The Echocardiographic Diagnosis of Rheumatic Heart Disease: A Review of the Performance of the World Heart Federation Criteria 2012-2023.

Humans Rheumatic Heart Disease / diagnostic imaging Echocardiography / methods Reproducibility of Results
2012 WHF echocardiographic criteria RHD performance

Journal

Global heart
ISSN: 2211-8179
Titre abrégé: Glob Heart
Pays: England
ID NLM: 101584391

Informations de publication

Date de publication:
2024
Historique:
received: 12 10 2023
accepted: 19 04 2024
medline: 20 5 2024
pubmed: 20 5 2024
entrez: 20 5 2024
Statut: epublish

Résumé

The World Heart Federation (WHF) published the first evidence-based guidelines on the echocardiographic diagnosis of rheumatic heart disease (RHD) in 2012. These guidelines have since been applied internationally in research and clinical practice. Substantial research has assessed the utility of the 2012 WHF criteria, including its applicability in low-resource settings. This article summarises the evidence regarding the performance of the guidelines. A scoping review assessing the performance of the guidelines was performed. Cochrane, Embase, Medline, PubMed Lilacs, Sielo, and Portal BVS databases were searched for studies on the performance of the guidelines between January 2012-March 2023, and 4047 manuscripts met the search criteria, of which 34 were included. This included papers assessing the specificity, inter-rater reliability, application using hand-carried ultrasound, and modification of the criteria for simplicity. The review followed the PRISMA Extension for Scoping Reviews guideline. The WHF 2012 criteria were 100% specific for definite RHD when applied in low-prevalence populations. The criteria demonstrated substantial and moderate inter-rater reliability for detecting definite and borderline RHD, respectively. The inter-rater reliability for morphological features was lower than for valvular regurgitation. When applied to hand-carried ultrasound performed by an expert, modified versions of the criteria demonstrated a sensitivity and specificity range of 79-90% and 87-93% respectively for detecting any RHD, performing best for definite RHD. The sensitivity and the specificity were reduced when performed in task-sharing but remains moderately accurate. The WHF 2012 criteria provide clear guidance for the echocardiographic diagnosis of RHD that is reproducible and applicable to a range of echocardiographic technology. Furthermore, the criteria are highly specific and particularly accurate for detecting definite RHD. There are limitations in applying all aspects of the criteria in specific settings, including task-sharing. This summary of evidence can inform the updated version of the WHF guidelines to ensure improved applicability in all RHD endemic regions.

Sections du résumé

Background UNASSIGNED
The World Heart Federation (WHF) published the first evidence-based guidelines on the echocardiographic diagnosis of rheumatic heart disease (RHD) in 2012. These guidelines have since been applied internationally in research and clinical practice. Substantial research has assessed the utility of the 2012 WHF criteria, including its applicability in low-resource settings. This article summarises the evidence regarding the performance of the guidelines.
Methods UNASSIGNED
A scoping review assessing the performance of the guidelines was performed. Cochrane, Embase, Medline, PubMed Lilacs, Sielo, and Portal BVS databases were searched for studies on the performance of the guidelines between January 2012-March 2023, and 4047 manuscripts met the search criteria, of which 34 were included. This included papers assessing the specificity, inter-rater reliability, application using hand-carried ultrasound, and modification of the criteria for simplicity. The review followed the PRISMA Extension for Scoping Reviews guideline.
Results UNASSIGNED
The WHF 2012 criteria were 100% specific for definite RHD when applied in low-prevalence populations. The criteria demonstrated substantial and moderate inter-rater reliability for detecting definite and borderline RHD, respectively. The inter-rater reliability for morphological features was lower than for valvular regurgitation. When applied to hand-carried ultrasound performed by an expert, modified versions of the criteria demonstrated a sensitivity and specificity range of 79-90% and 87-93% respectively for detecting any RHD, performing best for definite RHD. The sensitivity and the specificity were reduced when performed in task-sharing but remains moderately accurate.
Conclusion UNASSIGNED
The WHF 2012 criteria provide clear guidance for the echocardiographic diagnosis of RHD that is reproducible and applicable to a range of echocardiographic technology. Furthermore, the criteria are highly specific and particularly accurate for detecting definite RHD. There are limitations in applying all aspects of the criteria in specific settings, including task-sharing. This summary of evidence can inform the updated version of the WHF guidelines to ensure improved applicability in all RHD endemic regions.

Identifiants

DOI: 10.5334/gh.1327 PMID: 38765776 PMC: PMC11100538
pubmed: 38765776
doi: 10.5334/gh.1327
pmc: PMC11100538
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

47

Informations de copyright

Copyright: © 2024 The Author(s).

Déclaration de conflit d'intérêts

The authors have no competing interests to declare.

Auteurs

James Marangou (J)

Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
Department of Cardiology, Royal Perth Hospital, Perth, Australia.
Department of Cardiology, Fiona Stanley Hospital, Perth, Australia.

Joselyn Rwebembera (J)

Uganda Heart Institute, Kampala, Uganda.

Julius Mwita (J)

Department of Internal Medicine, University of Botswana and Princess Marina Hospital, Botswana.

Lene Thorup (L)

Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark.

Bo Remenyi (B)

Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
Department of Paediatrics, Royal Darwin Hospital, Darwin, Australia and NT Cardiac, Darwin, Australia.

Bruno Ramos Nascimento (BR)

Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Serviço de Cardiologia e Cirurgia Cardiovascular, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Andrea Beaton (A)

Department of Pediatrics, School of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
Division of Cardiology, The Heart Institute, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA.

Krishna Kumar (K)

Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India.

Emmy Okello (E)

Division of Adult Cardiology, Uganda Heart Institute, Kampala, Uganda.

Kate Raltson (K)

World Heart Federation, Geneva, Switzerland.

Craig Sable (C)

Division of Cardiology, Children's National Hospital, Washington, DC, USA.

Gavin Wheaton (G)

Women's and Children's Hospital, Adelaide, South Australia, Australia.

Nigel Wilson (N)

Green Lane Paediatric and Congenital Cardiac Services, Auckland, Te Whatu Ora, New Zealand.

Liesl Zuhlke (L)

Vice President-Extramural Research & Internal Portfolio, South Africa Medical Research Council, South Africa.
Division of Paediatric Cardiology, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.

Cleonice Mota (C)

Departamento de Pediatria, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Divisão de Cardiologia Pediátrica e Fetal/Serviço de Cardiologia e Cirurgia Cardiovascular e Serviço de Pediatria, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Ana Mocumbi (A)

University Eduardo Mondlane, Mozambique.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The Echocardiographic Diagnosis of Rheumatic...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Rhumatisme cardiaque › The Echocardiographic Diagnosis of Rheumatic...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic cardiovasculaire › Tests de la fonction cardiaque › Échocardiographie › The Echocardiographic Diagnosis of Rheumatic...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Reproductibilité des résultats › The Echocardiographic Diagnosis of Rheumatic...