Correlation of tissue selectin expression and hemodynamic parameters in rheumatic mitral valve disease.

BACKGROUND AND AIM OF THE STUDY: The study aim was to examine tissue expression of the adhesion molecules E-selectin and P-selectin on atrial, valvular and atrial myocardial blood vessel endothelium in patients with rheumatic mitral stenosis, and to investigate whether such expression was correlated with hemodynamics.

METHODS: Thirteen patients (eight women, five men; mean age 51 +/- 10 years) with severe rheumatic mitral stenosis who underwent mitral valve replacement surgery were examined on preoperative day 1, using cardiac catheterization and echocardiography. Specimens from the mitral valve and left atrium of each patient were evaluated for CD 62E and CD 62P expression using indirect immunoperoxidase and immunofluorescence techniques

RESULTS: A great majority of patients presented E and/or P selectin expression of variable intensity on atrial, valvular and atrial myocardial blood vessel endothelium. A more diffuse and stronger reaction for CD 62P was noted compared to that for CD 62E. The left ventricular end-diastolic diameter and left atrial diameter were positively correlated with endocardial CD 62P and CD 62E expression. Right atrial pressure was also strongly and positively correlated with endocardial expression of CD 62E (r = 0.80, p 0.03) and CD 62P (r = 0.8, p = 0.02).

CONCLUSION: Marked tissue expression of CD 62E and CD 62P was identified on atrial, valvular and atrial myocardial blood vessel endothelium. Moreover, the degree of expression of adhesion molecules was significantly correlated with the left atrial and left ventricular chamber diameters, as well as right atrial pressure.