Aziz İnan Çelik1, Reşit Coşkun2, Muhammet Buğra Karaaslan3, Tahir Bezgin1, Süleyman Karakoyun4, Metin Çağdaş1

1Clinic of Cardiology, Heart Center, Gebze Fatih State Hospital, Kocaeli, Turkey
2Department of Cardiology, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan, Turkey
3Clinic of Cardiology, Osmancık State Hospital, Çorum, Turkey
4 Clinic of Cardiology, Akademi Hospital, Kocaeli, Turkey

Keywords: Mitral valve; parathyroid hormone; vitamin D; inflammation


Introduction: 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 a high Wilkins score. Changes in PTH and vitamin D levels may trigger inflammation and be responsible for valve damage.

Ethics Committee Approval

The study was approved by the Health Sciences University Kocaeli Derince Training and Research Hospital Clinical Research Ethics Committee (Date: 25.02.2021, Decision No: 2020/135).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - AİÇ; Analysis/Interpretation - SK; Data Collection - AİÇ; Writing - TB; Critical Revision - MÇ; Final Approval - RC; Statistical Analysis - MÇ; Overall Responsibility - RC.

Conflict of Interest

The authors declared that there was no conflict of interest during the preparation and publication of this article.

Financial Disclosure

The authors declared that this study has received no financial support.