Global Heart最新文献

{"title":"Primary Causes and Direct Medical Cost of Heart Failure Among Adults Admitted with Acute Decompensated Heart Failure in a Public Tertiary Hospital, Kenya.","authors":"Victor M Wauye, G Titus Ngeno, Chrispine O Oduor, Felix A Barasa","doi":"10.5334/gh.1426","DOIUrl":"https://doi.org/10.5334/gh.1426","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a major contributor to cardiovascular morbidity and mortality. Adversely impacting health outcomes in Kenya and other developing countries, data on the direct medical cost of HF hospitalization remain limited.</p><p><strong>Methods: </strong>This was a prospective study conducted at Moi Teaching and Referral Hospital. Patients with HF were identified by sequential medical chart abstraction. Primary causes were extracted from echocardiogram reports and adjudicated by a cardiologist. Direct medical cost of hospitalization was derived using activity-based and micro-costing methods, adopting payers' system perspective. Drivers of overall cost were explored using linear regression models.</p><p><strong>Results: </strong>142 participants were consecutively recruited from September to November 2022. 51.4% were females, and the mean age was 54 (SD 20). The leading primary causes were cor pulmonale (CP), 28.9%; dilated cardiomyopathy (DCM), 26.1%; rheumatic heart disease (RHD), 19.7%; hypertensive heart disease (HHD), 16.9%; ischaemic heart disease (IHD), 6.3%; and pericardial disease (PD), 2.1%. Overall direct cost of HF hospitalization was KES 11,470.94 (SD 8,289.57) [USD 93.49 (67.56)] per patient per day, with the mean length of hospital stay of 10.1 (SD 7.1). RHD incurred the highest costs, KES 15,299.08 (SD 13,196.89) [USD 124.70 (107.56)] per patient per day; IHD, KES 12,966.47 (SD 6656.49) [USD 105.68 (54.25)]; and DCM, KES 12,268.08 (SD 7,816.12) [USD 99.99 (63.71)]. The cost of medications was the leading driver, β = 0.56 (0.55 - 0.56), followed by inpatient fees, β = 0.27 (0.27 - 0.28), and laboratory investigations, β = 0.19 (0.18 - 0.19).</p><p><strong>Conclusion: </strong>Cor pulmonale, CM, RHD, and HHD were the major causes of HF. The overall direct medical cost of hospitalization was extremely expensive compared with the Kenyan average monthly household income per capita. Widespread comprehensive health insurance coverage is therefore recommended to cushion families against such catastrophic health expenditures besides public health measures aimed at addressing primary causes of HF.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"42"},"PeriodicalIF":3.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028386","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":"Impact of Bicytopenia on Mortality in Hospitalised Patients With Heart Failure.","authors":"Toshitaka Okabe, Tadayuki Yakushiji, Daiki Kato, Hirotoshi Sato, Toshihiko Matsuda, Yui Koyanagi, Katsuya Yoshihiro, Takeshi Okura, Yuma Gibo, Yuki Ito, Tatsuki Fujioka, Shigehiro Ishigaki, Shuro Narui, Taro Kimura, Suguru Shimazu, Yuji Oyama, Naoei Isomura, Masahiko Ochiai","doi":"10.5334/gh.1425","DOIUrl":"https://doi.org/10.5334/gh.1425","url":null,"abstract":"<p><strong>Background: </strong>Limited data are available on bicytopenia (BC) in patients with heart failure (HF).</p><p><strong>Objectives: </strong>This study evaluated the association between BC and prognosis in patients with HF.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled consecutive hospitalised patients with HF. We compared all-cause and cardiovascular mortality between those with and without BC. BC was defined as the combination of any two conditions among leukopaenia, thrombocytopaenia, and anaemia. Propensity score matching and a Cox proportional hazards model were applied.</p><p><strong>Results: </strong>Among 935 hospitalised patients, 103 patients had BC. Patients in the BC group were older (80.0 ± 12.0 vs. 73.4 ± 14.7 years; <i>P</i> < 0.0001), including a higher proportion of females (55.3% vs. 41.7%; <i>P</i> = 0.009), had a higher prevalence of atrial fibrillation (51.5% vs 41.1%; <i>P</i> = 0.047), had a lower baseline estimated glomerular filtration rate (50.8 ± 24.1 vs. 56.2 ± 23.9 mL/min/1.73 m²; <i>P</i> = 0.03), and had a higher left ventricular ejection fraction (48.1 ± 16.1 vs. 42.4 ± 15.8%; <i>P</i> = 0.0008). Propensity score matching with a 1:1 ratio produced 63 matched pairs. All-cause mortality was significantly higher in the BC group than in the non-BC group (log-rank <i>P</i> = 0.069 and Wilcoxon <i>P</i> = 0.048); however, cardiovascular mortality and hospitalisation for HF showed no significant differences. In the multivariate Cox proportional hazard model, BC was associated with higher all-cause mortality but not with cardiovascular mortality (hazard ratio, 1.983; 95% confidence interval, 1.008-3.898; <i>P</i> = 0.047).</p><p><strong>Conclusion: </strong>BC was associated with all-cause mortality but not with cardiovascular mortality in patients with HF. BC is an important risk factor for all-cause mortality in patients with HF.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"41"},"PeriodicalIF":3.