Global Heart最新文献

{"title":"Burden of Hypertensive Heart Disease and Its Risk Factors in East Asia, 1990-2021: Findings From the Global Burden of Disease Study 2021.","authors":"Zhongqing Zhou, Zixiang Ji, Jiazhe Hou, Jing Yang, Hengjing Wu, Lijuan Zhang","doi":"10.5334/gh.1472","DOIUrl":"10.5334/gh.1472","url":null,"abstract":"<p><strong>Introduction: </strong>Long-term hypertensive heart disease (HHD) trends in East Asia offer insights for heart disease prevention. We analyzed HHD burden trends in East Asia (1990-2021).</p><p><strong>Methods: </strong>We analyzed trends in age-standardized prevalence (ASPR), death, and disability-adjusted life-years (DALYs) rates of HHD in East Asia from 1990 to 2021 using data from the Global Burden of Disease Study 2021. Annual average percent changes (AAPC) were calculated via Joinpoint regression. Relative risks were estimated via population attributable fraction (PAF).</p><p><strong>Results: </strong>In 2021, East Asia reported 4,354,899 prevalent cases of HHD, 361,483 deaths and 6,079,780 DALYs. East Asia has seen a decrease in the overall prevalence of hypertensive heart disease (HHD) from 1990 to 2021, yet the ASPR for HHD has increased in the last decade, from 2012 to 2021. During this period, developed areas such as Japan have observed a growing trend of HHD among younger demographics. In contrast, developing regions like North Korea continue to face challenges in managing the condition effectively. The burden of HHD is particularly pronounced among females over 75 years of age, while males exhibit higher risk due to poor lifestyle factors. From 1990 to 2021, the PAF due to high body mass index (BMI) consistently increased across East Asia, with the following AAPC and 95% confidence interval (95% CI): China (1.55, 95%CI: 1.54, 1.56), Japan (0.79, 95%CI: 0.78-0.81), South Korea (0.86, 95%CI: 0.85, 0.86), China-Taiwan (1.3, 95%CI: 1.28, 1.33), North Korea (1.55, 95%CI:1.54, 1.55), and Mongolia (0.24, 95%CI: 0.23, 0.25).</p><p><strong>Conclusions: </strong>East Asia faces a significant HHD prevalence, with elderly females needing particular focus. High BMI is a notable risk factor. Given the differing HHD impacts across regions, targeted strategies that consider regional and national differences are essential for reducing the burden.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"82"},"PeriodicalIF":3.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WHF Position Statement for United Nations Fourth High-Level Meeting-2025.","authors":"K Srinath Reddy, Bente Mikkelsen, George A Mensah, Philip J Landrigan, Amam Mbakwem, Renu Garg, Jeremiah Mwangi, Sean Taylor, Pablo Perel, Borjana Pervan, Finn-Jarle Rode, Daniel Pineiro, Dorairaj Prabhakaran, Jagat Narula","doi":"10.5334/gh.1467","DOIUrl":"https://doi.org/10.5334/gh.1467","url":null,"abstract":"","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"82"},"PeriodicalIF":3.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Following the Pandemic: Exploring Long COVID's impact on Global Health through the World Heart Federation Global COVID-19 Study.","authors":"Karla Santo, Leandro Favaro, Eduardo Martins","doi":"10.5334/gh.1468","DOIUrl":"10.5334/gh.1468","url":null,"abstract":"<p><p>Although the COVID-19 pandemic crisis has come to an end, Long COVID continues to pose a profound challenge to global health. Based on findings from the World Heart Federation (WHF) Global COVID-19 Study, an international prospective cohort study, this editorial reflects on the enduring burden of symptoms and complications among 2,535 previously hospitalized patients across 16 countries during the Omicron era. Beyond a mortality rate of 15% and clinical manifestations such as fatigue, dyspnea, and adverse cardiovascular events, the study highlighted substantial psychosocial and socioeconomic impacts, with reduced work capacity and functional limitations particularly affecting populations in low- and middle-income countries captured through EuroQol 5-dimension scale and employment data. These findings emphasize that the burden of Long COVID extends beyond individual health, with significant implications for healthcare systems and economic stability. Addressing this challenge requires ongoing multidisciplinary research, validated diagnostic criteria, novel biomarkers, and effective preventive and therapeutic strategies. Furthermore, decentralized monitoring models-exemplified by telephone-based data collection in the WHF study-may offer scalable approaches to improve surveillance and inform global health policies for current and future public health crises.