An analysis of the relationship between mitral valve chordae tendi̇nea rupture and the level of alpha-1 antitrypsin and oxidative stress

Background and Aim: In this study, we planned to seek the relationship among IL-6 and TNF-alpha, markers of inflammation; total oxidant activity (TOA) and total antioxidant activity (TAA) important indicators of oxidative balance; alpha-1 antitrypsin, an important role in the anti-inflammatory balance and mitral chorda tendinea rupture (CTR). Material and Method: 30 patients with severe rheumatic mitral regurgitation (MR), 30 patients having (CTR) and 20 healthy participants took part in this study. After transthoracic echocardiography was performed, diagnoses were confirmed by transoesophageal echocardiography. Plasma IL-6, TAA-TOA, TNF-alpha, alpha 1-antitrypsin levels were measured and OSI indexes were calculated. Results: Compared with the rheumatic severe MR patients and the control group, the TOS-OSI levels in the CTR group were significantly higher (p=0.038, p=0.019 respectively). The alpha 1-antitrypsin levels in the rheumatic severe MR were significantly lower compared with the control group (p=0.017). The TNF-alpha levels in the rheumatic severe MR group were significantly higher compared to CTR group (p=0.028). Conclusion: We found a significant relationship between the CTR and oxidative stress levels (TOA-OSI) in our study. According to our study, high oxidative stress might be accepted as a risk factor for CTR. We think that the low levels of alpha 1- antitrypsin may play a role in the development of severe rheumatic MR. Also we observed that the TNF-alpha levels in the rheumatic severe MR group were higher than CTR group. These data support the role of inflammation in rheumatic MR. Keywords: Oxidative stress, alpha 1 – antitrypsin, mitral valve chorda tendinea rupture