Evidence map›Paper›PMID 34154748›Full record

ArticleIndian heart journal

Detecting sub-clinical disease activity in patients with chronic rheumatic valvular heart disease.

Aayush Kumar Singal, Velayoudam Devagourou, Milind Padmakar Hote, Shiv Kumar Choudhary, Neeraj Parakh, Ruma Ray, Ramakrishnan Lakshmy, Ganesan Karthikeyan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Indian heart journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 27% 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

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Review
  3. The Role of Inflammation and Oxidative Stress in Rheumatic Heart Disease.International journal of molecular sciences · 2022
    Review
  4. 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

8 authors at 1 institution in 1 country.

Aayush Kumar SingalDepartment of Cardiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Velayoudam DevagourouDepartment of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Milind Padmakar HoteDepartment of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Shiv Kumar ChoudharyDepartment of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Neeraj ParakhDepartment of Cardiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Ruma RayDepartment of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Ramakrishnan LakshmyDepartment of Cardiac Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Ganesan KarthikeyanDepartment of Cardiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India. Electronic address: karthik2010@gmail.com.
All India Institute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveValve disease progression in rheumatic heart disease(RHD) is generally attributed to recurrent attacks of acute rheumatic fever(ARF). However, persistence of chronic sub-clinical inflammation remains a plausible but unproven cause. Non-invasive means to identify sub-clinical inflammation may facilitate research efforts towards understanding its contribution to disease progression.

methodsPatients with chronic RHD, without clinical evidence of ARF, undergoing elective valve surgery were enrolled. Sub-clinical inflammation was ascertained by histological evaluation of left atrial appendage and valve tissue excised during surgery. We assessed the diagnostic utility of Gallium-67 scintigraphy imaging, and inflammatory biomarkers, hsCRP, IL-2, IL-6, Tumor Necrosis Factor-Alpha(TNF-α), Interferon-gamma(IFN-γ), and Serum Amyloid A(SAA), in identifying patients with sub-clinical inflammation.

resultsOf the 93 RHD patients enrolled(mean age 34 ± 11 years, 45% females), 86 were included in final analysis. Sub-clinical inflammation was present in 27 patients(31.4%). Patients with dominant regurgitant lesions were more likely to have sub-clinical inflammation compared to those with stenotic lesions, though this association was not statistically significant(dominant regurgitant lesions vs isolated mitral stenosis: OR 3.5, 95%CI 0.68-17.96, p = 0.133). Inflammatory biomarkers were elevated in the majority of patients: hsCRP, IL-2, IL-6, TNF-α, and IFN-γ in 44%, 89%, 90%, 79%, and 81% patients, respectively. However, there was no significant association between biomarker elevation and histologically ascertained sub-clinical inflammation. Ga-67 imaging was unable to identify inflammation in the 15 patients in whom it was performed.

conclusionSub-clinical inflammation is common in RHD patients. Conventional inflammatory markers are elevated in the majority, but aren't discriminatory enough to identify the presence of histologic inflammation.

Indexed as

Heart Valve DiseasesRheumatic Heart DiseaseAdultFemaleHumansInflammationMaleMiddle AgedMitral Valve StenosisRheumatic FeverGa-67 scintigraphyInterferonsMyocardial lympho-mononuclear infiltrationRheumatic heart diseaseSub-clinical inflammation

Identifiers

PMID34154748
PMCPMC8322815
OpenAlexW3134477885

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.