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"79"},"PeriodicalIF":3.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake and Effectiveness of Outpatient vs. Residential Cardiac Rehabilitation After Myocardial Infarction: A Nationwide Analysis.","authors":"Borut Jug, Zlatko Fras, Tjaša Furlan, Marko Novaković, Jerneja Tasič, Mitja Lainščak, Jerneja Farkaš, Dalibor Gavrić, Irena Ograjenšek, Petra Došenović Bonča","doi":"10.5334/gh.1470","DOIUrl":"10.5334/gh.1470","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;To estimate the participation in, and the comparative effectiveness of, short-term residential and comprehensive outpatient cardiac rehabilitation (CR), after the latter was introduced in Slovenia by establishing dedicated regional CR centers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We extracted and analyzed data on all patients hospitalized for myocardial infarction in Slovenia (&lt;i&gt;n&lt;/i&gt; = 15,639), focusing on CR participation - either comprehensive outpatient (introduced in 2017) or short-term residential (available throughout the study period 2015-2021). Impact on nation-wide CR participation rates was assessed by interrupted time series analysis; impact on patient-level outcomes (all-cause mortality and cardiovascular hospitalizations) was assessed using Kaplan Meier estimators and 'doubly robust' Cox regression with propensity score-derived inverse probability of treatment weighting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 11,815 eligible patients (event-free after 180-day landmark), 3819 (32.3%) attended CR. Nation-wide CR participation rates increased both in level (9.7%, 95% CI 6.3-3.1) and in trend (0.41% per month, 95% CI 0.22-0.60) after outpatient CR was introduced in 2017. After propensity score-based adjustment, participation in either CR was associated with lower event rates (12.8%, 17.2%, and 21.0% at 3-year follow-up for outpatient, residential, and no CR, respectively; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Risk reductions were significant for composite outcomes (outpatient: HR 0.58, 95% CI 0.47-0.70; residential: HR 0.79, 95% CI 0.68-0.93) and all-cause mortality (outpatient: HR 0.56, 95% CI 0.38-0.83; residential: HR 0.59, 95% CI 0.45-0.77), whereas the risk reduction for cardiovascular hospitalizations was only significant for outpatient CR (HR 0.60, 95% CI 0.48-0.74). The incremental cost-effectiveness ratio per life-year gained was €6421 and €7381 for outpatient and residential CR, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Participation in either CR improves outcomes after myocardial infarction, but comprehensive outpatient CR conveys superior risk reductions, primarily through reduced cardiovascular hospitalizations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay summary: &lt;/strong&gt;Our study highlights the importance of expanding cardiac rehabilitation services (by setting up dedicated regional comprehensive outpatient centers) and provides new evidence on improved outcomes in patients after myocardial infarction, who undergo cardiac rehabilitation. While previous studies have demonstrated the efficacy and effectiveness of cardiac rehabilitation, ours is the first to compare two distinctive cardiac rehabilitation modalities - comprehensive outpatient (introduced in 2017) and short-term residential (available throughout the study period 2015-2021).In our nationally representative population of patients after myocardial infarction (&lt;i&gt;n&lt;/i&gt; = 15,639), participation in cardiac rehabilitation increased both in level (by ~10%) and in trend (by ~0.4% pe","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"80"},"PeriodicalIF":3.