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Revista Médica Sinergia

2023, Number 04

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Revista Médica Sinergia 2023; 8 (04)

Rheumatic heart disease: principles, pathophysiology and treatment

Rodríguez SD, Coto QA, Hernández GR

Language: Spanish
References: 16
Page:
PDF size: 131.20 Kb.


ABSTRACT

Rheumatic heart disease is the main cause of mitral stenosis in developing countries. Recurrent infections secondary to Streptococcus pyogenes pharyngitis usually develop this disease. Its pathophysiology can be explained by two theories. Molecular mimicry consists in a molecule which is part of this bacteria presents antigenic similarity to the affected tissue. A new theory was developed recently, known as neoantigen theory, this suggests that S. pyogenes acquires access to the subendothelial collagen, inducing an autoimmune response against this tissue. Long-term valvular inflammation results in anatomic and functional abnormality of the affected valve. Surgical treatment for rheumatic valve disease has changed during the years. Initially the stenotic mitral valve was dilated manually using the surgeon ́s finger, a technique known as “closed” commissurotomy. Other treatment options nowadays consist in valve repair, percutaneous and open heart mitral valve replacement. Most of the patients present a great outcome after the adequate treatment and procedure.


REFERENCES

  1. Watkins DA, Beaton AZ, Carapetis JR, Karthikeyan G, Mayosi BM, Wyber R, Yacoub MH, Zühlke LJ. Rheumatic Heart Disease Worldwide: JACC Scientific Expert Panel. J Am Coll Cardiol [internet]. 2018 Sep 18 [citado 2023 ene. 02];72(12):1397-1416. Disponible en: http://www.doi.org/10.1016/j.jacc.2018.06.063 . PMID: 30213333.

  2. Passos LSA, Nunes MCP, Aikawa E. Rheumatic Heart Valve Disease Pathophysiology and Underlying Mechanisms. Front Cardiovasc Med [internet]. 2021 ene. 18 [citado 2023 ene. 02];7:612716. Disponible en: http://www.doi.org/10.3389/fcvm .2020.612716. PMID: 33537348; PMCID: PMC7848031.

  3. Han J, Tian B, Wu F, Jiao Y, Pang S, Xu J, Meng X. Surgical rheumatic mitral valve repair compared with percutaneous balloon mitral valvuloplasty in mitral stenosis in current era: a propensity score matching study. J Thorac Dis [internet]. 2020 Nov [citado 2023 ene. 02]; 12(11):6752-6760. Disponible en: http://www.doi.org/10.21037/jtd-20-1694. PMID: 33282376; PMCID: PMC7711429.

  4. Ibrahim KS, Kheirallah KA, Mayyas FA, Alwaqfi NR, Alawami MH, Aljarrah QM.Predictors of short-term mortality after rheumatic heart valve surgery: A single-center retrospective study. Ann Med Surg (Lond) [internet]. 2021 ene. 26 [citado 2023 ene. 02];62:395-401. Disponible en: http://www.doi.org/10.1016/j.amsu.2021.01.077 . PMID: 33552502; PMCID: PMC7851328.

  5. Vieira MLC, Branco CEB, Gazola ASL, Vieira PPAC, Benvenuti LA, Demarchi LMMF, Gutierrez PS, Aiello VD, Tarasoutchi F, Sampaio RO. 3D Echocardiography for Rheumatic

  6. Heart Disease Analysis: Ready for Prime Time. Front Cardiovasc Med [internet]. 2021 Jul 20 [citado 2023 ene. 02];8:676938. Disponible en: http://www.doi.org/10.3389/fcvm . 2021.676938 PMID: 34355026; PMCID: PMC8329529.

  7. Leo LA, Paiocchi VL, Schlossbauer SA, Gherbesi E, Faletra FF. Anatomy of Mitral Valve Complex as Revealed by Non-Invasive Imaging: Pathological, Surgical and Interventional Implications. J Cardiovasc Dev Dis [internet]. 2020 Nov 4 [citado 2023 ene. 02];7(4):49. Disponible en: http://www.doi.org/10.3390/jcdd7040049 . PMID: 33158082; PMCID: PMC7712333.

