Etiological profile in patients with heart failure

Background: The incidence and prevalence rates of heart failure (HF) are increasing worldwide. The prevalence of HF rises exponentially with increasing age and affects 4% to 8% of people older than 65. The leading causes of HF in India include coronary artery disease (CAD), diabetes, hypertension, rheumatic valvular heart diseases and primary cardiac muscle diseases. Rheumatic heart disease (RHD) is still a common cause of HF in India. Epidemiological studies have estimated that 1.5% to 2% population experience HF and it is the main reason for hospital admission of elderly patients. The objective of this study was to establish the etiological factors of heart failureMethods: A cross sectional study of 150 patients above the age of 18 years presented with heart failure diagnosed clinically on the basis of Framingham heart failure criteria and echocardiography, done over a period of one year in department of medicine in BRD medical college Gorakhpur Uttar Pradesh.Results: A total of 150 patients were include in this analysis the majority of patients were male (57.3%). Age of patients ranged from 18 - 70 years and 84% patients were above the age of 40 years.Conclusions: Heart failure was more prevalent in elderly male above 40 years of age. Myocardial infarction, DCMP, rheumatic heart disease and hypertensive heart failure are the common etiology leading to heart failure.

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Underuse of Injectable Penicillin in Secondary Prophylaxis of Rheumatic Heart Disease in Nepal

10.37179/rijccm.000004 ◽

2020 ◽

Vol 01 (01) ◽

pp. 009-012

Author(s):

Laudari S

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Rheumatic Heart Disease ◽

Cross Sectional Study ◽

Secondary Prophylaxis ◽

Medical Sciences ◽

Cross Sectional ◽

Governmental Organizations ◽

Non Governmental Organizations ◽

Rheumatic Heart

Background and Aims: Secondary prophylaxis has remained the mainstay of rheumatic fever and rheumatic heart disease management. Despite the proven ef􀏐icacy and superiority of injectable penicillin in rheumatic heart disease patients, it has been underused in Nepal. Materials and Methods: This is a hospital based cross-sectional study during June 2014 to October 2018 over a period of 52 months at College of Medical Sciences-Bharatpur including 350 patients with clinical and/or echocardiographic evidence of de􀏐inite rheumatic heart disease. Data was collected from both cardiology outpatients and inpatients (admitted in cardioward/coronary care unit). Relevant data and information were entered into the pre-structured proforma and then analyzed by SPSS-16 software. Results: The age of the patients ranged from 6 to 80 years with mean age 36.76±4.6years with female preponderance (F:M=1.26:1). The predominantly involved isolated valve was mitral in 152 patients (44.43%) followed by aortic valve in 70 patients (20.00%) and rest 90 (25.71%) had dual valvular involvement. The common complications encountered were heart failure in 200(57.14%) and arrhythmias in 155(44.29%) patients. Two hundred ten (60.00%) of the patients received penicillin (oral and injectable) and erythromycin. Majority 180/210=85.71%) were prescribed on oral penicillin whereas only 46/210=21.90% received injectable penicillin; the ratio being 3.35:1. Conclusion: RHD is a leading cause of heart failure and death among young population. There is underuse of penicillin with very minimal focus on use of injectable penicillins currently. Hence, Nepal government and other non-governmental organizations should consider implementation of use of penicillin broadly and moreover focus on use and adherence of injectable penicillin. Keywords: Rheumatic Heart Disease, Penicillin, Underuse, Secondary Prophylaxis.

