Recently, we have also found that the circulating levels of adhesion molecules, such as vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1), were significantly elevated in patients with rheumatic mitral stenosis.5 In addition, the plasma levels of soluble VCAM-1 and ICAM-1 in the left atrium (1,232.8 ± 612.1 ng/mL and 778.5 ± 311.8 ng/mL, respectively) did not differ from those in the right atrium (1,157.7 ± 477.1 ng/mL and 755.6 ± 334.7 ng/mL, respectively), femoral vein (1,205.4 ± 462.4 ng/mL and 772.6 ± 305.8 ng/mL, respectively) or femoral artery (1,211.5 ± 503.9 ng/mL and 808.3 ± 391.3 ng/mL, respectively) [p = 0.668 for VCAM-1 and p = 0.232 for ICAM-1]. Moreover, we have demonstrated that the elevated plasma soluble VCAM-1 concentration is associated with hemodynamic abnormality rather than with rheumatic activity. As these adhesion molecules are expressed on vascular endothelium and on immune and inflammatory cells, our observation is consistent with the finding of Lip et al regarding the left atrial plasma levels of interleukin-6 in patients with mitral stenosis. In conclusion, different assay methods might produce different results. Larger studies should be conducted to provide a definite conclusion as to which method is optimal.