Strain patterns in primary mitral regurgitation due to rheumatic heart disease and mitral valve prolapse

Abstract Background Impact of heart disease (HD) on pregnancy is significant. Objective We aimed to evaluate the feasibility of integrating screening echocardiography (echo) into the Brazilian prenatal primary care to assess HD prevalence. Methods Over 13 months, 20 healthcare workers acquired simplified echo protocols, utilizing hand-held machines (GE-VSCAN), in 22 primary care centres. Consecutive pregnant women unaware of HD underwent focused echo, remotely interpreted in USA and Brazil. Major HD was defined as structural valve abnormalities, more than mild valve dysfunction, ventricular systolic dysfunction/hypertrophy, or other major abnormalities. Screen-positive women were referred for standard echo. Results At total, 1 112 women underwent screening. Mean age was 27 ± 8 years, mean gestational age 22 ± 9 weeks. Major HD was found in 100 (9.0%) patients. More than mild mitral regurgitation was observed in 47 (4.2%), tricuspid regurgitation in 11 (1.0%), mild left ventricular dysfunction in 4 (0.4%), left ventricular hypertrophy in 2 (0.2%) and suspected rheumatic heart disease in 36 (3.2%): all, with mitral valve and two with aortic valve (AV) involvement. Other AV disease was observed in 11 (10%). In 56 screen-positive women undergoing standard echo, major HD was confirmed in 45 (80.4%): RHD findings in 12 patients (all with mitral valve and two with AV disease), mitral regurgitation in 40 (14 with morphological changes, 10 suggestive of rheumatic heart disease), other AV disease in two (mild/moderate regurgitation). Conclusions Integration of echo screening into primary prenatal care is feasible in Brazil. However, the low prevalence of severe disease urges further investigations about the effectiveness of the strategy.

Download Full-text

Comparison of the Ventricle Muscle Proteome between Patients with Rheumatic Heart Disease and Controls with Mitral Valve Prolapse: HSP 60 May Be a Specific Protein in RHD

BioMed Research International ◽

10.1155/2014/151726 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Dawei Zheng ◽

Limin Xu ◽

Lebo Sun ◽

Qiang Feng ◽

Zishan Wang ◽

...

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Rheumatic Heart Disease ◽

Mitral Valve Prolapse ◽

Complex Disease ◽

Specific Protein ◽

Heat Shock Protein 60 ◽

Average Ratio ◽

Flight Mass Spectrometry ◽

Rheumatic Heart

Objective. Rheumatic heart disease (RHD) is a serious autoimmune heart disease. The present study was aimed at identifying the differentially expressed proteins between patients with RHD and controls with mitral valve prolapse.Methods. Nine patients with RHD and nine controls with mitral valve prolapsed were enrolled for this study. Two-dimensional difference in-gel electrophoresis (2D-DIGE) and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) were performed.Results. A total of 39 protein spots with differential expressions were identified between the two groups (P<0.05, Average Ratio > 1.2 or Average Ratio < −1.2) and four upregulated proteins (including heat shock protein 60 (HSP 60), desmin, PDZ and LIM domain protein 1, and proteasome subunit alpha type-1) and three downregulated proteins (including tropomyosin alpha-1 chain, malate dehydrogenase, and chaperone activity of bc1 complex homolog) were determined.Conclusion. These seven proteins, especially HSP 60, may serve as potential biomarkers for the diagnosis of RHD and provide evidence to explain the mechanisms of this complex disease in the future.

Download Full-text

Inter-scallop separations of the posterior leaflet of the mitral valve: an important cause of ‘pathological’ mitral regurgitation in rheumatic heart disease screening

Echo Research and Practice ◽

10.1530/erp-18-0010 ◽

2018 ◽

Vol 5 (2) ◽

pp. K29-K34 ◽

Cited By ~ 3

Author(s):

L D Hunter ◽

M Monaghan ◽

G Lloyd ◽

A J K Pecoraro ◽

A F Doubell ◽

...

