Incidence & Pattern of Valvular Heart Disease in Patients attended in Echo Lab at a tertiary care Hospital: A single Centre Study

2021 ◽  
Vol 13 (2) ◽  
pp. 144-153
Author(s):  
Masuma Jannat Shafi ◽  
Sahela Nasrin

Background: This echocardiographic study was undertaken to establish incidence, pattern & complications in patients of valvular heart disease. Methods: A total of 97 patients were enrolled among the patients attended in echo lab at Ibrahim cardiac hospital & Research Institute over a period of 1 year. Results: Mean age was 53.8±1.5 years. Male were predominant (58.76% vs 41.23%). Most common symptom was shortness of breath (60.8%) followed by palpitation (43.3%). 39.2% of patients had normal ECG & 12.4% revealed AF. The most common complication was pulmonary hypertension (54.6%) followed by pulmonary edema (26.8%), Stroke (10.3%), Left atrial thrombus (7.3%), & infective endocarditis (6.2%). MV was most commonly involved (72.2%) followed by aortic valve (AV) (66.0%), tricuspid valve (TV) (54.6%) & pulmonary valve (PV) was (20.6%). Rheumatic involvement (52.6%) constituted the dominant cause than degenerative & congenital (24.7% in each). Mitral stenosis (MS) was predominant (52.6%) & was rheumatic in origin; then aortic stenosis (AS) (48.5%) which was mostly degenerative followed by bicuspid aortic valve (8.2%). Mitral regurgitation (MR) was the most common valvular lesion (64.9%); then aortic regurgitation (AR) (51.5%) which was also rheumatic in etiology. Multiple valve involvement was also present. The most common variety was MS+MR (43.3%). Tricuspid stenosis (TS) was in association with MR+AR (1.03%). Tricuspid regurgitation (TR) was 58.8%, mostly secondary to rheumatic involvement of other valves. Severe TR (5.2%) was due to Ebstain anomaly and prolapse (4.1% & 3.1%). ventricular systolic & diastolic functions were normal mostly. Conclusion: Among the rheumatic heart disease patients’ mitral valve was the most commonly affected valve. Mitral regurgitation was the most common valvular lesion. Rheumatic involvement remains the dominant cause of valvular heart disease in Bangladesh. Cardiovasc. j. 2021; 13(2): 144-153

2019 ◽  
Vol 6 (3) ◽  
pp. 774
Author(s):  
Prakash R. Ghogale ◽  
Shishir K. Wanjari ◽  
Daneshwar Singh ◽  
Hanumanth N. ◽  
Harshal G. Mendhe

Background: Diseases of the heart valves constitute a major cause of cardiovascular morbidity and mortality worldwide with an enormous burden on healthcare resources. The present study was undertaken to study incidence and demography of valvular heart disease, to assess echocardiography and colour doppler findings of patients with valvular heart disease and to find out complications in patients with valvular heart disease.Methods: A hospital based longitudinal case study was undertaken at medicine department of Dr. V.M. Government Medical College, Solapur, Maharashtra, India for a period of two years. One hundred and twenty-four (124) patients attending OPD participated in the study.Results: In the present study, out of 124 patients, mitral valve was most commonly involved, 105(84.67%) and the least common involved was tricuspid 1(0.81%). The most common aetiology was rheumatic origin 75(94.94%). In the present study the most common complication was pulmonary hypertension 69(55.65%), followed by congestive cardiac failure (33.87%), acute pulmonary edema (12.09%), infective endocarditis (4.84%), cerebrovascular accident (4.03%), left atrial thrombus (3.23%) and death (3.23%).Conclusions: Multiple valves were affected in more than a third of all cases, although recent research in India continue to demonstrate a declining trend in the prevalence of RHD, rheumatic involvement is still the dominant form of valvular heart disease in India.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Min Sun Kim ◽  
Soo Jin Cho ◽  
Sung-Ji Park ◽  
Sung Won Cho ◽  
Soo-Hee Choi ◽  
...  

