Expression of the CD44 Protein in the Heart Valves Affected with Rheumatic Heart Disease

Problem statement: The primary aim was to study the expression of CD44 protein in the heart valves removed surgically for either stenosis or regurgitation and to study the morphology of valves using histochemical staining. Approach: We studied 107 valves which were collected from the International Centre for Cardio Thoracic and Vascular Diseases. Results: Aortic and mitral valves were obtained from the centre and processed in research pathology lab. CD44 protein is a receptor for the ligand hyaluronic acid which causes inflammation in the heart valves. A total of 107 valves were studied. Of the 61 mitral valves studied 38 (62.2%) showed CD44 positivity as brownish granules within the cytoplasm. Of the 46 aortic valves studied 19 (41.3%) showed CD44 positivity as brownish granules within the cytoplasm. The valves showed evidence of past inflammation showing thick and thin walled blood vessels and lymphocytes. CD44 protein increased in 62.2% of mitral valves, of which 60.5% were from patients presenting when they were less than 40 years old. CD44 protein increased in 41.3% of aortic valves, of which 63.15% were from patients presenting when they were less than 40 years old. CD44 positivity was seen in 57 valves as brownish granules within the cytoplasm of the cell. CD44 protein increased in 53.27% of mitral and aortic valves, of which 63.15% were from the males patients. CD44 protein increased in 53.27% of mitral and aortic valves, of which 36.84% were from the females patients. Conclusion/Recommendations: The results showed CD44 is over expressed in the heart valves removed surgically for stenosis or regurgitation where the hyaluronic acid content is high.