title: Increased levels of markers of oxidative stress and inflammation in patients with rheumatic mitral stenosis predispose to left atrial thrombus formation.
abstract: BACKGROUND
  Rheumatic mitral stenosis (MS) causes stagnation of blood flow, leading to thrombus formation in the left atrium (LA), which may lead to systemic thromboembolic complications. We compared alterations in circulating levels of pro-/anti-oxidants and markers of inflammation in patients of severe rheumatic MS with and without LA thrombus and studied their predictive power to detect the presence of LA thrombus in patients with rheumatic MS.
  
  
  METHODS
  This is a cross-sectional study of 80 patients with rheumatic MS, evaluated for percutaneous mitral commisurotomy. Group 1 comprised of patients with rheumatic MS with LA thrombus (n=35) and Group 2 included patients with rheumatic MS without LA thrombus (n=45). The following oxidative stress markers-malondialdehyde (MDA), protein carbonyls, total oxidant status and total antioxidant status and inflammation markers-high sensitivity C-reactive protein (hs-CRP), total sialic acid (TSA) and protein-bound sialic acid (PBSA) were estimated in all study subjects.
  
  
  RESULTS
  Levels of plasma MDA, protein carbonyl and total oxidant status were significantly elevated, whilst the total antioxidant status levels were significantly lowered, in Group 1, as compared with Group 2. hs-CRP, TSA and PBSA levels showed a significant rise in Group 1 patients, as compared with Group 2.
  
  
  CONCLUSIONS
  Our results suggest that circulating levels of MDA, protein carbonyl and PBSA were independent predictors of occurrence of LA thrombus in patients with rheumatic MS.
authors.affiliation: M. Sc., Department of Biochemistry, Jawaharlal Institute of Post Graduate Medical Education and Research , Puducherry, India .
authors.forename: Vinay Kumar
authors.initials: VK
authors.lastname: Pulimamidi
authors.affiliation: M. Sc., Department of Biochemistry, Jawaharlal Institute of Post Graduate Medical Education and Research , Puducherry, India .
authors.forename: Vengatesan
authors.initials: V
authors.lastname: Murugesan
authors.affiliation: Assistant Professor, Department of Biochemistry, Jawaharlal Institute of Post Graduate Medical Education and Research , Puducherry, India .
authors.forename: Medha
authors.initials: M
authors.lastname: Rajappa
authors.affiliation: Associate Professor, Department of Cardiology, Jawaharlal Institute of Post Graduate Medical Education and Research , Puducherry, India .
authors.forename: Santhosh
authors.initials: S
authors.lastname: Satheesh
authors.affiliation: Lecturer, Department of Biometrics, Jawaharlal Institute of Post Graduate Medical Education and Research , Puducherry, India .
authors.forename: Kottenyen Thazhath
authors.initials: KT
authors.lastname: Harichandrakumar
keywords: Inflammation; Left Atrium; Oxidative stress; Rheumatic mitral stenosis; Thrombosis