AbstractLimited information is available on the prevalence and clinical determinants of valvular heart disease (VHD) in apparently healthy people. This study sought to assess the frequency and clinical associating factors of aortic stenosis (AS), aortic regurgitation (AR), mitral stenosis (MS), mitral regurgitation (MR), tricuspid regurgitation (TR) in asymptomatic individuals with health check-up examination. We included 23,254 subjects ≥50 years of age who underwent a health check-up examination with transthoracic echocardiography (TTE) between 2012 and 2016 in a single tertiary-care hospital in Korea. Among a total of 23,254 subjects, 15,358 men (66.0%) and 7,896 women (34.0%) underwent TTE. Newly identified (predominantly mild) VHD was detected in 9.4% of subjects. The most common VHD were TR (4.6%), AR (3.0%) and MR (2.4%). Clinically significant (more than moderate) VHD was identified in 176 subjects (0.8%). Age ≥75 years was associated with all clinically significant VHD, and female gender was associated with AR, MS and TR. Korea has been very active in the health check-up examination including echocardiography. We find that VHD in apparently healthy people is not uncommon than believed; all VHD except MS were more frequent in elderly over 75 years of age in a large population-based study.


2021 ◽  
pp. 22-26
Author(s):  
Inkar Sagatov ◽  
◽  
Askhat Kudaibergen ◽  
Bakhytzhan Momynov

Valve defects or congenital/acquired heart defects are damage to the valve and/or subvalvular structures, which leads to impaired hemodynamics and the development of heart failure. Asymptomatic valvular heart disease is present in 2.5% of the population; with age, this figure rises to 13%. In the absence of permanent treatment, lesions of the heart valves significantly reduce the quality and duration of life. The European Society of Cardiology (ESC) and the American Heart Association (AHA) regularly review the effectiveness of new surgical treatments and reflect their findings in international guidelines. Today, minimally invasive surgery is the most effective and safe way to treat patients with valvular heart disease. The article presents two new methods for the treatment of valvular heart disease. Transapical mitral valve repair on a beating heart with neochord implantation (TOP-MINI) is a new MVP option that has been approved for patients with severe mitral regurgitation due to prolapse of the leaflet (s) or chord (grades 2-4). The new procedure with the NeoChord DS1000 device results in a significant reduction in mitral regurgitation and in reverse remodeling of the left ventricle and left atrium after 6 months of follow-up. Also reviewed is Minimally Invasive Aortic Valve Replacement (MAVR), which has been shown to be beneficial in improving patient satisfaction by minimizing pain and earlier recovery. Sutureless valves are preferred over traditional aortic valve replacement (AVR) due to the reduced operation time and the need for blood transfusion. The Perceval valve (Sorin, Sallugia, Italy) is a self-expanding bovine pericardial prosthesis placed in a nitinol stent designed to facilitate aortic valve implantation. A systematic review and meta-analysis demonstrated that the early clinical and hemodynamic characteristics of the Perceval valve are satisfactory and comparable to those of conventional AVRs. This literature review was carried out in accordance with the PRISM statement. The databases searched in this review included Pubmed, Web of Science, Scopus and Cochrane databases for systematic reviews


