Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T05:05:18.588Z Has data issue: false hasContentIssue false
  • English
  • Français

Pulmonary valvar involvement in rheumatic heart disease—a study of 100 post-mortem cases

Published online by Cambridge University Press:  19 August 2008

Alfonso Buendía ,
Fause Attie ,
Carlos Zabal ,
Juan Calderón-Colmenero ,
Alberto Aranda  and
Pedro Reyes
Alfonso Buendía
Affiliation:
From the Instituto Nacional de Cardiologia “Ignacio Chavez”, México
Fause Attie*
Affiliation:
From the Instituto Nacional de Cardiologia “Ignacio Chavez”, México
Carlos Zabal
Affiliation:
From the Instituto Nacional de Cardiologia “Ignacio Chavez”, México
Juan Calderón-Colmenero
Affiliation:
From the Instituto Nacional de Cardiologia “Ignacio Chavez”, México
Alberto Aranda
Affiliation:
From the Instituto Nacional de Cardiologia “Ignacio Chavez”, México
Pedro Reyes
Affiliation:
From the Instituto Nacional de Cardiologia “Ignacio Chavez”, México
*
Dr. Fause Attie, Instituto Nacional de Cardiologia “Ignaclo Chavez”Juan Badiano 1, Tlalpan, 14080 México, D.F. México. Tel. (5) 573-0480; Fax. (5) 573-0994.
Get access Rights & Permissions [Opens in a new window]

Abstract

Summary

We reviewed 100 postmortems of patients with pulmonary valvar involvement due to rheumatic heart disease. The patients were divided in two groups: the first group included 59 cases with acute rheumatic lesions of the pulmonary valve. At the time of death, the mean age in this group was 18.4 ± 9.7 years. The second group was formed by 41 patients with chronic rheumatic lesions of the pulmonary valve whose mean age at the time of death was 25± 16.5 years. The percentage of patients who died before the age of25 years was greater in the group with acute as opposed to chronic lesions (p=O.0003). The mean age of the first attack in those with acute lesions was 11.7±7.8 years, as compare to 13.8 ± 5.3 years in those with chronic lesions. All patients but one had at least one attack of the acute rheumatic process. There was no significant difference between the groups regarding the number of acute processes. The length of the acute rheumatic process was similar in both groups. Fifty-five cases having acute lesions, and 38 of those with chronic lesions suffered involvement of all cardiac valves. Three valves were affected in two hearts, while only one heart had two affected valves. Fifteen cases had an associated congenital defect of the pulmonary valve, and we found a significantly greater incidence of rheumatic pulmonary disease in the group with co-existing congenital lesions of the valve (p.O.00001). Three patients undergoing catheterization (21.4%) showed normal, or near normal, pulmonary arterial systolic pressure. Rheumatic damage to the pulmonary valve, therefore, exists in association with plurivalvar rheumatic disease. A congenital lesion of the pulmonary valve predisposes to its involvement in the rheumatic process.

