Prevalence and follow-up of subclinical rheumatic heart disease among asymptomatic school children in a north-western district of India based on the World Heart Federation echocardiographic criteria.
2D Echocardiography
anterior mitral leaflet
aortic regurgitation
mitral insufficiency
mitral valve prolapse
stenosis
Journal
Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Titre abrégé: Echocardiography
Pays: United States
ID NLM: 8511187
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
21
02
2021
received:
28
11
2020
accepted:
28
02
2021
pubmed:
29
5
2021
medline:
10
7
2021
entrez:
28
5
2021
Statut:
ppublish
Résumé
The present study is based on the World Heart Federation (WHF) echocardiographic criteria to assess the prevalence of subclinical rheumatic heart disease (RHD) and elucidate evolution of the disease when the cases were placed on appropriate antibiotic prophylaxis and regular follow-up. The prevalence of subclinical RHD reported by previous active surveillance studies among asymptomatic school children is not comparable to our study because of major differences in screening methods. A random inclusion strategy was adopted to recruit urban and rural school children of Bikaner district in the state of Rajasthan, India. The diagnosis of RHD was based on the echocardiographic criteria proposed by the WHF. All studies were reported on-site by a single experienced cardiologist and the digitally preserved studies were reported by a second cardiologist off-site. The final diagnosis was made by consensus. The second echocardiogram was performed for cases diagnosed with RHD after two years from start of study to document early evolution of the disease with ongoing antibiotic prophylaxis. A high prevalence of subclinical RHD was observed in the study population. Pathological mitral and/or aortic valve regurgitation was the commonest lesion, and a significant proportion of cases improved while on regular antibiotic prophylaxis. No case showed fixity of leaflets/ stenosis. The prevalence of subclinical RHD is high in the study population, and the disease seems to regress over time in the presence of appropriate antibiotic prophylaxis.
Sections du résumé
BACKGROUND
The present study is based on the World Heart Federation (WHF) echocardiographic criteria to assess the prevalence of subclinical rheumatic heart disease (RHD) and elucidate evolution of the disease when the cases were placed on appropriate antibiotic prophylaxis and regular follow-up. The prevalence of subclinical RHD reported by previous active surveillance studies among asymptomatic school children is not comparable to our study because of major differences in screening methods.
METHODS
A random inclusion strategy was adopted to recruit urban and rural school children of Bikaner district in the state of Rajasthan, India. The diagnosis of RHD was based on the echocardiographic criteria proposed by the WHF. All studies were reported on-site by a single experienced cardiologist and the digitally preserved studies were reported by a second cardiologist off-site. The final diagnosis was made by consensus. The second echocardiogram was performed for cases diagnosed with RHD after two years from start of study to document early evolution of the disease with ongoing antibiotic prophylaxis.
RESULTS
A high prevalence of subclinical RHD was observed in the study population. Pathological mitral and/or aortic valve regurgitation was the commonest lesion, and a significant proportion of cases improved while on regular antibiotic prophylaxis. No case showed fixity of leaflets/ stenosis.
CONCLUSION
The prevalence of subclinical RHD is high in the study population, and the disease seems to regress over time in the presence of appropriate antibiotic prophylaxis.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1173-1178Subventions
Organisme : Indian Council of Medical Research
Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Karthikeyan G. Rheumatic heart disease in India: declining, but not fast enough. Natl Med J India. 2017;30:247-248.
Watkins DA, Johnson CO, Colquhoun SM, et al. Global, regional, and national burden of rheumatic heart disease, 1990-2015. N Engl J Med. 2017;377(8):713-722.
Jones TD. Diagnosis of rheumatic fever. JAMA. 1944;126:481-485.
Hajar R. Rheumatic fever and rheumatic heart disease a historical perspective. Heart Views. 2016;17(3):120-126.
