THE RÔLE OF MITRAL STENOSIS AND OF POST-RHEUMATIC PULMONARY FIBROSIS IN THE EVOLUTION OF CHRONIC RHEUMATIC HEART DISEASE

1938 ◽  
Vol 196 (1) ◽  
pp. 11-17 ◽  
Author(s):  
BENJAMIN A. GOULEY
Keyword(s):  
Heart Disease ◽  
Pulmonary Fibrosis ◽  
Rheumatic Heart Disease ◽  
Mitral Stenosis ◽  
Rheumatic Heart

Impact of the Severity of Mitral Stenosis on the LV Systolic function as assessed by 2D Strain using Speckle tracking

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Adel ◽  
Tarek K Mosa ◽  
Ahmed Yehia ◽  
Ahmed Shawqi
Keyword(s):  
Heart Disease ◽  
Ejection Fraction ◽  
Healthy Volunteers ◽  
Rheumatic Heart Disease ◽  
Mitral Stenosis ◽  
Speckle Tracking ◽  
Systolic Function ◽  
University Hospitals ◽  
Lv Systolic Function ◽  
Rheumatic Heart

Abstract Background Rheumatic heart disease remains a considerable cause of cardiovascular morbidity and mortality in developing countries and mitral stenosis is the most common valve affection of rheumatic heart disease worldwide.The left ventricular ejection fraction is the most widely used index of contractile function, but due to the visual component, assessment of endocardial excursion is subjective leading to inter-observer variability.Speckle-tracking echocardiography is an imaging technique developed as a method to objectively quantify myocardial function and analyzes cardiac motion and deformation by tracking naturally occurring speckle patterns in the myocardium. Objective To evaluate the effect of the severity of mitral stenosis on LV systolic function as assessed by speckle tracking. Patients and Methods This study was a case-control study involving 80 individuals which included 60 patients having mitral stenosis who presented to the outpatient clinics of Ain Shams University Hospitals and 20 healthy volunteers, The patients suffering from mitral stenosis were subdivided into 3 sub-groups: GROUP(1) 20 Patients having severe mitral stenosis (MV Area less than 1 cm²) GROUP (2) 20 Patients having moderate mitral stenosis (MV Area more than 1 cm² and less than 1.5 cm²) GROUP(3) 20 Patients having mild mitral stenosis (MV Area more than 1.5 cm²) A Control group involved 20 healthy volunteers recruited from health care workers in Ain Shams University hospitals. Results Study included 60 patients,16 males (26.7%) and 44 females (73.3%), with mean age of 41.30 ± 8.64 years. Patients living in rural Areas were 34 (57.7%) while those in urban areas were 26 (43.3%).Which was significant.There was no significant difference between gender or habitat and the severity of mitral Stenosis.There was a strong significance between the duration of the disease and its severity. The more the duration of mitral Stenosis, the more severe the mitral stenosis.A strong positive relation was noticed between the severity of mitral stenosis and both RVSP and LA diameter, while a strong negative relation between severity of mitral stenosis and GLPS. GLPS was affected in severe mitral stenosis only. Conclusion Subtle LV systolic dysfunction is present in large number of patients with severe mitral stenosis even in patients with normal ejection fraction by conventional 2D echocardiography.There was a significant relationship between the duration of mitral stenosis and its severity. The longer the duration of mitral stenosis, the more severe the mitral stenosis.Speckle tracking echocardiography (STE) can play a great role in identification of higher risk subgroups in whom earlier and more aggressive intervention could have a significant impact on their prognosis.

scholarly journals Mean Levels of B-type Natriuretic Peptide (BNP) in Patients with Mitral Stenosis Caused by Rheumatic Heart Disease

2021 ◽  
pp. 96-102
Author(s):  
Altaf Hussain ◽  
Faraz Farooq Memon ◽  
Iftikhar Ahmed ◽  
Syed Ahsan Raza ◽  
Lajpat Rai ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Natriuretic Peptide ◽  
Mitral Stenosis ◽  
Final Analysis ◽  
Severe Intensity ◽  
The Mean ◽  
Valvular Lesion ◽  
Rheumatic Heart ◽  
Valve Area