Keywords

Rheumatic pulmonary valve diseaserheumatic heart diseasepulmonay valve
Type
Original Articles
Information
Cardiology in the Young , Volume 2 , Issue 2 , April 1992 , pp. 147 - 151
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kaplan, MH. Immunologic relation ofstreptococcal and tissue antigens. I. Properties of an antigen in certain strains of group A streptococci exhibiting an immunologic cross reaction with human heart tissue. J Immunol 1962; 90: 595–606.CrossRefGoogle Scholar
2.Zabriskie, JB. Rheumatic fever: the interplay between host, genetics and microbe. Circulation 1985; 71: 1077–1086.CrossRefGoogle ScholarPubMed
3.Tomai, M, Koth, M, Majumdar, G, Beachey, EH. Superantige nicity of streptococcal M protein. J Exp Med 1990; 172: 359–362.CrossRefGoogle Scholar
4.Gulizia, JM, Cunningham, MW, McManus, BM. Immunore activity of antistreptococcal monoclonal antibodies to human heart valves. Am J Pathol 1991; 138: 285–301.Google Scholar
5.Kaplan, S. Chronic rheumatic heart disease. In: Adams, FH, Emmanouilides, GC, Riemenschneider, T.H. (eds). Heart Disease in Infants, Children and Adolescents. The Williams & Wilkins Company, Baltimore, 1989, pp 705–708.Google Scholar
6.Ferrans, VJ, Roberts, WC. Pathology of rheumatic heart dis ease. In: Borman, JB, Gotsman, MS (eds). Rheumatic Valvular Disease in Children. Springer-Verlag, Berlin, 1980, pp 28–58.CrossRefGoogle Scholar
7.Sukumar, IP. Acute and chronic rheumatic heart disease. In: Anderson, RH, Macartney, FJ, Shinebourne, F.A, Tynan, M (eds). Paediatric Cardiology. Churchill Livingstone, Edinburgh, 1987, pp 1179–1221.Google Scholar
8.Stollerman, GH, Markowitz, M, Taranta, A, Wannamaker, LW, Wittemore, R. Jones criteria (revisited) for guidance in the diagnosis of rheumatic fever. Circulation 1965; 32: 664–668.Google Scholar
9.Attie, F, Kuri, J, Zanoniani, C, Renteria, V, BuendIa, A, Ovseyevitz, J, López-Soriano, F, Garcia-Cornejo, M, MartInez-RIos, MA. Mitral valve replacement in children with rheumatic heart disease. Circulation 1981; 64: 812–817.CrossRefGoogle ScholarPubMed
10.Attie, F, López-Soriano, F, Ovseyevitz, J, Martinez, J, Moreno, Gil M, Buendía, A, Chavez-DomInguez, R, Richheimer, R. Late results of mitral valve replacement with the Bjork Shiley prosthesis in children under 16 years of age. J Thorac Cardiovasc Surg 1986; 91: 754–758.CrossRefGoogle ScholarPubMed
11.Solymar, L, Rao, S, Mardini, MK, Fawzy, ME, Guinn, G. Prosthetic valves in children and adolescents. Am Heart J 1991; 121: 557–568.CrossRefGoogle ScholarPubMed
12.Kalke, BR, Desai, JM, Magrote, R. Mitral valve surgery in children. J Thorac Cardiovasc Surg 1989; 98: 994–998.CrossRefGoogle ScholarPubMed
13.DiSciacio, G, Taranta, A. Rheumatic fever in children. Am Heart J 1980; 99: 635–658.CrossRefGoogle Scholar
14.Shibata, H, Matsuzaki, T, Hayashi, N, Morishima, A, Seino, T. Congenital heart disease in high school and college students. Jpn Heart J 1977; 8: 457–461.CrossRefGoogle Scholar
15.Chen, SC, Laks, H, Fagan, L, Tershluse, D, Kaiser, G, Barner, H, Willman, VL. Valve replacement in children. Circulation (Suppl II) 1977; 56: 117–121.Google ScholarPubMed
16.Gotsman, MS, Horst, Vander RL.Surgical management of severe mitral valve disease in childhood. Am Heart J 1975; 90: 685–687.CrossRefGoogle ScholarPubMed
17.Chavez-Rivera, I, Leon, Ponce de J, Robles-Gil, J.Las valvulopatfas reumáticas en 1,000 casos. Arch Inst Cardiol Mexico 1958; 24: 492–508.Google Scholar
18.Espino-Vela, J, Contreras, R, Rustrian, F. Rheumatic pulmo nary valve disease. Am J Cardiol 1969; 23: 12–18.CrossRefGoogle Scholar
19.Bandin, MA, Vargas-Barron, J, Keirns, C, Romero-Cárdenas, A, Villegas, M, BuendIa, A. Echocardiographic diagnosis of rheu matic cardiopathy affecting all four cardiac valves. Am Heart J 1990; 120: 1004–1007.CrossRefGoogle Scholar