Author(s):  
Krupa R. Mange ◽  
Vidyadhar B. Bangal

Background: Maternal cardiac disease associated with pregnancy is considered as a high-risk pregnancy. Various physiological and hemodynamic alterations during the course of pregnancy make these women prone for various complications and related morbidity and mortality.Methods: A prospective cross-sectional study of 105 cases of pregnancy complicated by cardiac disease, reporting to tertiary care hospital for delivery, was carried out to find out the maternal and perinatal outcome.Results: The incidence of cardiac disease in pregnancy in the present study was 0.54%. Most of the women (91%) belonged to low socioeconomic class. Rheumatic heart lesions constituted 87% of the cases. Mitral stenosis alone or in combination, was the commonest (57%) valvular lesion. Incidence of spontaneous vaginal delivery was 53 percent and for ventose or outlet forceps was 12 percent. Incidence of caesarean section was 35%. There were 2 maternal deaths, one each due to complication like pulmonary oedema and atrial fibrillation. The perinatal mortality was 36 per 1000 live births, mainly due to combination of factors like prematurity, low birth weight, neonatal sepsis and birth asphyxia.Conclusions: Early diagnosis of heart disease, regular antenatal checkup, institutional delivery, limiting family size can reduce the maternal and perinatal mortality and morbidity associated with heart disease.


Author(s):  
Muhammad Hanif Ahmad Nizar ◽  
Chow Khuen Chan ◽  
Azira Khalil ◽  
Ahmad Khairuddin Mohamed Yusof ◽  
Khin Wee Lai

Background: Valvular heart disease is a serious disease leading to mortality and increasing medical care cost. The aortic valve is the most common valve affected by this disease. Doctors rely on echocardiogram for diagnosing and evaluating valvular heart disease. However, the images from echocardiogram are poor in comparison to Computerized Tomography and Magnetic Resonance Imaging scan. This study proposes the development of Convolutional Neural Networks (CNN) that can function optimally during a live echocardiographic examination for detection of the aortic valve. An automated detection system in an echocardiogram will improve the accuracy of medical diagnosis and can provide further medical analysis from the resulting detection. Methods: Two detection architectures, Single Shot Multibox Detector (SSD) and Faster Regional based Convolutional Neural Network (R-CNN) with various feature extractors were trained on echocardiography images from 33 patients. Thereafter, the models were tested on 10 echocardiography videos. Results: Faster R-CNN Inception v2 had shown the highest accuracy (98.6%) followed closely by SSD Mobilenet v2. In terms of speed, SSD Mobilenet v2 resulted in a loss of 46.81% in framesper- second (fps) during real-time detection but managed to perform better than the other neural network models. Additionally, SSD Mobilenet v2 used the least amount of Graphic Processing Unit (GPU) but the Central Processing Unit (CPU) usage was relatively similar throughout all models. Conclusion: Our findings provide a foundation for implementing a convolutional detection system to echocardiography for medical purposes.


2020 ◽  
Vol 4 (5) ◽  
pp. 1-6
Author(s):  
Gilles Uijtterhaegen ◽  
Laura De Donder ◽  
Eline Ameloot ◽  
Kristof Lefebvre ◽  
Jo Van Dorpe ◽  
...  

Abstract Background Granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis, is a systemic inflammatory process predominantly affecting upper and lower respiratory tract and kidneys. Valvular heart disease is a rare manifestation of GPA. Case summary We report two cases of acute valvular heart disease mimicking acute endocarditis caused by GPA. Both patients were middle-aged females with acute aortic valve regurgitation suggestive of possible infective endocarditis. In their recent medical history, atypical otitis and sinusitis were noted. The first patient was admitted with heart failure and the second patient because of persisting fever. Echocardiogram revealed severe aortic regurgitation with an additional structure on two cusps, suggestive of infective endocarditis in both patients. Urgent surgical replacement was performed; however, intraoperative findings did not show infective endocarditis, but severe inflammatory changes of the valve and surrounding tissue. In both patients, the valve was replaced by a prosthetic valve. Microscopic examination of the valve/myocardial biopsy showed diffuse acute and chronic inflammation with necrosis and necrotizing granulomas, compatible with GPA after infectious causes were excluded. Disease remission was obtained in both patients, in one patient with Rituximab and in the other with Glucocorticoids and Cyclophosphamide. Both had an uneventful follow-up. Discussion Granulomatosis with polyangiitis can be a rare cause of acute aortic valve regurgitation mimicking infective endocarditis with the need for surgical valve replacement. Atypical ear, nose, and throat symptoms can be a first sign of GPA. Symptom recognition is important for early diagnosis and appropriate treatment to prevent further progression of the disease.