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Factors Affecting Therapeutic Compliance among the Patients with Rheumatic Heart Disease in Bangladesh

Cardiovascular Journal ◽

10.3329/cardio.v10i2.36289 ◽

2018 ◽

Vol 10 (2) ◽

pp. 180-185 ◽

Cited By ~ 2

Author(s):

Kakon Farzana ◽

Mohammad Omar Faruque ◽

Salma Zareen ◽

Kamrun Nahar Choudhury ◽

Ahmed Hossain

Keyword(s):

Logistic Regression ◽

Heart Disease ◽

Rheumatic Fever ◽

Disease Control ◽

Rheumatic Heart Disease ◽

Communicable Disease ◽

Heart Diseases ◽

Regression Analyses ◽

Cross Sectional ◽

Rheumatic Heart

Background: Acute rheumatic fever (ARF) can recur as a result of subsequent Group A Streptococcus (GAS) infections and each recurrence can worsen Rheumatic heart disease (RHD) that has evoked a substantial disease burden in developing countries, including Bangladesh. The objective of this study was to determine the penicillin compliance for rheumatic fever patients.Methods: A matched cross sectional study was conducted among 160 patients in National Center for the Control of Rheumatic Fever and Heart Diseases (NCCRF/HD), Dhaka. Data was collected on face-to-face interview using a standard structured questionnaire about socio-demographic, clinical and behavioral factors. Descriptive and multivariate logistic regression analyses were used to analyze the data.Results: The multiple logistic regression analyses indicated that duration of diagnosis>5 beyond the duration of diagnosis <5 years (OR=2.484, CI=1.170-5.421), age (OR=0.548,CI=0.217-0.574), sex (OR=0.916, CI=0.422-1.964), education (OR=1.963, CI= 0.737-05.361), marital status(OR=0.700, CI=0.272-1.774), fathers education (OR=0.482 CI=0.176 -1.279) and family member (OR= 0.619 CI= 0.2 97 -1.261) were significantly or almost significantly associated with RHD status.Conclusion: In this study, the identified risk groups for rheumatic heart disease reflect a complex interaction between socioeconomic conditions and chronic disease status. Interventions focused on education and poverty will undoubtedly be useful, but not sufficient. Rheumatic heart disease control would benefit from a collaboration of broad public health activities aimed at the prevention and control other chronic diseases. The integration of rheumatic heart disease control activities with non communicable disease programme is crucial in Bangladesh.Cardiovasc. j. 2018; 10(2): 180-185

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AN EPIDEMIOLOGICAL ANALYSIS OF SOCIOECONOMIC RISK FACTORS AMONG PATIENTS OF RHEUMATIC HEART DISEASE, ISLAMABAD, PAKISTAN

Pakistan Journal of Public Health ◽

10.32413/pjph.v6i4.13 ◽

1970 ◽

Vol 6 (4) ◽

pp. 41-43 ◽

Cited By ~ 1

Author(s):

Zafar Hayat Maken ◽

Faizan Ahmed ◽

Ferogh E- Elahi ◽

Ali Arumghan ◽

Mehar . ◽

...

Keyword(s):

Risk Factors ◽

Heart Disease ◽

Rheumatic Heart Disease ◽

Economic Status ◽

Sampling Technique ◽

Medical Sciences ◽

Cross Sectional ◽

Male Predominance ◽

Significant Burden ◽

Rheumatic Heart

BACKGROUND: Rheumatic Heart Disease (RHD) is a disease of developing countries where it inflects significant burden dis-proportionality. We investigated the role of socio-economic and environmental risk factors for RHD. METHODS:Â· This was descriptive cross-sectional conducted at Pakistan Institute of Medical Sciences Islamabad by including the patients coming to cardiology out door patient department through convenient sampling technique. Study was approved from ethical committee of Pakistan institute of Medical Sciences Islamabad and written consent was taken prior to start the interview. RESULTS: In this study, the average age of patient with rheumatic heart disease was 29.4 years, male predominance of patients was observed. 67% of subjects had income below Rs. 20,000. Average BMI of subjects was 22.4Â±4.04. It was observed that 75.25 % of people lived in houses with an area of less than 5 marla. Average area of house was found to be 5.12Â±2.8 marla. Overcrowding was noticed in 60.8 % of the subjects. CONCLUSION: There is a high prevalence of RHD and Acute Rheumatic Fever (ARF) in Pakistan. The major findings of this study were that Overcrowding, poor hygienic conditions, low socio-economic status, are major risk factors for RHD. In order to address this alarming situation, platforms like Pakistan Pediatric Cardiac Society and Pakistan Pediatric Association need to be mobilized for health promotion regarding awareness of the disease.

