Evidence map›Paper›PMID 28431520›Full record

Observational studyBMC infectious diseases2017

Infectious agents is a risk factor for myxomatous mitral valve degeneration: A case control study.

Marcos Gradim Tiveron, Pablo Maria Alberto Pomerantzeff, Maria de Lourdes Higuchi, Marcia Martins Reis, Jaqueline de Jesus Pereira, Joyce Tieko Kawakami, Renata Nishiyama Ikegami, Carlos Manuel de Almeida Brandao, Fabio Biscegli Jatene

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 46% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Immune Mechanisms of Heart Valve Development, Homeostasis, and Disease.Arteriosclerosis, thrombosis, and vascular biology · 2026
    Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Marcos Gradim TiveronProgram in Thoracic and Cardiovascular Surgery, Medical School, University of Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44, Sao Paulo, 05403-900, Sao Paulo, Brazil. mgtiveron@yahoo.com.br.
Pablo Maria Alberto PomerantzeffHeart Institute of the Clinical Hospital, Medical School, University of Sao Paulo, Sao Paulo, Brazil.
Maria de Lourdes HiguchiHeart Institute of the Clinical Hospital, Medical School, University of Sao Paulo, Sao Paulo, Brazil.
Marcia Martins ReisHeart Institute of the Clinical Hospital, Medical School, University of Sao Paulo, Sao Paulo, Brazil.
Jaqueline de Jesus PereiraHeart Institute of the Clinical Hospital, Medical School, University of Sao Paulo, Sao Paulo, Brazil.
Joyce Tieko KawakamiHeart Institute of the Clinical Hospital, Medical School, University of Sao Paulo, Sao Paulo, Brazil.
Renata Nishiyama IkegamiHeart Institute of the Clinical Hospital, Medical School, University of Sao Paulo, Sao Paulo, Brazil.
Carlos Manuel de Almeida BrandaoHeart Institute of the Clinical Hospital, Medical School, University of Sao Paulo, Sao Paulo, Brazil.
Fabio Biscegli JateneHeart Institute of the Clinical Hospital, Medical School, University of Sao Paulo, Sao Paulo, Brazil.
Universidade de São Paulo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe etiology of myxomatous mitral valve degeneration (MVD) is not fully understood and may depend on time or environmental factors for which the interaction of infectious agents has not been documented. The purpose of the study is to analyze the effect of Mycoplasma pneumoniae (Mp), Chlamydophila pneumoniae (Cp) and Borrelia burgdorferi (Bb) on myxomatous mitral valve degeneration pathogenesis and establish whether increased in inflammation and collagen degradation in myxomatous mitral valve degeneration etiopathogenesis.

methodsAn immunohistochemical test was performed to detect the inflammatory cells (CD20, CD45, CD68) and Mp, Bb and MMP9 antigens in two groups. The in situ hybridization was performed to detect Chlamydophila pneumoniae and the bacteria study was performed using transmission electron microscopy. Group 1 (n = 20), surgical specimen composed by myxomatous mitral valve degeneration, and group 2 (n = 20), autopsy specimen composed by normal mitral valve. The data were analyzed using SigmaStat version 20 (SPSS Inc., Chicago, IL, USA). The groups were compared using Student's t test, Mann-Whitney test. A correlation analysis was performed using Spearman's correlation test. P values lower than 0.05 were considered statistically significant.

resultsBy immunohistochemistry, there was a higher inflammatory cells/mm2 for CD20 and CD45 in group 1, and CD68 in group 2. Higher number of Mp and Cp antigens was observed in group 1 and more Bb antigens was detected in group 2. The group 1 exhibited a positive correlation between the Bb and MVD percentage, between CD45 and Mp, and between MMP9 with Mp. These correlations were not observed in the group 2. Electron microscopy revealed the presence of structures compatible with microorganisms that feature Borrelia and Mycoplasma characteristics.

conclusionsThe presence of infectious agents, inflammatory cells and collagenases in mitral valves appear to contribute to the pathogenesis of MVD. Mycoplasma pneumoniae was strongly related with myxomatous mitral valve degeneration. Despite of low percentage of Borrelia burgdorferi in MD group, this agent was correlated with myxomatous degeneration and this may occour due synergistic actions between these infectious agents likely contribute to collagen degradation.

Indexed as

AgedBorrelia burgdorferiCase-Control StudiesChicagoChlamydophila pneumoniaeCollagenFemaleHumansImmunohistochemistryMaleMatrix Metalloproteinase 9Microscopy, Electron, TransmissionMiddle AgedMitral ValveMitral Valve InsufficiencyMycoplasma pneumoniaeCollagenMatrix Metalloproteinase 9Borrelia burgdorferiChlamydophila pneumoniaeInflammatory markersMetalloproteinasesMitral valveMycoplasma pneumoniaeMyxomatous degeneration

Identifiers

PMID28431520
PMCPMC5399830
OpenAlexW2606454495

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.