title: Elevated hyaluronan levels in patients with rheumatic mitral stenosis and pulmonary arterial thromboembolism.
abstract: BACKGROUND
  The role of hyaluronan (HA) was previously demonstrated in patients with idiopathic pulmonary arterial hypertension (PAH). Mitral stenosis (MS) and pulmonary arterial thromboembolism (PTE) are important health problems that can cause pulmonovascular pathology. Pulmonary arterial hypertension develops especially in untreated patients with severe MS and most of patients with PTE. However, there is no data about HA levels in patients with MS and PTE. In this study, we investigated HA levels in patients with rheumatic MS and PTE.
  
  
  METHODS
  Study population was divided into three groups. MS group consisted of 18 patients with moderate or severe MS. PTE group consisted of 16 patients with PTE. Control group consisted of 15 subjects without cardiac and pulmonary disease. Percutaneous mitral balloon valvuloplasty (PMV) was performed on all patients in MS group. Mitral gradients and systolic pulmonary arterial pressure (sPAP) were measured in all patients. HA levels were measured at baseline and first month after PMV.
  
  
  RESULTS
  Mean sPAP±SD (mmHg) was 23±3 in the control group, 44±9 in the MS group and 66±11 in the PTE group (p<0.001). Baseline serum HA levels were significantly correlated with sPAP(echo) (r=0.332 p=0.03) and sPAP(cath) (r=0.559, p=0.007). Serum HA levels (ng/ml) in MS were significantly higher compared to controls [39±14 vs 24±11; p=0.01]. Patients in PTE group had the highest HA levels (61±21; p<0.001). Serum HA levels were significantly decreased at the first month after PMV in patients with MS [MS group: 39±14 (ng/ml), after PMV: 31±8; p=0.03].
  
  
  CONCLUSIONS
  This is the first article showing that both MS and PTE can cause increased serum HA levels. HA levels were decreased with PMV procedure in patients with MS.
authors.affiliation: Department of Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Kalay
authors.affiliation: Department of Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Elcik
authors.affiliation: Department of Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey.
authors.forename: Göktuğ
authors.initials: G
authors.lastname: Savaş
authors.affiliation: Department of Medical Biology, Faculty of Medicine, and Genome & Stem Cell Center, Erciyes University, Melikgazi 38039, Kayseri, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Altın
authors.affiliation: Department of Medical Biology, Faculty of Medicine, and Genome & Stem Cell Center, Erciyes University, Melikgazi 38039, Kayseri, Turkey.
authors.forename: Çağrı
authors.initials: Ç
authors.lastname: Şakalar
authors.affiliation: Department of Medical Biology, Faculty of Medicine, and Genome & Stem Cell Center, Erciyes University, Melikgazi 38039, Kayseri, Turkey.
authors.forename: Öznur
authors.initials: Ö
authors.lastname: Kaya
authors.affiliation: Department of Medical Biology, Faculty of Medicine, and Genome & Stem Cell Center, Erciyes University, Melikgazi 38039, Kayseri, Turkey. Electronic address: metin.aytekin@gmail.com.
authors.forename: Metin
authors.initials: M
authors.lastname: Aytekin
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000097:blood* / Q000150:complications / Q000601:surgery; D011651:Pulmonary Artery / Q000601:surgery; D011655:Pulmonary Embolism / Q000097:blood* / Q000150:complications / Q000601:surgery; D012214:Rheumatic Heart Disease / Q000097:blood* / Q000150:complications / Q000601:surgery
chemical_list: D006820:Hyaluronic Acid
keywords: Hyaluronan; Percutaneous mitral balloon valvuloplasty; Pulmonary arterial hypertension; Pulmonary arterial thromboembolism; Rheumatic mitral stenosis