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Study on Heart Failure Patients Admitted in National Institute of Cardiovascular Diseases

Cardiovascular Journal ◽

10.3329/cardio.v13i2.52971 ◽

2021 ◽

Vol 13 (2) ◽

pp. 172-176

Author(s):

Nur Alam ◽

Abdullah Al Shafi Majumder

Keyword(s):

Heart Failure ◽

Acute Coronary Syndrome ◽

Heart Disease ◽

Cardiovascular Diseases ◽

Epidemiological Studies ◽

Clinical Syndrome ◽

Cross Sectional ◽

Common Cause ◽

Heart Failure Patients ◽

Coronary Syndrome

Background: Heart failure is a complex clinical syndrome that arises secondary to abnormalities of cardiac structure and/or function (inherited or acquired) that impair the ability of the left ventricle to fill or eject blood. There is a paucity of data on characteristics of the patients of heart failure admitted in hospitals in terms of demographic and etiological information. So, this study aimed to see the disease burden of heart failure patients and the age and sex specific prevalence of heart failure among patients admitted into NICVD and to identify the etiological pattern of diseases leading to heart failure with associated comorbid factors. Methods: It was a cross sectional study carried out at National Institute of Cardiovascular Diseases (NICVD) Dhaka Bangladesh and was conducted from January 2015 to December 2015. Total 400 heart failure patients were taken. Results: The mean age of the patients were 54 ± 14 years ranging from 16 to 95 years with a high preponderance of male. Most the patient population was in the age group of 51- 60 years (29.5%). 79% of the cases were male & 21% female by gender specification. Ischaemic cardiomyopathy (ICM) was found to be the common cause of heart failure (n=153, 40.75%) followed by Acute coronary syndrome (32.5%) and Valvular heart disease (18.25%). The patients with heart failure having acute coronary syndrome (n=107) had hypertension (46.8%) as the most prevalent major risk factor. In the present study only 11% patient had heart failure with preserved ejection fraction. Mortality rate of the study population were 6.3%. Conclusion: In this study, the most common cause of heart failure is ischaemic heart disease. So, patients of acute and chronic ischemic heart disease patients should be treated and follow up with care. Clinical and epidemiological studies are needed to explore further. Cardiovasc. j. 2021; 13(2): 172-176

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Acute Decompensated Heart Failure Following Cesarean Delivery: A Case of Undiagnosed Rheumatic Heart Disease [14B]

Obstetrics and Gynecology ◽

10.1097/01.aog.0000559399.94042.66 ◽

2019 ◽

Vol 133 (1) ◽

pp. 24S-24S

Author(s):

Sarah Hmaidan ◽

Meagan Benson ◽

Emily Hadley ◽

Wyman Gilmore

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Cesarean Delivery ◽

Rheumatic Heart Disease ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Rheumatic Heart

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Validation of a simplified score for predicting latent rheumatic heart disease progression using a prospective cohort of Brazilian schoolchildren

BMJ Open ◽

10.1136/bmjopen-2020-036827 ◽

2020 ◽

Vol 10 (5) ◽

pp. e036827 ◽

Cited By ~ 1

Author(s):

Bárbara Martins Bechtlufft ◽

Bruno Ramos Nascimento ◽

Craig Sable ◽

Clara Leal Fraga ◽

Márcia Melo Barbosa ◽

...

