Cardiol Young. 2026 Oct 28:1-7. doi: 10.1017/S1047951126124615. Online ahead of print.
ABSTRACT
PURPOSE: Rheumatic heart disease remains a major cause of cardiovascular morbidity in children. Although echocardiography is central to diagnosis and staging, it does not directly reflect inflammatory processes that may contribute to ongoing valvular damage. This study aimed to evaluate the association between baseline haematologic parameters and persistent rheumatic heart disease stage in children with prior acute rheumatic fever.
METHODS: In this single-centre retrospective pilot study, 45 children with persistent rheumatic heart disease were classified as Stage A (n = 23), Stage B (n = 14), or Stage C (n = 8) according to the 2023 World Heart Federation echocardiographic staging framework. Baseline laboratory values obtained during acute presentation were analysed. Clinical and laboratory variables were compared across stages using non-parametric tests. Binary logistic regression identified factors associated with advanced disease (Stage B-C vs Stage A).
RESULTS: Markers reflecting acute inflammatory activity, including leukocyte counts and derived indices, did not differ significantly among stages. In contrast, red cell distribution width, mean platelet volume, and platelet distribution width differed significantly. In multivariable analysis, red cell distribution width, and mean platelet volume were independently associated with advanced persistent rheumatic heart disease stage, with higher values linked to increased odds of Stage B-C disease.
CONCLUSION: Red cell distribution width and mean platelet volume were associated with advanced stages of persistent paediatric rheumatic heart disease. These widely available haematologic markers may complement echocardiographic assessment. Larger prospective studies are needed to define their clinical utility.Trial registration: Not applicable (retrospective study).
PMID:42947450 | DOI:10.1017/S1047951126124615