Relevance of Rheumatic Valvular Heart Disease in the Aetiology of Heart Failure in Contemporary Times.

Abstract

BACKGROUND:

Rheumatic valvular heart disease (RVHD) is one of the foremost causes of heart failure (HF) in our population, particularly among young adults, but a decline in the prevalence of RVHD has been observed. The effect of this decline on the relevance of RVHD among other causes of HF is not established in our setting.

OBJECTIVE:

To determine whether RVHD is still a leading cause of HF in our population or not.

METHODS:

This was a retrospective study of HF patients hospitalized between August 2018 and June 2020. The demographic features, blood pressure, aetiology of HF and ejection fraction were retrieved from the unit's HF register. Data were presented as frequencies and medians. Associations were tested as appropriate.

RESULTS:

RVHD accounted for 78 (35.5%) of HF, with a median age of 47 years. The young and middle- aged subgroups were 10(12.8%) and 48(61.6%), respectively. The affected valves were all regurgitant and 68 (77.2%) had definite RVHD. Isolated mitral valve, combined mitral and aortic valves were affected in 40 (51.3%) and 22 (28.2%), respectively. The median systolic blood pressure and ejection fraction were 110mmHg and 26% respectively. RVHD was associated with HF with reduced ejection fraction. (P value < 0.001).

CONCLUSION:

RVHD remains one of the leading causes of HF (35.5%) among adults in our population. Young adults are now in the minority and most patients present late in the course of the disease. Valve surgery should be made readily accessible. Primary and secondary prevention of acute rheumatic fever should be reinforced.

• Authors: E J Ogbemudia, E M Umuerri
• Journal: West African journal of medicine (West Afr J Med) Vol. 38 Issue 3 Pg. 241-245 (03 22 2021) ISSN: 0189-160X [Print] Nigeria
• PMID: 33765372 (Publication Type: Journal Article)

Topics

• Aged
• Heart Failure (epidemiology, etiology)
• Heart Valve Diseases (complications, epidemiology)
• Humans
• Middle Aged
• Mitral Valve
• Retrospective Studies
• Rheumatic Heart Disease (complications, epidemiology)
• Young Adult