Keyword(s):

Heart Disease ◽

Public Schools ◽

Rheumatic Heart Disease ◽

Heart Diseases ◽

Diagnostic Category ◽

Secondary Outcome ◽

Unfavourable Outcome ◽

History Of ◽

Rheumatic Heart

ObjectivesEchocardiographic (echo) screening is an important tool to estimate rheumatic heart disease (RHD) prevalence, but the natural history of screen-detected RHD remains unclear. The PROVAR+ (Programa de RastreamentO da VAlvopatia Reumática) study, which uses non-experts, telemedicine and portable echo, pioneered RHD screening in Brazil. We aimed to assess the mid-term evolution of Brazilian schoolchildren (5–18 years) with echocardiography-detected subclinical RHD and to assess the performance of a simplified score consisting of five components of the World Heart Federation criteria, as a predictor of unfavourable echo outcomes.SettingPublic schools of underserved areas and private schools in Minas Gerais, southeast Brazil.ParticipantsA total of 197 patients (170 borderline and 27 definite RHD) with follow-up of 29±9 months were included. Median age was 14 (12–16) years, and 130 (66%) were woman. Only four patients in the definite group were regularly receiving penicillin.Primary and secondary outcome measuresUnfavourable outcome was based on the 2-year follow-up echo, defined as worsening diagnostic category, remaining with mild definite RHD or development/worsening of valve regurgitation/stenosis.ResultsAmong patients with borderline RHD, 29 (17.1%) progressed to definite, 49 (28.8%) remained stable, 86 (50.6%) regressed to normal and 6 (3.5%) were reclassified as other heart diseases. Among those with definite RHD, 13 (48.1%) remained in the category, while 5 (18.5%) regressed to borderline, 5 (18.5%) regressed to normal and 4 (14.8%) were reclassified as other heart diseases. The simplified echo score was a significant predictor of RHD unfavourable outcome (HR 1.197, 95% CI 1.098 to 1.305, p<0.001).ConclusionThe simple risk score provided an accurate prediction of RHD status at 2-year follow-up, showing a good performance in Brazilian schoolchildren, with a potential value for risk stratification and monitoring of echocardiography-detected RHD.

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Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap: A Scientific Statement From the American Heart Association

Circulation ◽

10.1161/cir.0000000000000921 ◽

2020 ◽

Vol 142 (20) ◽

Author(s):

Raman Krishna Kumar ◽

Manuel J. Antunes ◽

Andrea Beaton ◽

Mariana Mirabel ◽

Vuyisile T. Nkomo ◽

...

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Rheumatic Heart Disease ◽

Treatment Options ◽

Heart Association ◽

Population Based ◽

Diagnosis And Treatment ◽

Optimal Care ◽

Percutaneous Balloon ◽

Rheumatic Heart

The global burden of rheumatic heart disease continues to be significant although it is largely limited to poor and marginalized populations. In most endemic regions, affected patients present with heart failure. This statement will seek to examine the current state-of-the-art recommendations and to identify gaps in diagnosis and treatment globally that can inform strategies for reducing disease burden. Echocardiography screening based on World Heart Federation echocardiographic criteria holds promise to identify patients earlier, when prophylaxis is more likely to be effective; however, several important questions need to be answered before this can translate into public policy. Population-based registries effectively enable optimal care and secondary penicillin prophylaxis within available resources. Benzathine penicillin injections remain the cornerstone of secondary prevention. Challenges with penicillin procurement and concern with adverse reactions in patients with advanced disease remain important issues. Heart failure management, prevention, early diagnosis and treatment of endocarditis, oral anticoagulation for atrial fibrillation, and prosthetic valves are vital therapeutic adjuncts. Management of health of women with unoperated and operated rheumatic heart disease before, during, and after pregnancy is a significant challenge that requires a multidisciplinary team effort. Patients with isolated mitral stenosis often benefit from percutaneous balloon mitral valvuloplasty. Timely heart valve surgery can mitigate the progression to heart failure, disability, and death. Valve repair is preferable over replacement for rheumatic mitral regurgitation but is not available to the vast majority of patients in endemic regions. This body of work forms a foundation on which a companion document on advocacy for rheumatic heart disease has been developed. Ultimately, the combination of expanded treatment options, research, and advocacy built on existing knowledge and science provides the best opportunity to address the burden of rheumatic heart disease.

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