Prevalence of rheumatic heart disease in adults from the Brazilian Amazon Basin
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Prevalence of rheumatic heart disease in adults from the Brazilian Amazon Basin. / Wegener, Alma; Holm, Anna Engell; Gomes, Laura C.; Lima, Karine O.; Kaagaard, Molly D.; Matos, Luan O.; Vieira, Isabelle V. M.; de Souza, Rodrigo Medeiros; Farias Marinho, Claudio Romero; Nascimento, Bruno R.; Biering-Sorensen, Tor; Silvestre, Odilson M.; Brainin, Philip.
In: International Journal of Cardiology, Vol. 352, 2022, p. 115-122.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Prevalence of rheumatic heart disease in adults from the Brazilian Amazon Basin
AU - Wegener, Alma
AU - Holm, Anna Engell
AU - Gomes, Laura C.
AU - Lima, Karine O.
AU - Kaagaard, Molly D.
AU - Matos, Luan O.
AU - Vieira, Isabelle V. M.
AU - de Souza, Rodrigo Medeiros
AU - Farias Marinho, Claudio Romero
AU - Nascimento, Bruno R.
AU - Biering-Sorensen, Tor
AU - Silvestre, Odilson M.
AU - Brainin, Philip
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Rheumatic heart disease
KW - Echocardiography
KW - Cross-sectional
KW - Amazon Basin
KW - GLOBAL BURDEN
KW - ECHOCARDIOGRAPHY
KW - CHILDREN
KW - UPDATE
KW - RISK
U2 - 10.1016/j.ijcard.2022.01.026
DO - 10.1016/j.ijcard.2022.01.026
M3 - Journal article
C2 - 35065154
VL - 352
SP - 115
EP - 122
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -
ID: 317449654