Aziz Inan Celik1, Resit Coskun2, Muhammet Bugra Karaaslan3, Tahir Bezgin1, Suleyman Karakoyun4, Metin Cagdas1

1Gebze Fatih State Hospital, Heart Center, Cardiology, Kocaeli, Turkey
2Erzincan Binali Yıldırım University, Faculty Of Medicine, Cardiology, Erzincan, Turkey
3Osmancik State Hospital, Cardiology, Corum, Turkey
4Akademi Hospital, Cardiology, Kocaeli, Turkey

Keywords: rheumatic mitral valve, parathyroid hormone, vitamin d, wilkins score, inflammation

Abstract

Objectives: Rheumatic mitral valve disease (RMVD) is associated with autoimmune heart valve injury. Parathyroid hormone (PTH) and vitamin D are two essential molecules that have effects on the immune system. In this study, we aimed to evaluate the relationship between PTH and vitamin D in patients with RMVD.

Patients and Methods: We investigated 81 patients with RMVD and 75 healthy subjects. According to Wilkins score, baseline clinical, laboratory, and echocardiographic parameters were recorded, and all RMVD patients were analyzed. Multivariate logistic regression analysis was performed between the groups.

Results: Vitamin D levels were significantly low in the RMVD group. Patients were stratified according to Wilkins score [Wilkins score < 7 (n:50) vs. Wilkins score 7 (n:31)]. Age, BMI, and PTH were significantly higher, and mitral valve area was significantly lower in Wilkins score 7 patients. In multivariate analysis, age (OR: 1.052; 95% CI 1.005-1.100, p=0.028) and PTH (OR: 1.017; 95% CI 1.000-1.033, p=0.047) were found to be independent predictors of high Wilkins score.

Conclusion: This study showed that vitamin D levels were low in patients with RMVD. According to the Wilkins score, PTH levels were significantly high in patients with high Wilkins score. The contrary changes in PTH and vitamin D levels may trigger inflammation and be responsible for valve damage.