A hospital-based survey of patients with severe valvular heart disease in China

Hu, Po; Liu, Xianbao; Liang, Jie; Zhu, Qionghua; Pu, Chao-Xia; Tang, May; Wang, Jianan

doi:10.1016/j.ijcard.2016.11.301

“… 23 For one facility in Zhejiang over the period 2010–2015, RHD prevalence was 1.6% in adult patients. 26 Similarly in 2008 RHD still comprised 20% of all cardiac surgery cases in Beijing. 27 At a Shanghai facility, 0.5% of 20 983 women delivering during 1993–2007 had RHD.…”

Section: Resultsmentioning

confidence: 99%

Rheumatic heart disease across the Western Pacific: not just a Pacific Island problem

Abouzeid

¹

,

Katzenellenbogen

²

,

Wyber

³

et al. 2017

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Some of the highest recorded rheumatic heart disease (RHD) prevalence and mortality rates are from the World Health Organization’s Western Pacific Region (WPR). RHD burden has been well documented in much of the WPR subregion of Oceania, but less is known about RHD outside the Pacific Islands and Australasia. We aimed to review RHD burden in WPR outside Oceania to identify countries with high RHD burden and those with contemporary data gaps. We searched the peer-reviewed literature for English-language primary studies published between 1980 and April 2017 that reported RHD prevalence or mortality in the 13 WPR countries/areas outside Oceania, and Taiwan. We also searched for official government reports and health indicator documents. Results were synthesised narratively and reported stratified by 2015 Human Development Index (HDI) level. 30 peer-reviewed publications fulfilling inclusion criteria were identified, representing nine countries/areas. RHD prevalence and mortality have fallen in association with economic development, particularly in very high HDI countries. In several countries that have undergone recent economic development, RHD persists particularly among older populations. In poorer WPR countries there is a persistent RHD burden, including in young populations. Some countries had no available data. Although RHD burden has declined in many high-resource settings across the WPR, in several poorer countries, the impact of RHD appears to continue. Elsewhere, insufficient contemporary data make it difficult to gauge the current status of RHD burden and control. Concerted efforts are needed to fill information gaps and implement action to address this avoidable disease.

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“…Due to the superior social and economic status and favorable living environment found in China, the etiology of VHD may have changed. A retrospective hospital-based survey in China suggested that rheumatic fever and degenerative valvular changes remained predominant etiologies in patients < 65 and ≥65 years of age, respectively [16]. In our survey, degenerative diseases had become the leading cause of VHD in a population ≥ 65 years of age, average values being 30.6%, 49.2%, and 62.9% in 65-74, 75-84, and ≥85 years of age, respectively, which were consistent with the data from previous cross-sectional population studies [2].…”

Section: Discussionmentioning

confidence: 99%

The Evolving Epidemiology of Elderly with Degenerative Valvular Heart Disease: The Guangzhou (China) Heart Study

He

¹

,

Deng

²

,

Jiang

³

et al. 2021

BioMed Research International

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Aim. The present study was aimed at investigating the prevalence, incidence, progression, and prognosis of degenerative valvular heart disease (DVHD) in permanent residents aged ≥65 years from Guangzhou, China. Methods. This was a prospective study based on community population. Over a 3-year span, we conducted repeated questionnaires, blood tests, and echocardiographic and electrocardiogram examinations (2018) of a random sample of initially 3538 subjects. Results. The prevalence of DVHD increased with age, average values being 30.6%, 49.2%, and 62.9% in 65-74, 75-84, and ≥85 years of age, respectively. The incidence rate was 1.7%/year. Aortic stenosis was the result of DVHD, and the mean transvalvular pressure gradient increased by 5.6 mmHg/year. The increase of mild aortic stenosis was lower than that of more severe disease, showing a nonlinear development of gradient, but with great individual variations. Mortality was significantly increased in the DVHD group ( HR = 2.49 ). Risk factors for higher mortality included age ( χ 2 = 1.9 , P < 0.05 ), renal insufficiency ( χ 2 = 12.5 , P < 0.01 ), atrial fibrillation ( χ 2 = 12.2 , P < 0.01 ), mitral regurgitation ( χ 2 = 1.8 , P < 0.05 ), and tricuspid regurgitation ( χ 2 = 6.7 , P < 0.05 ) in a DVHD population. Conclusions. DVHD was highly prevalent among residents in southern China. With the progression of the disease, the mean transvalvular pressure gradient accelerated. DVHD was an independent predictor of death, and the mortality was higher in those with older age, renal insufficiency, atrial fibrillation, mitral regurgitation, and tricuspid regurgitation.

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“…Valvuloplasty and valve replacement are effective methods to treat valvular heart disease. However, in China, most patients are seriously ill when they visit the hospital, and most patients can only have valvular replacement to treat valvular diseases [ 18 ]. A large amount of clinical and literature data has shown that, after left heart valve replacement, the PAH of some patients could be significantly reduced after a short period, while that of other patients was not significantly changed [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Midterm postoperative prognosis of patients with severe left heart valvular disease combined with moderate or severe pulmonary hypertension treated with treprostinil

Xu

¹

,

Huang

²

,

Kim

³

et al. 2020

BMC Cardiovasc Disord

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Background To investigate the midterm postoperative prognosis of patients with severe left heart valvular disease combined with moderate or severe pulmonary hypertension (PAH) using subcutaneous injection of treprostinil. Methods A retrospective study was conducted on 61 patients with severe left heart valvular disease combined with moderate or severe PAH who had undergone mechanical mitral and/or aortic valve replacement from April 2018 to October 2018. The patients were divided into the treprostinil group and the conventional treatment group according to whether they received treprostinil. The patients were assessed by SwanGanz catheterization, echocardiography, the 6-min walk test (6-MWT), the Borg dyspnoea score and the SF-36 questionnaire. Results Compared with the preoperative data, the mPAP measured by SwanGanz catheterization, the results of the 6-MWT and the Borg score were significantly improved in both groups during the 1 year follow-up (P < 0.05). Regarding the comparison between the groups, the results in group T were significantly better than those in group C, including the results of the 6-MWT and the general health, vitality and mental health of SF-36 during the 1 year follow-up (P < 0.05). Conclusions Continuous subcutaneous infusion of treprostinil was not capable of decreasing pulmonary pressures in patients with severe left heart valvular disease combined with moderate or severe PAH during 1 year follow-up, although which some of our data suggest that might improve the symptoms and quality of life of these patients.

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A hospital-based survey of patients with severe valvular heart disease in China

Cited by 33 publications

References 29 publications

Rheumatic heart disease across the Western Pacific: not just a Pacific Island problem

Rheumatic heart disease across the Western Pacific: not just a Pacific Island problem

The Evolving Epidemiology of Elderly with Degenerative Valvular Heart Disease: The Guangzhou (China) Heart Study

Midterm postoperative prognosis of patients with severe left heart valvular disease combined with moderate or severe pulmonary hypertension treated with treprostinil

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