  8. Aggarwal P, Reddy R, Yashvinder, Singh RS. Multivalvular rheumatic heart disease in a case of dextrocardia with situs inversus: an arduous surgical access. Indian J Thorac Cardiovasc Surg [internet]. 2019 Oct [citado 2023 ene. 02];35(4):584-586. Disponible en: http://www.doi.org/10.1007/s12055-019-00822-1 . Epub 2019 May 10. PMID: 33061056; PMCID: PMC7525518.

  9. Wunderlich NC, Dalvi B, Ho SY, Küx H, Siegel RJ. Rheumatic Mitral Valve Stenosis: Diagnosis and Treatment Options. Curr Cardiol Rep [internet]. 2019 Feb 28 [citado 2023 ene. 02];21(3):14. Disponible en: http://www.doi.org/10.1007/s11886-019-1099-7 . PMID: 30815750.

  10. Rosa VEE. Histopathological Characterization of Mitral Valvular Lesions in Patients With Rheumatic Heart Disease: Is Inflammation Also to Blame for Chronic Valvular Heart Disease Progression? Arq Bras Cardiol [internet]. 2021 Mar [citado 2023 ene. 02];116(3): 413-414. English, Portuguese. Disponible en: http://www.doi.org/10.36660/abc.20201244 . PMID: 33909768; PMCID: PMC8159542.

  11. Luo T, Meng X. Clinico-pathological classification of rheumatic mitral valve damage and surgical strategy. J Thorac Dis [internet]. 2021 May [citado 2023 ene. 02];13(5):2933-2941. Disponible en: http://www.doi.org/10.21037/jtd-20-3456 . PMID: 34164184; PMCID: PMC8182522.

  12. Unger P, Lancellotti P, Amzulescu M, David-Cojocariu A, de Canničre D. Pathophysiology and management of combined aortic and mitral regurgitation. Arch Cardiovasc Dis [internet]. 2019 Jun-Jul [citado 2023 ene. 02];112(6-7):430-440. Disponible en: http://www.doi.org/10.1016/j.acvd.2019.04.003 . Epub 2019 May 29. PMID: 31153874.

  13. Pomerantzeff PMA. Mitral Valve Repair in Young Rheumatic Patients. Arq Bras Cardiol [internet]. 2019 Nov 4 [citado 2023 ene. 02];113(4):757. Disponible en: http://www.doi.org/10.5935/abc.20190215 . PMID: 31691757; PMCID: PMC7020872.

  14. Dejsupa C, Chotivatanapong T, Caputo M, Vohra HA. Current Perspectives on Contemporary Rheumatic Mitral Valve Repair. Innovations (Phila) [internet]. 2021 Nov-Dic [citado 2023 ene. 02];16(6): 510-516. Disponible en: http://www.doi.org/10.1177/15569845211032942 . Epub 2021 Sep 3. PMID: 34478343; PMCID: PMC8679173.

  15. Trumello C, Giambuzzi I, Bonalumi G, Bargagna M, Naliato M, Ruggeri S, Fileccia D, Castiglioni A, Alfieri O, Alamanni F, De Bonis M. Rheumatic mitral regurgitation: is repair justified by the long-term results? Interact Cardiovasc Thorac Surg [internet]. 2021 Agosto 18 [citado 2023 ene. 02];33(3): 333-338. Disponible en: http://www.doi.org/10.1093/icvts/ivab091 . PMID: 33948663; PMCID: PMC8691521.

  16. Mentias A, Saad M, Desai MY, Krishnaswamy A, Menon V, Horwitz PA, Kapadia S, Sarrazin MV. Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Rheumatic Aortic Stenosis. J Am Coll Cardiol [internet]. 2021 abril 13 [citado 2023 ene. 02];77(14):1703-1713. Disponible en: http://www.doi.org/10.1016/j.jacc.2021.02.032 . PMID: 33832596; PMCID: PMC8043573.




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