High Sensitivity C-reactive Protein and Antistreptolysin O Titers in Chronic Rheumatic Mitral Stenosis

Background: We aimed to determine whether there is persistent of the inflammatory process in chronic rheumatic mitral stenosis by measuring the levels of high sensitive C-reactive protein (hs-CRP) and antistreptolysin O (ASO) titers. Positive result could provide insights into new therapies for delaying the progression of rheumatic heart disease. Methods: hs-CRP and ASO titers were collected from stable rheumatic mitral stenosis patients who were being followed up as outpatients at Rhamathibodi Hospital, and also from a control group of healthy subjects. Patients with acute infection malignancy and coronary artery disease (CAD) were excluded. Hs-CRP was determined using latex-enhanced particle immunoturbidimetry assays. Results: A total of 31 patients with chronic rheumatic mitral stenosis (20 women, 11 men) and a control group of 31 healthy subjects (5 women, 26 men) were assessed. The levels of hs-CRP were significantly higher in patients with chronic rheumatic mitral stenosis than in the healthy subjects (3.85 ± 4.42 vs 1.02 ± 1.12 mg/ml, p 0.002). There were no significant differences in ASO titers between both groups (131.2 ± 91.2 vs 153.4 ± 87.7 iu/ml, p 0.26). No correlation was observed between hs-CRP and ASO titers, severity of mitral stenosis or left atrium dimensions. Conclusion: Our study found that hs-CRP levels are increased in chronic rheumatic heart disease. This finding may indicate that the inflammatory response still persists in the chronic phase, although the etiology of the inflammatory process could not be identified due to the lack of correlation between hs-CRP levels and ASO titers.