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Disparities in Cardiogenic Shock: Risk Factors, Treatment Intensity, and Mortality in a Single Latin American Country.","authors":"Alexandra Arias-Mendoza, Héctor González-Pacheco, Amada Álvarez-Sangabriel, Diego Araiza-Garaygordobil, Pamela Ramírez-Rangel, Rodrigo Gopar-Nieto, Maria Del Carmen López-Rodríguez, Daniel Sierra-Lara-Martínez, Salvador Mendoza-García, Braiana Ángeles Díaz-Herrera, María Nila Papaqui-Quitl, Jaime Hernández-Montfort, Jorge A Ortega-Hernández","doi":"10.5334/gh.1469","DOIUrl":"10.5334/gh.1469","url":null,"abstract":"<p><strong>Background: </strong>Cardiogenic shock (CS) carries a high in-hospital mortality, with limited data on sex-related disparities in Latin America. Women remain underrepresented in CS studies.</p><p><strong>Objectives: </strong>To evaluate sex-specific differences in characteristics, management, and mortality in acute myocardial infarction-related (AMI-CS) and non-AMI-CS in a large Latin-American cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed 9430 patients (5016 AMI-CS and 4414 non-AMI-CS) with SCAI-CSWG stages B-E in a reference center in Mexico City from 2005 to 2023. The primary outcome was in-hospital mortality. Analyses included multivariable Cox models and propensity score matching (PSM).</p><p><strong>Results: </strong>Women with AMI-CS were older (67 vs. 60 years), had more hypertension (66% vs. 52%) and diabetes (53% vs. 38%), and received less primary reperfusion (62% vs. 71%) and mechanical circulatory support (11.6% vs. 14.7%) than men (all <i>P</i> < 0.05). In non-AMI-CS, women were older (66 vs. 60 years), had more prior heart failure (33% vs. 24%), while men had more chronic obstructive pulmonary disease (COPD) and prior MI (all <i>P</i> < 0.05). Unadjusted mortality was higher in women in AMI-CS (24.6% vs. 16.3%, HR 1.48, 95% CI 1.28-1.72) and non-AMI-CS (HR 1.18, 95% CI 1.05-1.32). After PSM, mortality differences were not significant in AMI-CS (HR 1.22, 95% CI 1.00-1.48) or non-AMI-CS (HR 1.07, 95% CI 0.92-1.24).</p><p><strong>Conclusions: </strong>Women with CS in Latin America present with greater comorbidity and less aggressive/invasive management. While unadjusted mortality was higher in women, these differences were no longer significant after PSM, indicating that baseline factors and treatment disparities largely explain excess risk.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"78"},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Silent Surge: Obesity Driving a Global Cardiovascular Crisis.","authors":"Panniyammakal Jeemon, Sivasankaran Sivasubramonian","doi":"10.5334/gh.1464","DOIUrl":"10.5334/gh.1464","url":null,"abstract":"<p><p>Recent global estimates indicate that more than one billion people live with obesity, a figure that has doubled since 1990. When overweight individuals are included, nearly 2.5 billion adults are affected, with high body mass index contributing to an estimated 1.9 million cardiovascular disease (CVD) deaths annually. Obesity and its close association with CVD remain pressing public health challenges that require sustained, coordinated action. Recent global policy discussions, including the UN General Assembly's Zero Draft Political Declaration, highlight the importance of improving food labelling, taxing sugary drinks, limiting the marketing of unhealthy foods, and encouraging active living through supportive urban planning. Countries are encouraged to align national obesity strategies with the WHO's 2022 Acceleration Plan to STOP Obesity, with clear goals and mechanisms for accountability and monitoring. Preventive measures are most effective when introduced early, such as encouraging breastfeeding and creating supportive school environments that offer balanced meals, limit access to unhealthy foods, and incorporate regular physical activity into daily schedules. Fiscal measures, including taxes, subsidies, and mandatory nutrition labels, can help guide consumer choices towards healthier options. Supportive built environments with safe access to parks, pedestrian routes, and cycling paths further encourage active lifestyles. Health systems are central in ensuring equitable access to prevention and treatment, delivered through stigma-free and evidence-based care. Community-based and family-oriented programs have shown promise, while pharmacological options may complement lifestyle approaches where appropriate. Long-term progress depends on sustained commitment, cross-sectoral collaboration, and integration of obesity prevention into broader public health frameworks.