Assessment of serum trace element levels in rheumatic heart disease: A case-control study

Aim: Some trace elements play important roles in various heart diseases. In this study, we aimed to determine the changes in some trace element concentrations in the serum of patients with rheumatic heart disease (RHD). Methods: Sixty-one patients with RHD and 60 healthy subjects were included in the study. Six subgroups were defined in the study group according to the Wilkins score, the degree of aortic involvement, and the presence or absence of pulmonary hypertension. Selenium (Se), Zinc (Zn), and Cupper (Cu) levels were measured, and transthoracic echocardiography was performed in all participants. Results: Serum Se and Zn concentrations were significantly lower in the patients compared to the controls (mean±SD and p 43.08±1.83 μg/dL vs. 60.75±2.44 μg/dL; t=-5.305？, p=0.001 and 64.65±2.77 μg/dL vs. 87.34±3.33 μg/dL; t=-5.458, p=0.001, respectively). However, the serum Cu concentration was significantly higher in the patient group than in the control group (84.50±3.50 μg/dL vs. 74.23±3.08 μg/dL; t=2.309, p=0.023). Similarly, the Cu/Zn ratio in the patient group was found to be significantly higher than the control group (1.4±0.09 μg/dL vs. 0.9±0.04 μg/dL; t=5.267, p=0.001). In the patient group, there was no significant relationship between the Wilkins score, aortic involvement, pulmonary hypertension, the serum trace element concentrations, and Cu/Zn ratio (p>0.05 for all). Conclusions: We conclude that the changes in the concentrations of the measured trace elements can predispose ？to RHD and play a role in the formation of certain factors that leads to the development of the ？disease. Besides, serum Cu levels and Cu/Zn ratio can be used as inflammatory process markers