECs may be considered a marker for the severity of functional regurgitation in RHD. CECs could be recommended as a measure for RHD with HF.
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循环内皮细胞和血管细胞粘附分子-1与风湿性心脏病反流病变严重程度和心力衰竭相关
目的:探讨风湿性心脏病(RHD)患者血管细胞粘附分子-1 (VCAM-1)和循环内皮细胞(CEC)与心脏瓣膜病变严重程度和心力衰竭(HF)的相关性。方法:采用横断面观察性研究方法,采集36例6 ~ 14岁儿童外周血标本,分为两组:18例RHD患者和18例健康对照组。采用流式细胞术检测CECs和VCAM-1在CECs上的表达,ELISA法检测可溶性VCAM-1 (sVCAM-1)水平。以定性的方式确定瓣膜病变的严重程度。结果:患者组CECs的平均表达水平、VCAM-1对CECs表达的影响及sVCAM-1水平均显著高于健康组。VCAM-1在CECs上的表达在轻度、中度和重度反流中有显著差异。相关性分析显示CECs表达与HF有显著相关性。此外,VCAM-1在CECs上的表达与瓣膜病变的严重程度存在相关性。血浆sVCAM-1与HF及瓣膜病变均无相关性。结论:VCAM-1在CECs上的表达与严重反流相关,CECs水平与HF相关。CECs上的VCAM-1可能被认为是RHD功能性反流严重程度的标志。CECs可作为诊断RHD合并HF的一种措施。
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