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Review

Upstream and Downstream Cardiovascular Changes in Rheumatic Mitral Stenosis: An Update

by
Estu Rudiktyo
1,
Arco J. Teske
2,
Emir Yonas
1,
Ade M. Ambari
1,
Maarten J. Cramer
2,
Marco Guglielmo
2,*,
Tommaso Semino
3,
Bambang Budi Siswanto
1,
Pieter A. Doevendans
2,4,5 and
Amiliana M. Soesanto
1
1
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia—National Cardiovascular Center Harapan Kita, Jakarta 11420, Indonesia
2
Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, 3584 Utrecht, The Netherlands
3
Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties (Di.M.I.), University of Genoa, 16126 Genova, Italy
4
Central Military Hospital, 3584 Utrecht, The Netherlands
5
Netherlands Heart Institute, 3511 Utrecht, The Netherlands
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(8), 2639; https://doi.org/10.3390/jcm14082639
Submission received: 28 January 2025 / Revised: 6 March 2025 / Accepted: 10 April 2025 / Published: 11 April 2025
(This article belongs to the Section Cardiovascular Medicine)
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Abstract

Rheumatic heart disease (RHD) and its complications are major health problems worldwide, especially in developing countries, owing to their high prevalence. Mitral stenosis (MS) is one of the most common lesions in RHD, either isolated or in combination with mitral regurgitation, and eventually leads to atrial fibrillation (AF), congestive heart failure, pulmonary hypertension (PH), and other complications, including ischemic stroke or limb ischemia, if not promptly diagnosed and treated. Recent studies have suggested that MS affects the cardiovascular system beyond mere obstructions. The presence of MS in RHD causes significant changes in the cardiovascular system, both upstream and downstream, affecting both the left and right ventricles. Rheumatic MS causes significant structural changes through inflammatory pathways and hemodynamic changes, owing to its obstructive effects. This review aims to discuss the vast changes in the cardiovascular system caused by rheumatic MS.
Keywords: rheumatic heart disease; mitral stenosis; ventricular dysfunction; atrial fibrillation; pulmonary hypertension rheumatic heart disease; mitral stenosis; ventricular dysfunction; atrial fibrillation; pulmonary hypertension

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MDPI and ACS Style

Rudiktyo, E.; Teske, A.J.; Yonas, E.; Ambari, A.M.; Cramer, M.J.; Guglielmo, M.; Semino, T.; Siswanto, B.B.; Doevendans, P.A.; Soesanto, A.M. Upstream and Downstream Cardiovascular Changes in Rheumatic Mitral Stenosis: An Update. J. Clin. Med. 2025, 14, 2639. https://doi.org/10.3390/jcm14082639

AMA Style

Rudiktyo E, Teske AJ, Yonas E, Ambari AM, Cramer MJ, Guglielmo M, Semino T, Siswanto BB, Doevendans PA, Soesanto AM. Upstream and Downstream Cardiovascular Changes in Rheumatic Mitral Stenosis: An Update. Journal of Clinical Medicine. 2025; 14(8):2639. https://doi.org/10.3390/jcm14082639

Chicago/Turabian Style

Rudiktyo, Estu, Arco J. Teske, Emir Yonas, Ade M. Ambari, Maarten J. Cramer, Marco Guglielmo, Tommaso Semino, Bambang Budi Siswanto, Pieter A. Doevendans, and Amiliana M. Soesanto. 2025. "Upstream and Downstream Cardiovascular Changes in Rheumatic Mitral Stenosis: An Update" Journal of Clinical Medicine 14, no. 8: 2639. https://doi.org/10.3390/jcm14082639

APA Style

Rudiktyo, E., Teske, A. J., Yonas, E., Ambari, A. M., Cramer, M. J., Guglielmo, M., Semino, T., Siswanto, B. B., Doevendans, P. A., & Soesanto, A. M. (2025). Upstream and Downstream Cardiovascular Changes in Rheumatic Mitral Stenosis: An Update. Journal of Clinical Medicine, 14(8), 2639. https://doi.org/10.3390/jcm14082639

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