Clinical and echocardiographic features of children with rheumatic carditis: correlation with high sensitivity C-reactive protein

ABSTRACT

Rheumatic fever [RF] and rheumatic heart disease [RHD] are leading causes of cardiovascular mortality and morbidity in developing countries. To describe the clinical and echocardiographic features of children with RF and RHD and compare these features with their serum C-reactive protein in 2 pediatric cardiology centers in Khartoum. It was a prospective cross sectional study. Patients were examined clinically and by echocardiography. Serum high sensitivity C-reactive protein [hsCRP] was measured from children with Acute RF as well as from healthy age and sex matched controls selected from children attending the clinics. Statistical Analysis Used Mean and standard deviation, P value using Fisher's exact test. Sixty six patients [45% males] were enrolled. Mitral regurgitation [MR] was found in 65 patients [98%], it was severe in 42 patients [64%], combined with aortic regurgitation [AR] in 27 patients [41%] and with Mitral stenosis [MS] in 3 patients [4.5%]. For patients with carditis, hsCRP ranged between 1.10 and 15 mg/1 [mean 8.0817, SD 4.47]. In the control group it was 0.6-1.3 mg/1 [mean 0.93 SD 0.23] P<0.0001.Patients with Acute RF had hsCRP mean of 12.35 mg/1 [SD 2.11] while those with chronic RHD had hsCRP mean of 7.34 mg/1 [SD 4.16], P<0.0001. RHD is manifested in our patients with severe valve damage dominated by MR and there is evidence of an ongoing inflammation during the chronic phase. RHD is manifested in a severe form in Sudan. High sensitivity CRP is elevated in acute phase as well as in the chronic phase