Further evidence of inflammation in chronic rheumatic valve disease (CRVD): High levels of advanced oxidation protein products (AOPP) and high sensitive C-reactive protein (hs-CRP)

Chronic rheumatic valve disease (CRVD) is a late sequel of Rheumatic Fever (RF) which appears in approximately 30% of RF patients, leading to valve injury. Advanced Oxidation Protein Products (AOPP) and high sensitive C-Reactive Protein (hs-CRP) plasma levels were measured in patients with CRVD in order to evaluate the presence of oxidative stress and systemic inflammation. A total of 90 patients (70 female, 20 male, mean age 46.01 ± 11.72 years, range 24–69 years) with CRVD, who have or have not undergone valve replacement due to rheumatic ethiology, and 46 healthy subjects (27 female, 19 male, mean age 41.89 ± 9.02 years range 28–60 years) were studied. Levels of AOPP were measured by the determination of optical density (OD) at 340 nm under acidic conditions and hs-CRP by enhanced immunonephelometric assays. Significantly elevated levels of AOPP and hs-CRP were observed in CRVD patients when compared to the controls (AOPP 212.62 ± 34.14 umol/l vs. 126.97 ± 27.74 umol/l p < 0.00006 and for hs-CRP 5.40 ± 1.98 mg/l vs. 2.66 ± 1.36 mg/l p < 0.05). In addition, high levels of AOPP were associated to the presence of prosthethic valve and time after surgery (p < 0.0008 and p < 0.005, respectively). No correlation was observed between the levels of AOPP and hs-CRP with age, sex and degree of mitral valve stenosis. No correlation was found between AOPP and hs-CRP plasma values. These results suggest the involvement of oxidative stress and systemic inflammation in the pathogenesis of CRVD.