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Role of Lymphocyte Subsets in Pathogenesis of Chronic Rheumatic Heart Disease

Department of Cardiovascular and Thoracic Surgery 1 Department of Experimental Medicine 2 Department of General Surgery Postgraduate Institute of Medical Education and Research Chandigarh, India

For reprint information contact: Rajendar K Suri, MS Department of Cardiovascular and Thoracic Surgery Postgraduate Institute of Medical Education and Research Chandigarh 160012, India Tel: 91 172 54 1031 Ext. 302 Fax: 91 172 54 0401

Analyses of lymphocyte subsets using flow cytometry were conducted to determine the significance of these cells in the pathogenesis of chronic rheumatic heart disease. Lymphocytes (B cells, T cells, CD4 cells, CD8 suppressor or cytotoxic T cells, activated T cells, and natural killer cells) were measured in blood and left atrial appendage samples of 30 patients with rheumatic heart disease and 10 patients with acyanotic congenital heart disease. Monoclonal fluorescent-labeled antibodies were used to identify various cells by flow cytometry. There was a significant increase in CD4 cells and activated T cells with a significant decrease in B cells in the left atrial appendage tissue of patients with rheumatic heart disease compared to those in the control group. There was no significant difference between the two groups in the distribution pattern of T lymphocytes in peripheral blood. These changes in rheumatic heart disease reflect an abnormal immunoregulatory mechanism with an ongoing enhanced immunological process continuing into the chronic phase of the disease. In our opinion, this persistent T cell response may lead to fresh damage to the myocardium and deformation of the heart valves.