ABSTRACT
The purpose of this study was to evaluate the tenascin-C levels in severe rheumatic mitral stenosis before and after percutaneous mitral balloon valvuloplasty [PMBV]. Forty patients with severe mitral stenosis requiring PMBV and 20 age-matched healthy subjects were included in the study. The mitral valve areas, mitral gradients and systolic pulmonary artery pressure [sPAP] were measured by echocardiography. The sPAP values and mitral gradients were also measured by catheterization before and after PMBV. The blood tenascin-C levels were measured before PMBV and 1 month after the procedure. The echocardiographic mean mitral gradients had a significant decrease after PMBV [11.7 +/- 2.8 vs. 5.6 +/- 1.7 mm Hg; p < 0.001] and also those of catheterization [13.9 +/- 4.4 vs. 4.0 +/- 2.4 mm Hg; p < 0.001]. Mitral valve areas increased significantly after PMBV [from 1.1 +/- 0.1 to 1.8 +/- 0.2 cm[2], p < 0.001]. Tenascin-C levels decreased significantly in patients after PMBV [from 15.0 +/- 3.8 to 10.9 +/- 3.1 ng/ml; p < 0.001]. Tenascin-C levels were higher in patients with mitral stenosis before PMBV than in healthy subjects [15.0 +/- 3.8 and 9.4 +/- 2.9 ng/ml; p < 0.001, respectively]. There were no significant differences between patients with mitral stenosis after PMBV and healthy subjects [10.9 +/- 3.1 and 9.4 +/- 2.9 ng/ml; p = 0.09, respectively]. There was a significant positive correlation between tenascin-C levels and sPAP [r = 0.508, p < 0.001]. In multivariant analysis, tenascin-C predicted mitral stenosis [p = 0.004, OR: 2.31]. Tenascin-C was an independent predictor for rheumatic mitral stenosis