Increased nitric oxide in exhaled air in patients with rheumatic heart disease

Background: Endogenous production of nitric oxide and its presence in exhal ed air was observed in humans. Prior studies have yielded contrasting infor mation about the production of nitric oxide in patients with heart failure. Aims: The aim of this study was to measure nitric oxide in the exhaled air of patients with chronic rheumatic heart disease with and without pulmonar y hypertension. Methods: Seventy-four patients (6 patients had isolated mit ral stenosis; 13 patients had combined mitral stenosis and mitral regurgita tion; 1 patient had isolated mitral regurgitation; 54 patients had combined mitral and aortic valve disease) and 27 healthy subjects were entered in t he study. The nitric oxide concentration in exhaled air was determined with a chemiluminescence analyser. Echocardiography was performed in all patien ts to assess the severity of the valve disease and for the measurement of p ulmonary artery pressure. Results: The level of exhaled nitric oxide was si gnificantly greater in patients with rheumatic heart disease than in contro ls. The value of nitric oxide concentration in exhaled air was significantl y increased in patients with pulmonary hypertension, as compared with patie nts who had normal pulmonary artery systolic pressure. Conclusion: We found increased nitric oxide in the exhaled air in patients with rheumatic heart disease, especially in those with pulmonary hypertension, compared with he althy patients. (C) 2001 European Society of Cardiology. All rights reserve d.