Prevalence of rheumatic heart disease in adults from the Brazilian Amazon Basin
Copyright © 2022 Elsevier B.V. All rights reserved..
BACKGROUND: Rheumatic heart disease (RHD) continues to be a burden in low- and middle-income countries and prevalence estimates are lacking from South America. We aimed to determine the prevalence of RHD in the Brazilian Amazon Basin.
METHODS: We examined a random sample of adults (≥18 years) from the general population, who underwent echocardiographic image acquisition by a medical doctor. All images were analyzed according to (i) the 2012 World Heart Federation criteria and (ii) a simplified algorithm for RHD from a previously validated risk score (categories: low-, medium-, high-risk) which involved assessment of the mitral valve (leaflet thickening and excessive motion, regurgitation jet length) and aortic valve (thickening and any regurgitation).
RESULTS: A total of 488 adults were screened (mean age 40 ± 15 years, 38% men). The prevalence of RHD was 39/1000 adults (n = 17 definite and n = 2 borderline). Fourteen (74%) had pathological mitral regurgitation, four (21%) mitral stenosis, 0 (0%) pathological aortic regurgitation and six (32%) both mitral and aortic valve disease. None had a prior diagnosis of RHD, 10 (53%) had positive cardiac auscultation and two (11%) reported a history of rheumatic fever. The simplified algorithm identified four (21%) adults as low-risk, six (32%) as intermediate, and nine (47%) as high-risk.
CONCLUSIONS: The prevalence of RHD was 39/1000 in adults from the Brazilian Amazon Basin, indicating the need for screening programs in remote areas. A simplified model was only able to categorize every second case of RHD as high-risk. External validation of simplified screening models to increase feasibility in clinical practice are encouraged.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:352 |
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| Enthalten in: |
International journal of cardiology - 352(2022) vom: 01. Apr., Seite 115-122 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wegener, Alma [VerfasserIn] |
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| Links: |
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| Themen: |
Amazon Basin |
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| Anmerkungen: |
Date Completed 14.03.2022 Date Revised 14.03.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijcard.2022.01.026 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM335997279 |
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| 100 | 1 | |a Wegener, Alma |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prevalence of rheumatic heart disease in adults from the Brazilian Amazon Basin |
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| 500 | |a Date Revised 14.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Rheumatic heart disease (RHD) continues to be a burden in low- and middle-income countries and prevalence estimates are lacking from South America. We aimed to determine the prevalence of RHD in the Brazilian Amazon Basin | ||
| 520 | |a METHODS: We examined a random sample of adults (≥18 years) from the general population, who underwent echocardiographic image acquisition by a medical doctor. All images were analyzed according to (i) the 2012 World Heart Federation criteria and (ii) a simplified algorithm for RHD from a previously validated risk score (categories: low-, medium-, high-risk) which involved assessment of the mitral valve (leaflet thickening and excessive motion, regurgitation jet length) and aortic valve (thickening and any regurgitation) | ||
| 520 | |a RESULTS: A total of 488 adults were screened (mean age 40 ± 15 years, 38% men). The prevalence of RHD was 39/1000 adults (n = 17 definite and n = 2 borderline). Fourteen (74%) had pathological mitral regurgitation, four (21%) mitral stenosis, 0 (0%) pathological aortic regurgitation and six (32%) both mitral and aortic valve disease. None had a prior diagnosis of RHD, 10 (53%) had positive cardiac auscultation and two (11%) reported a history of rheumatic fever. The simplified algorithm identified four (21%) adults as low-risk, six (32%) as intermediate, and nine (47%) as high-risk | ||
| 520 | |a CONCLUSIONS: The prevalence of RHD was 39/1000 in adults from the Brazilian Amazon Basin, indicating the need for screening programs in remote areas. A simplified model was only able to categorize every second case of RHD as high-risk. External validation of simplified screening models to increase feasibility in clinical practice are encouraged | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Amazon Basin | |
| 650 | 4 | |a Cross-sectional | |
| 650 | 4 | |a Echocardiography | |
| 650 | 4 | |a Rheumatic heart disease | |
| 700 | 1 | |a Holm, Anna Engell |e verfasserin |4 aut | |
| 700 | 1 | |a Gomes, Laura C |e verfasserin |4 aut | |
| 700 | 1 | |a Lima, Karine O |e verfasserin |4 aut | |
| 700 | 1 | |a Kaagaard, Molly D |e verfasserin |4 aut | |
| 700 | 1 | |a Matos, Luan O |e verfasserin |4 aut | |
| 700 | 1 | |a Vieira, Isabelle V M |e verfasserin |4 aut | |
| 700 | 1 | |a de Souza, Rodrigo Medeiros |e verfasserin |4 aut | |
| 700 | 1 | |a Marinho, Claudio Romero Farias |e verfasserin |4 aut | |
| 700 | 1 | |a Nascimento, Bruno R |e verfasserin |4 aut | |
| 700 | 1 | |a Biering-Sørensen, Tor |e verfasserin |4 aut | |
| 700 | 1 | |a Silvestre, Odilson M |e verfasserin |4 aut | |
| 700 | 1 | |a Brainin, Philip |e verfasserin |4 aut | |
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