Objective: Mitral stenosis caused by rheumatic heart disease (RHD) is the most common cause of valvular lesion in adults and prevalent in developing countries like Pakistan. Higher natriuretic peptide (BNP) levels can be observed in patients with moderate to severe untreated mitral stenosis and are associated with higher rates of morbidity and mortality. That is why this study aims to determine the association between levels of pro-BNP with severity (mild. Moderate, and severe) of mitral stenosis. Patients and Methods: This was a clinical prospective study carried out in the department of adult cardiology, national institute of cardiovascular diseases, Karachi from 8th august 2019 to 7th February 2020. Total 68 patients of either gender with age between 25-70 years had mitral stenosis of moderate to severe intensity (mitral valve area ≤1.5 cm2), diagnosed on echocardiography were included for final analysis. A simple blood sample was taken for the assessment of pro-BNP levels. Questionnaire was used for demographic & clinical data collection and analysed using SPSS version 22.0. Results: The overall mean age of study subjects was 42.21±11.50 years, ranging from 25 – 70 years. Among them, females were prevalent (n = 43, 63.2%). The overall mean serum BNP level was 1071.12±807.26 pg/ml and the mean difference of serum BNP level was not significant among groups of gender, age, and diabetes mellitus with p>0.05. Significantly raised levels of BNP were observed in patients with severe mitral stenosis as compared to moderate mitral stenosis, p<0.05 Conclusion: In conclusion, the mean BNP levels were higher in patients with severe Mitral Stenosis. Therefore, BNP may be used to complement the clinical and echocardiographic assessments in patients with Mitral Stenosis.

scholarly journals The personal and clinical impact of screen-detected maternal rheumatic heart disease in Uganda: a prospective follow up study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sonia Voleti ◽  
Emmy Okello ◽  
Meghna Murali ◽  
Rachel Sarnacki ◽  
Albert Majwala ◽  
...  
Keyword(s):  
Heart Disease ◽  
Social Determinants Of Health ◽  
Rheumatic Heart Disease ◽  
Social Determinants ◽  
Determinants Of Health ◽  
World Health ◽  
Medical Decision ◽  
Rheumatic Heart

Abstract Background Pre-existing maternal cardiac disease is a significant contributor to adverse maternal, fetal, and neonatal outcomes. In 2015–2017, our team conducted the first community-based study of maternal rheumatic heart disease (RHD) in sub-Saharan Africa and identified RHD in 88% of those with pre-existing heart disease. Here we conducted a follow up investigation of women previously identified with RHD, describing clinical and echocardiographic outcomes, identifying barriers to medical adherence and evaluating the personal impact of RHD. Methods A 2 week prospective follow up was completed at sites in Central and Eastern Uganda. Participants underwent a three-step mixed methods study comprising of 1) direct structured interview targeting clinical history and medication adherence, 2) echocardiogram to evaluate left-sided heart valves, and 3) semi-structured guideline interview to elicit personal impacts of RHD. Results The team evaluated 40 (80%) of the original 51 mothers with RHD at a median post-partum time of 2.5 years after delivery (IQR 0.5). Echocardiographic data showed improvement in nine women with the remaining 31 women showing stable echocardiographic findings. Adherence to Benzathine penicillin G (BPG) prophylaxis was poor, with 70% of patients either poorly adherent or non-adherent. Three major themes emerged from interviews: 1) social determinants of health (World Health Organization, Social determinants of health, 2019) negatively affecting healthcare, 2) RHD diagnosis negatively affecting female societal wellbeing, 3) central role of spouse in medical decision making. Conclusions Screening echocardiography can identify women with pre-existing rheumatic heart disease during pregnancy, but long-term follow-up in Uganda reveals adherence to medical care following diagnosis, including BPG, is poor. Additionally, mothers diagnosed with RHD may experience unintended consequences such as social stigmatization. As identification of occult RHD is critical to prevent adverse pregnancy outcomes, further research is needed to determine how to best support women who face a new diagnosis of RHD, and to determine the role of screening echocardiography in high-risk settings.

O028 Role of Technology In Creating Rheumatic Heart Disease Awareness Among School-Going Children In Kenya

Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e7-e8 ◽  
Author(s):  
Duncan M. Matheka ◽  
Mellany Murgor ◽  
Edward Kibochi ◽  
Steve Nigel ◽  
Joseph Nderitu ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Disease Awareness ◽  
Rheumatic Heart
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