The Role of Inflammation and Oxidative Stress in Rheumatic Heart Disease

Franczyk, Beata; Gluba-Brzózka, Anna; Rysz-Górzyńska, Magdalena; Rysz, Jacek

doi:10.3390/ijms232415812

Cited by 9 publications

(2 citation statements)

References 137 publications

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“…There is still a research gap for CS in clinical RHD in LICs. Both basic research [ 74 , 75 ] as well as non-interventional clinical studies [ 27 , 76 ] into RHD have taken off in previous years. In the near absence of CS, however, and no comparable international collaborations in place which cardiology established a few years ago [ 75 , 77 ], the sky is the limit for highly targeted clinical research focusing on rheumatic heart valve surgery under the circumstances of LICs.…”

Section: Way Forwardmentioning

confidence: 99%

Making a difference: 5 years of Cardiac Surgery Intersociety Alliance (CSIA)

Bolman,

Zilla,

Beyersdorf

et al. 2024

European Journal of Cardio-Thoracic Surgery

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Summary Informed by the almost unimaginable unmet need for cardiac surgery in the developing regions of the world, leading surgeons, cardiologists, editors in chief of the major cardiothoracic journals as well as representatives of medical industry and government convened in December 2017 to address this unacceptable disparity in access to care. The ensuing “Cape Town Declaration” constituted a clarion call to cardiac surgical societies to jointly advocate the strengthening of sustainable, local cardiac surgical capacity in the developing world. The Cardiac Surgery Intersociety Alliance (CSIA) was thus created, comprising The Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS), the European Association for Cardio-Thoracic Surgery (EACTS) and the World Heart Federation (WHF). The guiding principle was advocacy for sustainable cardiac surgical capacity in low-income countries. As a first step, a global needs assessment confirmed rheumatic heart disease as the overwhelming pathology requiring cardiac surgery in these regions. Subsequently, CSIA published a request for proposals to support fledgling programmes that could demonstrate the backing by their governments and health care institution. Out of 11 applicants, and following an evaluation of the sites, including site visits to the 3 finalists, Mozambique and Rwanda were selected as the first Pilot Sites. Subsequently, a mentorship and training agreement was completed between Mozambique and the University of Cape Town, a middle-income country with a comparable burden of rheumatic heart disease. The agreement entails regular video calls between the heart teams, targeted training across all aspects of cardiac surgery, as well as on-site presence of mentoring teams for complex cases with the strict observance of ‘assisting only’. In Rwanda, Team Heart, a US and Rwanda-based non-governmental organization (NGO) that has been performing cardiac surgery in Rwanda and helping to train the cardiac surgery workforce since 2008, has agreed to continue providing mentorship for the local team and to assist in the establishment of independent cardiac surgery with all that entails. This involves intermittent virtual conferences between Rwandan and US cardiologists for surgical case selection. Five years after CSIA was founded, its ‘Seal of Approval’ for the sustainability of endorsed programmes in Mozambique and Rwanda has resulted in higher case numbers, a stronger government commitment, significant upgrades of infrastructure, the nurturing of generous consumable donations by industry and the commencement of negotiations with global donors for major grants. Extending the CSIA Seal to additional deserving programmes could further align the international cardiac surgical community with the principle of local cardiac surgery capacity-building in developing countries.

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Section: Way Forwardmentioning

confidence: 99%

Making a difference: 5 years of Cardiac Surgery Intersociety Alliance (CSIA)

Bolman,

Zilla,

Beyersdorf

et al. 2024

European Journal of Cardio-Thoracic Surgery

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“…Rheumatic heart disease, a post-streptococcal complication of rheumatic fever (RF), is a disorder characterized by the impairment of one or multiple-heart valves, resulting in significant structural and hemodynamic abnormalities. 1 According to the Global Burden of Disease Study, the prevalence of RHD was 142.6 per 100,000 people in 2015, largely impacting low- and middle-income countries. 2 Despite the fact that patients with RF/RHD require early medical attention and follow-up, a significant number of patients in developing nations tends to present with debilitating complications such as heart failure, pulmonary hypertension, and arrhythmias.…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic Parameters and Complication Profiles Among Adult Patients with Rheumatic Heart Disease at Jimma Medical Center

Berhanu,

Mossie,

Morankar

et al. 2024

VHRM

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Background Despite the fact that patients with rheumatic heart disease (RHD) need early medical attention and follow-up, most patients in developing countries tend to present with debilitating complications. The objective of this study was to evaluate the echocardiographic features of adult individuals diagnosed with RHD and examine the associated complications among patients who started follow-up at Jimma Medical Center’s (JMC) cardiac follow-up clinic. Methods A prospective cross-sectional study was conducted at JMC between January 5 and April 15, 2023. Echocardiographic patterns were taken by senior cardiologists; socio-demographic variables, anthropometric measurements, and behavioral factors were collected through a structured questioner. Results The study recruited a total of 115 participants, of whom 86 (74.8%) were female and 29 (25.2%) were male. The mean age of the patients was 32.31 (SD± 12.16) years. The mitral valve was affected in 98.26% of cases, while the aortic and tricuspid valve abnormalities were diagnosed in 49.5% and 21.7%, respectively. The most frequent combinations of valve lesions were mitral regurgitation (MR) + mitral stenosis (MS) + aortic regurgitation (AR) (15.7%), followed by MR + AR + TR (8.7%). The occurrence of MR+MS+AR was higher in females (17.4%) compared to males (10.3%), whereas the occurrence of MS+MR was higher in males (24.1%) compared to females (20.9%). Females have a severely reduced ejection fraction compared to males (84.8% vs 15.2%, P = 0.044). Nearly two-thirds (63.5%) of individuals experienced RHD-related complications; the most commonly encountered complications were pulmonary hypertension (26.1%) and atrial fibrillation (19.1%). Conclusion RHD predominantly affects individuals in their active and productive years, particularly females. Most patients have multiple-valve lesions.

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