2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Aceituno Melgar ◽  
JF Fritche-Salazar ◽  
ME Soto-Lopez

Abstract Funding Acknowledgements Type of funding sources: None. Background  The autoimmune diseases (AD) have high morbidity and mortality due to their affection to the heart. Purpose Our objective was to describe the valvular heart disease (VHD) in patients with AD. Methods Patients with systemic lupus erythematous (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SS) diagnosis were included, from January 1st 2008 to December 31th 2018. Prevalence rates of valve involvement were calculated. Results A total of 163 patients (57.6% with SLE, 23.3% with RA, 19.0% with SS) were included. The global prevalence of VHD was 5.4% in SLS, 23.6% en RA, and 15.9% in SS. The more affected valve in SLS was the tricuspid valve in 24% (12% with severe tricuspid regurgitation (STR), p = 0.028), in RA was the aortic valve in 26% (13% with severe aortic stenosis (SAS), p = 0.02), and with SS was the tricuspid valve in 48% (29% with moderate tricuspid regurgitation (MTR)). The calcium deposit was present in 66% in RA (37% in aortic valve, p < 0.001). The valve thickening (>5 mm) was higher in RA (50%, p < 0.001), with predominance in mitral valve (26%). Conclusions We found significant higher rates of STR in SLE, SAS in RA, and MTR in SS compared with the literature. Moreover, calcification and valve thickening were found more often in RA. Early diagnosis of subclinical VHD is mandatory to improve the long-term prognosis of these patients. Valvular heart disease. Autoimmune Disease (n = 163) P value* SLE (n = 94) RA (n = 38) ES (n = 31) Demographic characteristics Age, years. Gender, Male / Female, n Body Mass Index (kg/m2) Arterial hypertension, n (%) Diabetes Mellitus, n (%) 38.8 (12.6) 9/85 26.2 (5.9) 21(22.3%) 6 (6.3%) 62.45 (12.3) 7/31 26.6 (7.1) 14(36.8%) 4 (10.5%) 53.8 (13.3) 2/29 25.4 (4.7) 12 (38.7) 5 (16.1%) <0.001 NS NS NS NS Echocardiographic findings. Valve thickening Aortic Mitral 8 (9%) 1 (1%) 7 (7%) 19 (50%) 9 (24%) 10 (26%) 1 (3%) 0 1 (3%) <0.001 Calcium Deposit Aortic Mitral 4 (4%) 2 (2%) 2 (2%) 25 (66%) 14 (37%) 11 (29%) 8 (26%) 4 (12.8%) 4 (12.9%) <0.001 Aortic valve disease 4 (4%) 10 (26%) 0 Aortic stenosis Moderate Severe 0 0 0 7 (18%) 2 (5%) 5 (13%) 0 0 0 0,02 Moderate Aortic Regurgitation 4 (4%) 3 (8%) 0 NS Mitral valve disease 8 (9%) 2 (5%) 2 (6%) Mitral stenosis Moderate Severe 4 (4%) 2 (2%) 2 (2%) 1 (3%) 0 1 (3%) 1 (3%) 0 1 (3%) NS Mitral Regurgitation Moderate Severe 4 (4%) 2 (2%) 2 (2%) 1 (3%) 0 1 (3%) 1 (3%) 0 1 (3%) NS Tricuspid Regurgitation Moderate Severe 22 (24%) 11 (12%) 11 (12%) 8 (21%) 7 (18%) 1 (3%) 15 (48%) 9 (29%) 6 (19%) 0,028 Pulmonic valve disease Moderate Pulmonic Stenosis Moderate Pulmonic Regurgitation 6 (6%) 1 (1%) 5 (5%) 1 (3%) 0 1 (3%) 0 0 0 NS * Not Significant.


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