The Study Of Inflammation Factors And Homocysteine In Patients With Senile Degenerative Heart Valve Disease

Objective:To investigate the effects of high-sensitivity C-reactive protein (Hs-CRP), tumor necrosis factor-alpha (TNF-a), interleukin-6(IL-6) and homocysteine (HCY) on the progression of senile degenerative heart valvular disease (SDHVD).Methods:The patients were enrolled from December2011to January2013in department of Cardiology and Special Medical Treatment,the first affiliated hospital of Kunming Medical University,they were divided into two groups based on their echocardiograph, including the group of senile degenerative heart valvular disease (SDHVDA,n=61),and the control group (NVC, n=30). The levels of high-sensitivity C-reactive protein, tumor necrosis factor-alpha, interleukin-6and homocysteine were measured by Enzyme-linked Immunosorbent Assay. Colected the clinical data, incuding gender, age, ethnic, height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), personal history, family history (hypertension, diabetes, coronary heart disease and hyperlipidemia). Meanwhile, fasting plasma glucose (FPG), blood calcium (Ca, P), blood lipid (TG TC, HDL-c, LDL-c),and alkaline phosphatase (ALP) were determined. Rrecording the results of electrocardiogram and/or24-hour Holter,To receive Doppler echocardiography examination for an observation of the cardiac structure,function and valve condition especially valve calcification and valve regurgitation, Calculating body mass index (BMI), pulse pressure (PP).All experiment data processing and analysis turned to SPSS17.0statistical package. Mesurement data was expressed as mean±standard deviation (x±s) and count data was expressed as component ratio.The comparison of inter-group quantitative data used t-test and the one of inter-group quantitative data used chi-square test, the comparision of the multiple sample mean differences and multiple comparison of sample mean diffences used one-way analysis of variance(one-way ANOVA).P<0.05was considered statistically significant. Correlation analysis used the linear correlation analysis.Results:1.Compared with the control group, SDHVD group has high levels of Hs-CRP, IL-6, TNF-a and HCY, the difference was statistically significant (P<0.05).2. According to the number of calcified valvular,the SDHVD are divided into different subgroups,The concentrations of Hs-CRP、TNF-a、IL-6and HCY grow with the increase of the number of calcified valvular, the differences among various subgroups are statistically significant (P<0.05).According to valvular stenosis degree, the SDHVD were divided into two groups, The concentrations of Hs-CRP、TNF-a、IL-6and HCY grow with the increase of the valvular stenosis degree, the differences between two groups were statistically significant (P<0.05).According to the differences of New York Heart Association,the SDHVD were divided into Different subgroups, subgroups compared with control group, Compared with the control group, there was no significant difference of the concentrations of Hs-CRP、TNF-a、IL-6and HCY of The SDHVD group NYHA class I group((P>0.05), meanwhile,NYHA class II and class III group was higher ((P<0.05), The concentrations of plasma Hs-CRP、TNF-a、IL-6and HCY grow with the increase of the NYHA,the differences among various groups were statistically significant (P<0.05).3.The correlation analysis-the Atrial/ventricular chamber diameter and LVEF,and the concentrations of plasma Hs-CRP、TNF-a、IL-6and HCY in the SDHVD, had significant correlation (P<0.05).There was a positive correlation between Left atrial diameter and the concentrations of plasma Hs-CRP,TNF-a,IL-6,HCY, there was a positive correlation between ventricular chamber diameter and the concentrations of Hs-CRP,TNF-a,IL-6,HCY.there was a negative correlation between LVEF and the concentrations of plasma Hs-CRP,TNF-a,IL-6,HCY.4. The concentrations of HCY and Hs-CRP、TNF-a、IL-6had significant correlation in the SDHVD (P<0.05), there was a positive correlation between the concentrations of plasma HCY and Hs-CRP,TNF-a,IL-6.5.In61case of calcificated valve group, the incidence of mere aortic valve calcification was the highest, accounting for42.62%.The incidence of arrhythmia in calcificated valve group was larger than control group, Atrial fibrillation is the common arrhythmia (P<0.05);Indicators of SDHVD group were higher than those in control group in the aspect of TC,LDL-c, LAId, LVEDd, IVST, RAId, while Indicators of SDHVD group were lower than those in control group in the aspect of HDL-c, LVEF (P<0.05).The rest of the clinical physiological indexes were no statistically significant differences.Conclusion:1.SDHVD group has high levels of Hs-CRP, IL-6, TNF-a and HCY, And the inflammatory factors is closely related to the degree of pathological changes, which suggest inflammatory factors play an importantrole in the progress of senile degeneration heart valvular disease.,and Serum concentrations of Hs-CRP,TNF-a,IL-6,HCY,they are helpful for early diagnosis of SDHVD.2.The inflammatory factors Hs-CRP, IL-6, TNF-a and HCY, that participate in the progress of senile degeneration heart valvular disease.3. Hyperlipidemia is a risk factor of SDHVD,which is involved in SDHVD.4. The predilection site of SDHVD is aortic, Arrhythmias and heart failure are more likely to occur, Atrial fibrillation is the common arrhythmia.