title: Parameters indicative of persistence of valvular pathology at initial diagnosis in acute rheumatic carditis: the role of albumin and CD19 expression.
abstract: OBJECTIVE
  The aim of this study is to define the predictors of chronic carditis in patients with acute rheumatic carditis (ARC).
  
  
  METHODS
  Patients diagnosed with ARC between May 2010 and May 2011 were included in the study. Echocardiography, electrocardiography, lymphocyte subset analysis, acute phase reactants, plasma albumin levels, and antistreptolysin-O (ASO) tests were performed at initial presentation. The echocardiographic assessments were repeated at the sixth month of follow-up. The patients were divided into two groups according to persistence of valvular pathology at 6th month as Group 1 and Group 2, and all clinical and laboratory parameters at admission were compared between two groups of valvular involvement.
  
  
  RESULTS
  During the one-year study period, 22 patients had valvular disease. Seventeen (77.2%) patients showed regression in valvular pathology. An initial mild regurgitation disappeared in eight patients (36.3%). Among seven (31.8%) patients with moderate regurgitation initially, the regurgitation disappeared in three, and four patients improved to mild regurgitation. Two patients with a severe regurgitation initially improved to moderate regurgitation (9.1%). In five (22.8%) patients, the grade of regurgitation [moderate regurgitation in one (4.6%), and severe regurgitation in 4 (18.2%)] remained unchanged. The albumin level was significantly lower at diagnosis in Group 2 (2.6±0.48g/dL). Lymphocyte subset analysis showed a significant decrease in the CD8 percentage and a significant increase in CD19 percentage at diagnosis in Group 2 compared to Group 1.
  
  
  CONCLUSIONS
  The blood albumin level and the percentage of CD8 and CD19 (+) lymphocytes at diagnosis may help to predict chronic valvular disease risk in patients with acute rheumatic carditis.
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Pediatric Cardiology, Izmir, Turkey.
authors.forename: Taliha
authors.initials: T
authors.lastname: Oner
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Pediatric Cardiology, Izmir, Turkey. Electronic address: rahmiozdemir35@gmail.com.
authors.forename: Rahmi
authors.initials: R
authors.lastname: Ozdemir
authors.affiliation: Sisli Etfal Training and Research Hospital, Pediatric Oncology, Istanbul, Turkey.
authors.forename: Dildar Bahar
authors.initials: DB
authors.lastname: Genc
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Pediatric Cardiology, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kucuk
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Pediatric Cardiology, Izmir, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Karadeniz
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Pediatric Cardiology, Izmir, Turkey.
authors.forename: Savas
authors.initials: S
authors.lastname: Demirpence
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Pediatric Cardiology, Izmir, Turkey.
authors.forename: Murat Muhtar
authors.initials: MM
authors.lastname: Yilmazer
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Pediatric Cardiology, Izmir, Turkey.
authors.forename: Timur
authors.initials: T
authors.lastname: Mese
authors.affiliation: Izmir Dr. Behcet Uz Children's Hospital, Pediatric Cardiology, Izmir, Turkey.
authors.forename: Vedide
authors.initials: V
authors.lastname: Tavli
authors.affiliation: Izmir Dr. Behçet Uz Children's Hospital, Pediatric Immunology, Izmir, Turkey.
authors.forename: Ferah
authors.initials: F
authors.lastname: Genel
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D018941:Antigens, CD19 / Q000276:immunology*; D000989:Antistreptolysin / Q000097:blood; D001022:Aortic Valve Insufficiency / Q000145:classification / Q000175:diagnosis*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002648:Child; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000145:classification / Q000175:diagnosis*; D009205:Myocarditis / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000097:blood / Q000175:diagnosis*; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D018941:Antigens, CD19; D012709:Serum Albumin; D000989:Antistreptolysin
keywords: Acute rheumatic carditis; Albumin; Albumina; CD19; CD8; Cardite reumática aguda; Lymphocyte subtypes; Subtipos de linfócitos