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Rheumatic Heart Disease ◽

Disease Screening ◽

Posterior Leaflet ◽

Rheumatic Heart

Download Full-text

Effect of Enalapril on Left Ventricular Diameters and Exercise Capacity in Asymptomatic or Mildly Symptomatic Patients With Regurgitation Secondary to Mitral Valve Prolapse or Rheumatic Heart Disease

The American Journal of Cardiology ◽

10.1016/j.amjcard.2005.02.056 ◽

2005 ◽

Vol 96 (1) ◽

pp. 117-121 ◽

Cited By ~ 16

Author(s):

Roney O. Sampaio ◽

Max Grinberg ◽

João J. Leite ◽

Flávio Tarasoutchi ◽

William A. Chalela ◽

...

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Rheumatic Heart Disease ◽

Exercise Capacity ◽

Mitral Valve Prolapse ◽

Left Ventricular ◽

Rheumatic Heart

Download Full-text

Pattern of rheumatic heart disease in patients admitted at tertiary care centre of Nepal

Nepalese Heart Journal ◽

10.3126/njh.v15i1.19713 ◽

2018 ◽

Vol 15 (1) ◽

pp. 29-33 ◽

Cited By ~ 1

Author(s):

Prabha Chapagain Koirala ◽

Ram Kishor Sah ◽

Deewakar Sharma

Keyword(s):

Developing Countries ◽

Heart Disease ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Rheumatic Heart Disease ◽

Tertiary Care ◽

Female Ratio ◽

National Heart ◽

Number Of Patients ◽

Rheumatic Heart

Background and Aims: As in other developing countries, Rheumatic Heart Disease (RHD) remains a major public health problem in Nepal. The most commonly affected people are children and adults in their productive years of age. The major contributing factors for high prevalence of Rheumatic Heart Disease in developing countries are poverty, illiteracy and limited access to healthcare services. The study was done to assess the basic pattern of Rheumatic Heart Disease among patients admitted at tertiary care center of Nepal: Shahid Gangalal National Heart Center.Methods: It is a cross sectional prospective study done among the patients admitted in Shahid Gangalal National Heart Center, Kathmandu.Results: RHD was more common among patients of age group 10-40 years, the most common age being 31-40 years (28.5%), with the male female ratio 1:1.6. Majority of the admitted patients had come from Central Development Region, and least number of patients had come from Far Western Region. About 46.5% of patients were illiterate and majority of patients were without any income source. Mitral valve was the most commonly affected valve (98.2%) and mitral regurgitation was the most common valvular lesion.Conclusion: RHD mainly affects children and young people of low socioeconomic group. In our study, mitral valve was the most commonly affected valve and mitral regurgitation was the most common valvular lesion. Mitral Stenosis was statistically significant in female patients while aortic regurgitation as well as aortic stenosis were significant in male patients.Nepalese Heart Journal 2018; 15(1): 29-33

Download Full-text

INTRAESOPHAGEAL PHONOCARDIOGRAPHY IN THE DIAGNOSIS OF OCCULT RHEUMATIC MITRAL VALVE DISEASE

PEDIATRICS ◽

10.1542/peds.38.5.892 ◽

1966 ◽

Vol 38 (5) ◽

pp. 892-896

Author(s):

Choompol Vongprateep ◽

Ronald M. Lauer ◽

Antoni M. Diehl

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Rheumatic Heart Disease ◽

Mitral Valve Disease ◽

Clinical Findings ◽

Normal Individuals ◽

Mitral Disease ◽

Rheumatic Patients ◽

Rheumatic Heart

Twenty-nine rheumatic subjects and 16 normal individuals have been studied by intraesophageal phonocardiography. In the normal group no unusual sounds or murmurs were discovered by this technique. However, in rheumatic patients with clinical mitral regurgitation the esophageal phonocardiogram more clearly recorded the murmur than the surface phonocardiogram. In five patients murmurs of mitral disease were recorded by the intraesophageal technique that were not discernible by clinical examination or surface phonocardiography. Intraesophageal phonocardiography is particularly valuable in clinical situations wherein rheumatic heart disease is suspected and the typical clinical findings of mitral regurgitation are absent or equivocal.

Download Full-text