Rheumatic heart disease in the modern era: recent developments and current challenges

Leal, Matheus Tozatto Baptista Coelho; Passos, Lívia Silva Araújo; Guarçoni, Felipe Vieira; Aguiar, João Marcelo de Souza; Silva, Rafael Benjamim Rosa da; Paula, Thiago Mendonça Nunes de; Santos, Rafael Figueiredo Dos; Nassif, Martina; Gomes, Nayana Flamini Arantes; Tan, Timothy C.; Nunes, Maria Carmo Pereira

doi:10.1590/0037-8682-0041-2019

Cited by 36 publications

(23 citation statements)

References 83 publications

(110 reference statements)

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“…Portanto, são excluídas dessa classificação valvopatias secundárias a uma valvopatia primária, como é o caso da IT funcional, consequente à doença mitral, assim como a IM secundária ao remodelamento ventricular esquerdo consequente à valvopatia aórtica (Quadro 54). [163][164][165] No Brasil, a doença multivalvar é resultado do acometimento reumático na maioria das vezes, porém há um aumento progressivo de doença mitroaórtica degenerativa calcífica (Quadro 55). 159 Os sintomas geralmente estão associados à valvopatia de maior gravidade anatômica e, nos casos em que ambas são importantes, a valvopatia mais proximal costuma prevalecer (Quadro 56).…”

Section: Doença Multivalvarunclassified

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Atualização das Diretrizes Brasileiras de Valvopatias – 2020

Tarasoutchi¹,

Montera²,

Ramos³

et al. 2020

Arquivos Brasileiros De Cardiologia

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Section: Doença Multivalvarunclassified

“…O tratamento padrão da doença mitroaórtica com sintomas e/ou complicadores é o tratamento cirúrgico, no entanto, as estratégias transcateter podem ser indicadas em casos selecionados, principalmente em pacientes com alto risco presumido para cirurgia convencional (Quadros 58 e 59). [163][164][165] Tarasoutchi et al…”

Section: Doença Multivalvarunclassified

Atualização das Diretrizes Brasileiras de Valvopatias – 2020

Tarasoutchi¹,

Montera²,

Ramos³

et al. 2020

Arquivos Brasileiros De Cardiologia

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“…Rheumatic heart disease (RHD) is a major burden in low-to mid-income countries, where it is the leading cause of cardiovascular death in children and young adults [5][6][7] . Severe valve disease, which is potentially amenable to intervention, remains strongly associated with mortality 6,8 , especially where life-saving cardiac surgery is either scarce or absent.…”

Section: Introductionmentioning

confidence: 99%

Raising awareness for rheumatic mitral valve disease

Passos

Nunes

Zilla

et al. 2020

gcsp

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Rheumatic heart disease (RHD) is a major burden in low- to mid-income countries, where each year it accounts for over a million premature deaths associated with severe valve disease. Life-saving valve replacement procedures are not available to the majority of affected RHD patients, contributing to an increased risk of death in young adults and creating a devastating impact. In December 2017, a group of representatives of major cardiothoracic societies and industry, discussed the plight of the millions of patients who suffer from RHD. A comprehensive solution based on this global partnership was outlined in "The Cape Town Declaration on Access to Cardiac Surgery in the Developing World". The key challenge in controlling RHD is related to identification and removal of barriers to the translation of existing knowledge into policy, programs, and practice to provide high-quality care for patients with RHD. This review provides an overview on RHD by emphasizing the disease medical and economic burdens worldwide, risk factors, recent advance for early disease detection, and overall preventive strategies.

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“…RHD is a preventable heart disease that is caused by Streptococcus pyogenes or group A streptococcal (GAS) infection [1]. RHD continues to be a leading cause of deaths and disability in young patients and remains a serious public health problem worldwide [2]. At present, the number of people with RHD disability in the world exceeds one quarter of the number of people with cancer disability, and the number of deaths caused by RHD each year is as high as 250,000 [3].…”

Section: Introductionmentioning

confidence: 99%

Intervening in the S1PR1/STAT3 Signaling Pathway Attenuates Valvular Damage Due to Rheumatic Heart Disease

Xian

Chen

et al. 2020

Preprint

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Background: Rheumatic heart disease (RHD) affects many patients every year, but its pathogenesis is still unclear. Recent studies have found that the sphingosine 1-phosphate receptor 1 (S1PR1)/signal transducer and activator of transcription 3 (STAT3) signaling pathway is involved in valvular damage by promoting the differentiation of T helper 17 (Th17) cells during the development of valvular damage caused by RHD. In this work, we investigated whether altering the S1PR1/STAT3 signaling pathway attenuates valvular damage due to RHD. Methods: Inactivated Group A streptococci (GAS) was used to establish the RHD rat model. Recombinant adeno-associated virus (serotype 9) vectors carrying the S1PR1 overexpression sequence was used to overexpress the expression of S1PR1. STAT3-small interfering RNA (STAT3-siRNA) was used to inhibit the expression of STAT3. Reverse transcription-quantitative PCR (RT-qPCR) was used to detect the mRNA expression of S1PR1, STAT3, collagen type III α1 chain (Col3a1) and fibroblast-specific protein 1 (FSP1). Western blotting (WB) and immunohistochemistry were used to detect the protein expression of S1PR1, STAT3, phosphorylated (p-) STAT3, retinoic acid-related orphan receptor gamma T (RORγt). Enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry were used to detect the levels of interleukin (IL)-6 and IL-17. Haematoxylin and eosin (H&E) staining and Sirius red staining were used to evaluate the degree of inflammation and fibrosis in valve tissues.Results: The expression of S1PR1 in valve tissues of RHD model rats was decreased. The levels of IL-6 and IL-17 in valves and serum of RHD model rats were increased as well as an increase of p-STAT3. The degree of valvular inflammation and fibrosis of RHD model rats was increased. Overexpression of S1PR1 and Inhibition of STAT3 overexpressed S1PR1 expression and decreased STAT3 expression respectively and reduced the total amount of p-STAT3, resulting in decreased expression of IL-6, IL-17 and RORγt and reduced the degree of valvular inflammatory and fibrosis. Conclusions: These results suggest that the S1PR1/STAT3 signaling pathway is involved in regulating the Th17 cell-related cytokines during the vavular damage due to RHD, and altering the S1PR1/STAT3 signaling pathway could affect the expression of Th17 cell-related cytokines then attenuate the vavular damage due to RHD.

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Rheumatic heart disease in the modern era: recent developments and current challenges

Cited by 36 publications

References 83 publications

Atualização das Diretrizes Brasileiras de Valvopatias – 2020

Atualização das Diretrizes Brasileiras de Valvopatias – 2020

Raising awareness for rheumatic mitral valve disease

Intervening in the S1PR1/STAT3 Signaling Pathway Attenuates Valvular Damage Due to Rheumatic Heart Disease

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