World Health Organization. Rheumatic Fever and Rheumatic Heart Disease: Report of a WHO Expert Consultation, Geneva, 29 October-1 November 2001.Geneva, Switzerland: World. Health Organization ; 2001. WHO Technical Report Series 923.
Negi PC, Sondhi S, Asotra S, et al. Current status of rheumatic heart disease in India. Indian Heart J. 2019;71(1):85-90.
Periwal KL, Gupta BK, Panwar RB, Khatri PC, Raja S, Gupta R. Prevalence of rheumatic heart disease in school children in Bikaner: an echocardiographic study. JAPI. 2006;54:279-282.
Marijon E, Ou P, Celermajer DS, et al. Prevalence of rheumatic heart disease detected by echocardiographic screen- ing. N Engl J Med. 2007;357(5):470-476.
Rothenbühler M, O'Sullivan CJ. Active surveillance for rheumatic heart disease in endemic regions: a systematic review and meta-analysis of prevalence among children and adolescents. Lancet Glob Health. 2014;2(12):e717-e726.
Roy SB. Prevalence of Rheumatic Fever and Rheumatic Heart Disease in Ballabhgarh.Annual Re- port.Indian Council of MedicalResearch:1968-1969:52
Mathur KS, Banerji SC, Nigam DK, et al. Rheumatic heart disease and rheumatic fever: prevalence in a village community of Bichpuri Block Agra. J Assoc Phys India. 1971;19:151-156.
Berry JN. Prevalence survey of chronic rheumatic fever in Northern India. Br Heart J. 1971;34:134-149.
Aggarwal AK, Yunus M, Ahmad J, et al. Rheumatic Heart Disease in India: Perspective in public health 1995
Gupta I, Gupta ML, Mocumbi A, et al. Epidemiological survey of rheumatic heart diseases and congenital heart disease in school children. J Indian MedAssoc. 1992;90:57-59.
Thakur JS, Negi PC, Ahluwalia SK, et al. Epidemiological survey of rheumatic heart disease among school children in the Shimla hills of North India: prevalence and risk factors. J epidemiological community health. 1996;50:57-59.
Jai Vigyan Mission mode project on community control of RHD.Non-communicable diseases.Indian Council Med Res Annu Rep.2007-08:63-64.
Bhaya M, Panwar S, Beniwal R, et al. High prevalence of rheumatic heart disease detected by echocardiography in school children. Echocardiography. 2010;27:448-453.
Saxena A, Ramakrishnan S, Roy A, et al. Prevalence and outcome of subclinical rheumatic heart disease in India: The RHEUMATIC (Rheumatic Heart Echo Utilisation and Monitoring Actuarial Trends in Indian Children) study. Heart. 2011;97(24):2018-2022
Saxena A, Desai A, Narvencar K, et al. Echocardiographic prevalence of rheumatic heart disease in Indian school children using World Heart Federation criteria - A multi-site extension of RHEUMATIC study (the e- RHEUMATIC study). Int J Cardiol. 2017;15(249):438-442.
Gewitz MH, Baltimore RS. American heart association committee on rheumatic fever, endo- carditis, and kawasaki disease of the council on cardiovascular disease in the young. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American HeartAssociation. Circulation. 2015;131(20):1806-1818.
Reményi B. “World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease-an evidence-based guideline”. Nature reviews. Cardiology. 2012;5:297-309.
Shrestha NR, Karki P, Mahto R, et al. Prevalence of subclinical rheumatic heart disease in Eastern Nepal. JAMA Cardiology. 2016;1(1):89-96.
Bhaya M, Panwar S, Sharma A, et al. Comparison of the newer proposed diagnostic score with the World Heart Federation criteria for echocardiographic detection of rheumatic heart disease. Echocardiography. 2019;36:2259-2264.
Bhaya M, Beniwal R, Panwar S, Panwar RB. Two years of follow-up validates the echocardiographic criteria for the diagnosis and screening of rheumatic heart disease in asymptomatic populations. Echocardiography. 2011;28(9):929-933.