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You are here: Contents > 2016 > Volume 25 Number 1 January 2016 > Valvular Heart Disease Epidemics

Valvular Heart Disease Epidemics

Blanca Domenech1, José Luis Pomar2, Susanna Prat-González1, Bárbara Vidal1, Alfons López-Soto3, Manel Castella2, Marta Sitges1

Departments of 1Cardiology and 2Cardiac Surgery, Cardiovascular Institute, and 3Department of Internal Medicine, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Spain

Background and aim of the study: The real burden of valvular heart disease (VHD) is scarcely known, as several factors may potentially lead to its increased prevalence. The study aim was to assess the prevalence of VHD and its treatment in the authors’ environment to plan the healthcare requisites for optimal management of the condition.

Methods: A retrospective analysis was conducted of data acquired from patients who had been assessed at different consultation levels for cardiovascular disorders during a six-month period between January and June 2014 in a public health referral area of 500,000 inhabitants. Patients included were those admitted to hospital cardiology, cardiac surgery and geriatric care units (n = 1,083), as well as ambulatory patients attending cardiology-specific outpatient clinics at the authors’ hospital or at two ascribed primary care centers (n = 852). Data were registered regarding the epidemiology, etiology, echocardiography and treatment of patients in whom VHD was detected.

Results: Among a total of 1,935 adult patients, moderate or severe valve disease was identified in 453 cases

(23.4%) who were evaluated for cardiovascular disease. The prevalence of VHD increased with age. Multivalvular moderate-severe dysfunction was present in two valves in 33% and in three valves in 5.7% of patients. Significant mitral valve disease was present in 39% and aortic valve disease in 48% of patients. The etiology of the valvular lesions was degenerative in 60%, functional in 15.5%, rheumatic in almost 10%, congenital in 6%, due to prosthetic dysfunction in 5.5% and due to endocarditis in only 3%. Patients with VHD represented up to 24.2% of the in-hospital admissions. An interventional treatment was required in 55% of the patients (mostly surgical valve procedures).

Conclusion: The present study results showed that VHD is a frequent occurrence and is increasingly prevalent with age, constituting up to one-fourth of all in-hospital admissions for cardiovascular disease. VHD is a growing public health problem that should be addressed with appropriate resources to improve research into its nature, diagnosis and treatment.

The Journal of Heart Valve Disease 2016;25:1-7

Valvular Heart Disease Epidemics