Background: Few reports demonstrated that increased inflammatory markers as well as platelet, coagulation, fibrinolytic activities in mitral stenosis (MS) decrease after percutaneous mitral valvotomy (PMV). The relationship between the inflammatory markers and platelet, coagulation, and fibrinolytic activities was not studied before.
Methods: The study included 65 patients with MS undergoing PMV, and 23 controls. Markers of platelet activity (P-Selectin), thrombin activity (Prothrombin fragment1,2 “PF1,2” and thrombin antithrombin complex “TAT”), fibrinolysis (D-Dimer), and inflammation (interleukin 1B “IL1B”) were measured from venous samples obtained before and 2 weeks after PMV and in all controls.
Results: All hemostatic and inflammatory markers were significantly higher in MS patients than the control and they significantly decreased after PMV. Only in PF1,2 the level became not significantly different from the control after PMV. The change in any of these variables didn’t correlate with the change in mitral valve area, mean transmitral pressure gradient, left ventriculat dimensions and function. P-selectin change was predicted by the changes in left atrial diameter “LAd” (r 0.4, P 0.02), pulmonary artery systolic pressure “PASP” (r 0.3, P 0.02) and IL1B (r 0.7, P <0.0001). D-dimer change had similar predictors; LAd (r 0.5, P <0.0001), PASP (r 0.3, p 0.04), and IL1B (r 0.5, P <0.0001). PF1,2 change was predicted with the change in IL1B (r 0.8, P <0.0001). TAT change was predicted by the changes in LAd (0.3, P 0.02) and right ventricular diameter “RVd” (r 0.3, P 0.04). IL1B change was predicted with the changes in aortic root diameter (0.4, p 0.02), RVd (r 0.5, P 0.04), and PASP (r 0.5, P 0.03).
Conclusion: MS is associated with heightened inflammatory, platelet, thrombin, and fibrinolytic activities that decrease after PMV. Altered hemodynamics might play a possible role in some of these changes. Reduced inflammatory activity might have a role in reduced platelet, thrombin, and fibrinolytic activities after PMV.
