Clinical information has low sensitivity for postmortem diagnosis of heart valve disease

Coffey, Sean; Harper, Andrew R.; Cairns, Benjamin J.; Roberts, Ian; Prendergast, Bernard

doi:10.1136/heartjnl-2016-310718

Cited by 13 publications

(6 citation statements)

References 18 publications

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“…The most commonnly occuring valve lesions are mitral regurgitation (MR), aortic stenosis (AS) and aortic regurgitation (AR) 3,4 . However, the true prevalance is higher than the clinical data as revealed by post-mortem studies 5 . Moreover, multivalvular heart lesions are highly prevalent [6][7][8] .…”

Section: Introductionmentioning

confidence: 69%

Distribution, Etiology and Myocardial deformation imaging by speckle-tracking echocardiography in Valvular heart disease: A sub-analysis from a Clinical Registry

Nayak,

Manjoosha

et al. 2023

Preprint

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Purpose Valvular Heart Disease (VHD) has been a major contributor of global cardiovascular morbidity and mortality with increasing need of percutaneous/surgical cardiac intervention. Strain echocardiography has been widely recognizable tool to guide the timings of interventions in these patients. The purpose of this study was to document the demographic, clinical signs and symptoms, Electrocardiographic and Echocardiographic parameters in different groups of VHD as well as to assess Left ventricular and right ventricular function in specific groups of VHD.Methods All patients with valvular heart disease who visited a tertiary care hospital in Karnataka during the study period were included in the registry. However, for the study purpose VHD with a severity of at least more than or equal to moderate and with preserved Left ventricle ejection fraction (LV EF) were included for the analysis. Basic demographic, clinical, electrocardiographic, standard echocardiographic and strain parameters were obtained and evaluated.Results During the study period of 10 month a total number of 5,271 subjects had VHD (excluding the presence of trivial or mild functional regurgitant lesion). The most commonly occurring single valvular disease was mitral regurgitation (31%) followed by aortic stenosis (15%) and aortic regurgitation (13%). Rheumatic heart disease (RHD) was the dominant etiology (32.8%) for VHD followed by degenerative heart disease (31.3%). Deformation imaging by 2D speckle-tracking echocardiography was preserved for left ventricle (LV) but mildly reduced for right ventricle (RV).Conclusion MR was the most common valvular lesion followed by AS and AR. Rheumatic disease still prevails as the major precursor. Ventricular remodelling varied depending on the lesion type.

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Section: Introductionmentioning

confidence: 69%

Distribution, Etiology and Myocardial deformation imaging by speckle-tracking echocardiography in Valvular heart disease: A sub-analysis from a Clinical Registry

Nayak,

Manjoosha

et al. 2023

Preprint

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“…Second, we used the underlying cause of death in the national death certificate as the outcome. Therefore, the mortality rate in the present study might be underestimated because clinical documentation of valvar heart disease was generally highly specific but relatively insensitive as a cause of death, compared with postmortem autopsy identification of valvar heart disease 27) . Finally, despite our efforts to adjust for potential confounding factors, we cannot rule out the effects of unmeasured factors AR 15) , and the progression of aortic valve calcification 16) .…”

Section: Statistical Analysesmentioning

confidence: 77%

Body Mass Index and Mortality from Nonrheumatic Aortic Valve Disease among Japanese Men and Women

Teramoto

Yamagishi

Cui

et al. 2023

JAT

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Aim: We aimed to examine the impact of overweight and obesity on mortality from nonrheumatic aortic valve disease. Methods: In the Japan Collaborative Cohort Study, we analyzed data of 98,378 participants aged 40–79 years, with no history of coronary heart disease, stroke, or cancer at baseline (1988–1990) and who completed a lifestyle questionnaire including height and body weight; they were followed for mortality until the end of 2009. The Cox proportional hazards model was used to calculate the multivariable hazard ratios (HRs) with 95% conﬁdence intervals (CIs) of nonrheumatic aortic valve disease mortality according to body mass index (BMI) after adjusting for potential confounding factors. Results: During the median 19.2 years follow-up, 60 deaths from nonrheumatic aortic valve disease were reported. BMI was positively associated with the risk of mortality from nonrheumatic aortic valve disease; the multivariable HRs (95% CIs) were 0.90 (0.40–2.06) for persons with BMI ＜21 kg/m 2 , 1.71 (0.81–3.58) for BMI 23–24.9 kg/m 2 , 1.65 (0.69–3.94) for BMI 25–26.9 kg/m 2 , and 2.83 (1.20–6.65) for BMI ≥ 27 kg/m 2 ( p for trend=0.006), compared with persons with BMI 21–22.9 kg/m 2 . Similar associations were observed between men and women ( p for interaction=0.56). Excluding those who died during the first ten years of follow-up or a competing risk analysis with other causes of death as competing risk events did not change the association materially. Conclusions: Overweight and obesity may be independent risk factors for nonrheumatic aortic valve disease mortality in Asian populations.

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“…Moreover, they heavily rely on routinely collected data (including ICD-10 codes). This epidemiological approach can be unreliable, as post-mortem analyses have revealed the true prevalence of VHD to be significantly greater than that clinically coded and reported [ 3 ]. Indeed, population-based data tend to be collected only when VHD is at least moderate or clinically relevant, with patients referred to a diagnostic test because of symptom complaints or the presence of some clinical indications.…”

Section: Introductionmentioning

confidence: 99%

The Global Burden of Valvular Heart Disease: From Clinical Epidemiology to Management

Santangelo

Bursi

Faggiano

et al. 2023

JCM

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Valvular heart disease is a leading cause of cardiovascular morbidity and mortality and a major contributor of symptoms and functional disability. Knowledge of valvular heart disease epidemiology and a deep comprehension of the geographical and temporal trends are crucial for clinical advances and the formulation of effective health policy for primary and secondary prevention. This review mainly focuses on the epidemiology of primary (organic, related to the valve itself) valvular disease and its management, especially emphasizing the importance of heart valve centers in ensuring the best care of patients through a multidisciplinary team.

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Clinical information has low sensitivity for postmortem diagnosis of heart valve disease

Abstract: Clinical information recorded premortem is highly specific but relatively insensitive for the cause of death established at autopsy. Population-based mortality statistics that depend on premortem clinical information are likely to routinely underestimate the mortality burden of VHD.

Cited by 13 publications

References 18 publications

Distribution, Etiology and Myocardial deformation imaging by speckle-tracking echocardiography in Valvular heart disease: A sub-analysis from a Clinical Registry

Distribution, Etiology and Myocardial deformation imaging by speckle-tracking echocardiography in Valvular heart disease: A sub-analysis from a Clinical Registry

Body Mass Index and Mortality from Nonrheumatic Aortic Valve Disease among Japanese Men and Women

The Global Burden of Valvular Heart Disease: From Clinical Epidemiology to Management

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