Abstract

DIAZ RUIZ, María Valentina; BLANDENIER DE SUAREZ, Claudia Antonieta; TREJO, Ernesto  and  HAMANA DE RAMIREZ, Leticia. Determinación de la densidad y heterogeneidad de la angiogénesis en la valvulitis crónica reumática. Gac Méd Caracas. [online]. 2009, vol.117, n.1, pp.29-40. ISSN 0367-4762.

In the developing countries the rheumatic fever still constitutes a health problem. The rheumatic valvulopathy is serious because in most of the cases replacement of the affected valve is needed, including adolescent patients and in the average age of the life. The evolution of the valvular lesions is progressive with fibrous remodeling of the structures. Histologically the angiogenesis density is variable and heterogeneous depending on different growth factors. The objective was to determine the angiogenesis density and heterogeneity in three stages of progression of the rheumatic chronic valvulitis and their relation with the fibrosis and inflammation. Histopathologic and immunohisthochemical analysis of 60 biopsies was done on patients with replacement of the mitral valve, of both sexes, divided in three groups that characterize stages of progression of the chronic valvulitis. Each type of neovasculature’s valvular density and its relation to the inflammation and fibrosis degree was estimated. The age averages of groups 1.2 and 3, were: 15.3 ± 0.6; 31 ± 1.5 and 49.7 ± 1.4 years, respectively. The total angiogenesis, density (vasos/mm2) decreassed from group 1 to the 3; 14.78±1.92; 5.98±1.08 and 3.55±0.76 (P< 0.001), ANOVA, F = 19.162. The predominant angiogenesis was the “mother-vase”, transitory structure that evolves to the intermediate and most stable forms: (“children vases” and “vases with muscular walls”). The presence of the neovascular density’s variability and the heterogeneity in the chronic stage of the rheumatic valvulopathy in relation to the inflammatory and of healing process could be explained as the effect of different growth factors.

Keywords : Rheumatic fever; Rheumatic heart disease; Valvular disease.