Acute Rheumatic Fever and Rheumatic Heart Disease

Itzikowitz, G.; Prendergast, E A; Prendergast, Bernard; Zühlke, Liesl

doi:10.1007/978-3-030-23104-0_11

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…Rheumatic heart disease results from valvular damage secondary to an abnormal autoimmune reaction after infection with group A streptococcal bacteria. This disease has disappeared in developed countries but is still a major problem in the third world countries particularly with low social economic status (1,2).…”

Section: Introductionmentioning

confidence: 99%

Prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among patients with rheumatic heart disease attending Jakaya Kikwete Cardiac Institute: A prospective cohort study

Makatu

Mutagaywa

Peter

et al. 2022

Preprint

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Background Arrhythmia is a known complication of rheumatic heart disease (RHD). It is critical to recognize arrhythmias early on so that prompt preventative actions and vigilant monitoring may be considered while treating these patients. Aim This study aimed at determining the prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among RHD patients attending Jakaya Kikwete Cardiac Institute (JKCI). Methodology: Hospital-based cross-sectional study was conducted among 390 patients with an echocardiography diagnosis of RHD aged 18years and above attending JKCI. Demographic and clinical information was documented. Echocardiography and a resting and 24 hours ambulatory Holter monitoring electrocardiography were done. Chi square test was used to determine association between variables and those with a p value ≤ 0.2 were entered in a multivariate logistic regression analysis to determine the independent factors associated with arrhythmias. P value of < 0.05 was considered statistically significant. The receiver operating curve was used to determine the critical point beyond which arrhythmias develop. Results Median age was 39 years IQR (30,52). Females were 257(65.9%). Asymptomatic patients were 208 (53.3%). Most patients belonged to NYHA functional class I&II. The most common valve lesion was mitral stenosis 228 (58.5%). Arrhythmias were found in 276 (70.77%) patients, of which 193 (49.5%) patients were from resting ECG and 83/197 (44.7%) patients from holter electrocardiography. Independent factors for arrhythmias were, New York Heart Association (NYHA) functional class III&IV (a0R 4.67, 95% CI 1.82-12.00 p = < 0.01) and severe left atrial diameter enlargement (aOR 7.28, 95% CI 3.17–16.70 p = < 0.01). The critical point beyond which arrhythmias develop was found to be left atrium diameter > 48mm. Conclusion We found a high prevalence of arrhythmias among patients with RHD. The independent predictors of arrhythmias were left atrium dilatation and NYHA functional class III-IV. We recommend close monitoring for arrhythmias among RHD patients in sinus rhythm with higher NYHA functional class and dilated left atrium.

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Section: Introductionmentioning

confidence: 99%

Prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among patients with rheumatic heart disease attending Jakaya Kikwete Cardiac Institute: A prospective cohort study

Makatu

Mutagaywa

Peter

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

Prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among patients with rheumatic heart disease attending Jakaya Kikwete Cardiac Institute: a prospective cohort study

Makatu,

Mutagaywa,

Peter

et al. 2023

BMC Cardiovasc Disord

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Background Arrhythmia is a known complication of rheumatic heart disease (RHD). It is critical to recognize arrhythmias early on so that prompt preventative actions and vigilant monitoring may be considered while treating these patients. Aim This study aimed at determining the prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among RHD patients attending Jakaya Kikwete Cardiac Institute (JKCI). Methodology Hospital-based cross-sectional study was conducted among 390 patients with an echocardiographic diagnosis of RHD aged 18years and above attending JKCI. Demographic and clinical information was documented. Echocardiography, a resting electrocardiography and 24 h ambulatory Holter monitoring electrocardiography were done. Chi square test was used to determine association between variables and those with a p value ≤ 0.2 were entered in a multivariate logistic regression analysis to determine the independent factors associated with arrhythmias. P value of < 0.05 was considered statistically significant. The receiver operating curve was used to determine the critical point for left atrial size beyond which arrhythmias develop. Results A total of 390 patients were included in the analysis. The median age was 39 years interquartile range (IQR 30–52). Females were 257/390 (65.9%). Asymptomatic patients were 208/390 (53.3%). Most patients belonged to New York heart Association (NYHA) functional class I&II 247/390 (62.1%). The most common valve lesion was mitral stenosis 228/390 (58.5%). Arrhythmias were found in 276/390 (70.77%) patients, of which 193/390 (49.5%) patients were from resting electrocardiography (ECG) and 88/197 (44.7%) patients from holter ECG. Independent factors for arrhythmias were, NYHA functional class III&IV (a0R 4.67, 95% CI 1.82-12.00 p = < 0.01) and severe left atrial diameter enlargement (aOR 7.28, 95% CI 3.17–16.70 p = < 0.01). The critical point beyond which arrhythmias develop was found to be left atrium diameter > 48 mm. Conclusion We found a high prevalence of arrhythmias among patients with RHD. The independent predictors of arrhythmias were left atrium dilatation and NYHA functional class III-IV. We recommend close monitoring for arrhythmias among RHD patients in sinus rhythm with higher NYHA functional class and dilated left atrium.

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Rheumatic heart disease secondary prophylaxis prescribing patterns and outcomes: A tertiary care hospital experience in Saudi Arabia

Aldardeer¹,

Mukhtar²,

Kalkatawi³

et al. 2023

Saudi J Clin Pharm

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Acute Rheumatic Fever and Rheumatic Heart Disease

Cited by 3 publications

References 38 publications

Prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among patients with rheumatic heart disease attending Jakaya Kikwete Cardiac Institute: A prospective cohort study

Prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among patients with rheumatic heart disease attending Jakaya Kikwete Cardiac Institute: A prospective cohort study

Prevalence, clinical characteristics and echocardiographic parameters of arrhythmias among patients with rheumatic heart disease attending Jakaya Kikwete Cardiac Institute: a prospective cohort study

Rheumatic heart disease secondary prophylaxis prescribing patterns and outcomes: A tertiary care hospital experience in Saudi Arabia

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