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"77"},"PeriodicalIF":3.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimism Model by a Cardiology Pharmacist in Breaking Bad News Among Patients with CTRCD and its Impact on Outcomes.","authors":"Israa Fadhil Yaseen, Hasan Ali Farhan","doi":"10.5334/gh.1465","DOIUrl":"10.5334/gh.1465","url":null,"abstract":"","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"76"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Rehabilitation in Patients with Coronary Heart Disease - Provision, Attendance, and Outcomes: Results from the INTERASPIRE Survey from Fourteen Countries Across Six WHO Regions.","authors":"Kornelia Kotseva, Dirk De Bacquer, Catriona Jennings, John William McEvoy, Lars Ryden, Kausik K Ray, Gregory Y H Lip, Iris Erlund, Sandra Ganly, Terhi Vihervaara, Agnieszka Adamska, Ana Abreu, Wael Almahmeed, Ade Meidian Ambari, Susan Connolly, Junbo Ge, Irene Gibson, Hosam Hasan-Ali, Sue Hennessy, Yong Huo, Piotr Jankowski, Rodney M Jimenez, Jennifer Jones, Yong Li, Ahmad Syadi Mahmood Zuhdi, Abel Makubi, Amam Chinyere Mbakwem, Lilian Mbau, Jose Luis Navarro Estrada, Okechukwu Samuel Ogah, Elijah Nyainda Ogola, Adalberto Quintero-Baiz, Mahmoud Umar Sani, Maria Ines Sosa Liprandi, Jack Wei Chieh Tan, David R Thompson, Miguel Alberto Urina Triana, Tee Joo Yeo, David Wood, Guy G De Backer","doi":"10.5334/gh.1458","DOIUrl":"10.5334/gh.1458","url":null,"abstract":"<p><strong>Background: </strong>INTERASPIRE was an observational study of patients with coronary heart disease (CHD) from 88 hospitals in 14 countries across all six WHO regions. The objective was to describe the proportions of patients referred to and attending cardiac rehabilitation (CR) programmes and to compare lifestyle and risk factor target achievement according to participation in a CR programme.</p><p><strong>Methods: </strong>Patients 18-80 years of age, with a first or recurrent coronary hospitalisation (acute coronary syndrome and/or revascularisation procedure) were identified and invited to an interview and examination, between six months and two years after the index hospitalisation.</p><p><strong>Results: </strong>Overall, 4,548 (21.1% female) patients were interviewed a median of 1.05 (interquartile range 0.76-1.45) years after hospitalization. Of those patients, 34.4% reported having been advised to participate in a CR programme, though the percentage varied widely by country, from 4.0% in Kenya to 69.6% in Poland. Among patients advised to participate in CR, 57.1% participated in ≥50% of all sessions, 15.4% participated in <50% of the sessions, and 27.4% did not participate at all. Only 19.6% of all patients recruited to the study attended ≥50% of sessions. Content of programmes reported by patients also varied enormously between countries. Low education level, elective PCI, or unstable angina as recruiting events were associated with lower attendance rates. Attendance at ≥50% of all CR sessions was associated with a lower prevalence of persistent smoking and physical inactivity, better control of blood pressure and LDL-cholesterol, and a higher use of cardioprotective medications.</p><p><strong>Conclusions: </strong>INTERASPIRE provides a standardised international picture of CR provision and attendance in patients with CHD. Despite CR being a Class 1 recommendation in all international guidelines, only one third of CHD patients reported being advised to attend any form of CR and just one in five patients attended 50% of the sessions, with striking heterogeneity between regions and countries. National cardiology societies should advocate to their governments for urgent investment in standardised CR services.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"75"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Apple Watch to Measure Cardiovascular Indices in Patients with Cardiac Diseases: Observational Study.","authors":"Alaa Abdulhafiz Khushhal, Ashraf Abdelaal Mohamed, Mahmoud Elshahat Elsayed","doi":"10.5334/gh.1456","DOIUrl":"10.5334/gh.1456","url":null,"abstract":"<p><p>The validity of Apple Watch for measuring heart rate (HR) and oxygen saturation (SpO₂) in patients with cardiac diseases is still unclear. Therefore, this study aimed to investigate the accuracy of the Apple Watch in measuring HR and SpO₂ in patients with cardiac diseases. A cross-sectional study recruited 260 cardiac patients, including 190 with regular heart rhythm and 70 with cardiac arrhythmia. Each patient wore the Apple Watch alongside a Polar HR monitor at rest, during and after mild- to moderate-intensity exercise sessions, and wore the Apple Watch alongside a Contec pulse oximeter at rest and after exercise. The Apple Watch showed excellent validity (ICC = 0.100) in measuring the HR at rest, during mild- to moderate-intensity exercise, and after exercise in cardiac patients, as well as in measuring SpO₂ at rest (ICC = 0.100) and after exercise (ICC = 0.92). However, the validity of the Apple Watch for measuring SpO₂ decreased slightly after exercise (ICC = 0.85; good validity), especially in patients with an irregular heart rhythm. Overall, the Apple Watch appears valid for measuring HR and SpO₂ at rest and after exercise, and for measuring HR during mild- to moderate-intensity training in cardiac patients.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"74"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Acute Rheumatic Fever Diagnosis on Rheumatic Heart Disease Severity.","authors":"Jacqueline Maree Williamson, Gillian Whalley, Simon Thornley, James Marangou, Peter Morris, Joshua R Francis, Vicki Wade, Bo Remenyi","doi":"10.5334/gh.1454","DOIUrl":"10.5334/gh.1454","url":null,"abstract":"<p><strong>Background: </strong>Acute rheumatic fever (ARF) is the precursor to rheumatic heart disease (RHD) following Group A Streptococcal infection. However, many diagnoses of RHD are made in the absence of ARF history. We compared RHD severity between those with and those without a documented history of ARF.</p><p><strong>Methods: </strong>A retrospective audit of echocardiographic images determined RHD stage at diagnosis and at follow-up based on the 2023 WHF guidelines for the diagnosis of RHD.Individuals aged ≤ 20 years from the Top End of the Northern Territory (NT) of Australia with RHD diagnosis between January 2012 and December 2021 were included.Primary outcome was RHD stage at the time of diagnosis. Secondary outcomes were RHD stage progression or regression. Those with ARF and those with no ARF (noARF) were compared.</p><p><strong>Results: </strong>Study population (<i>n</i>) of 292 individuals with mean age 11.9 ± 3.8 years. At baseline, the ARF group had more Stage A RHD (28.6% versus 12.0%), while the noARF group had more Stage B (50.0% versus 38.0%), <i>p</i> = 0.009. There was no difference in advanced RHD (Stage C and D combined) between the groups (<i>p</i> = 0.440). Follow-up (median 46 months, IQR: 27-71 months) sample size was 230. Regression of RHD was greater in the ARF group (46% versus 28%, <i>p</i> = 0.014). No difference was found in stage progression (including to surgery), with 21% (32/156) in the ARF group and 15% (11/74) in the noARF group (<i>p</i> = 0.367).</p><p><strong>Conclusions: </strong>Individuals at all stages of RHD severity were detected amongst those with and without an accompanying diagnosis of ARF. Individuals with first RHD diagnosis accompanied by ARF were more likely to regress. These findings support echocardiographic screening in high-risk populations to detect early RHD that can be treated with secondary antibiotic prophylaxis. Further research is required to understand the reason for differences between the ARF and noARF groups.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"72"},"PeriodicalIF":3.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}