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023640","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":"Association Between High Sensitivity Cardiac Troponin and All-Cause and Cardiovascular Mortality in Adults at Risk of Non-Alcoholic Fatty Liver Disease: A Cohort Study.","authors":"Enfa Zhao, Hang Xie, Yuan Gao, Xiaolin Wen, Bingtian Dong, Chaoxue Zhang","doi":"10.5334/gh.1427","DOIUrl":"https://doi.org/10.5334/gh.1427","url":null,"abstract":"<p><strong>Objective: </strong>Cardiovascular disease (CVD) is the leading cause of death among patients with non-alcoholic fatty liver disease (NAFLD). This study investigates the association between high-sensitivity cardiac troponin (hs-cTn) levels and mortality in adults at risk of NAFLD in a representative U.S. population sample.</p><p><strong>Methods: </strong>Among participants aged 18 years and older in the 1999-2004 National Health and Nutrition Examination Survey, we measured high-sensitivity troponin T using a single assay (Roche) and high-sensitivity troponin I using three assays (Abbott, Siemens, and Ortho). Myocardial injury was identified by elevated levels of hs-cTn. Mortality outcomes were determined through linkage with the National Death Index database, with follow-up until December 31, 2019. A multivariable Cox proportional hazards model was used to evaluate the associations between myocardial injury and mortality in the NAFLD population. Sensitivity analyses were conducted to assess the robustness of the main findings.</p><p><strong>Results: </strong>A total of 2581 at risk of NAFLD were included in this observational study, with myocardial injury identified in 7.01%. Over a median follow-up of 16.7 years, 937 all-cause deaths occurred, including 319 cardiovascular disease-related deaths. NAFLD individuals with myocardial injury had worse survival rates at 5, 10, and 15 years compared to those without myocardial injury. After adjusting for baseline characteristics, myocardial injury was associated with an increased risk of all-cause mortality (adjusted Hazard Ratio [aHR] 1.785, 95% CI 1.494-2.134, <i>P</i> < 0.001) and cardiovascular mortality (aHR 2.155, 95% CI 1.606-2.893, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>This large, nationally representative study demonstrates that myocardial injury, defined by elevated hs-cTn levels, is independently associated with increased all-cause and cardiovascular mortality risks in the adult population at risk of NAFLD in the United States. This association persisted after adjusting for various factors and in patients without pre-existing cardiovascular disease. The Siemens hs-cTn I assay demonstrated the strongest association with all-cause mortality. These findings highlight the potential of hs-cTn as a valuable prognostic marker in NAFLD patients, even in those without clinically apparent cardiovascular disease. Routine hs-cTn assessment may aid in risk stratification and guide targeted interventions to reduce mortality risk in this population.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"40"},"PeriodicalIF":3.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044895","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":"Community Health Workers Equipped with an mHealth Application Can Accurately Diagnose Hypertension in Rural Guatemala.","authors":"Sean Duffy, Taryn McGinn Valley, Alejandro Chavez, Valerie Aguilar, Juan Aguirre Villalobos, Kaitlin Tetreault, Guanhua Chen, Elizabeth White, Alvaro Bermudez-Cañete, Do Dang, Julie Cornfield, Yoselin Letona, Rafael Tun","doi":"10.5334/gh.1423","DOIUrl":"10.5334/gh.1423","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a leading global cause of morbidity and mortality and is increasing in low- and middle-income countries, where unawareness of hypertension is a primary obstacle to management. Community health workers (CHWs) in combination with mobile health (mHealth) tools are increasingly used in LMIC health systems to strengthen primary care infrastructure. In this study, we applied this care model to hypertension in rural Guatemala by comparing the accuracy of CHWs equipped with an mHealth clinical decision support application in diagnosing hypertension to concurrent physician evaluation.</p><p><strong>Methods: </strong>We performed a prospective diagnostic accuracy study in which adults from rural Guatemalan communities were assessed independently by a CHW aided by a mHealth application and a physician. Assessment included medical history; measurement of blood pressure, height and weight; and determination of hypertension status. CHW-physician agreement on hypertension status and past medical history elements was assessed by Kappa analysis and proportional agreement, with <i>a priori</i> thresholds of Kappa = 0.61 and agreement of 90%. Agreement on patient measurements was evaluated using Bland-Altman and regression analyses.</p><p><strong>Results: </strong>Of 359 participants enrolled, 47 (13%) were confirmed to have hypertension and another 11 (3%) had possible hypertension. CHW-physician agreement was high for hypertension diagnosis, with Kappa = 0.8 (95% CI = 0.72, 0.88) and overall agreement 92.8% (95% CI = 90.1%, 95.4%). Bland-Altman analysis showed small biases toward lower systolic blood pressure, higher height, and lower BMI measurements by CHWs. Most patient history characteristics showed moderate to almost perfect (Kappa: 0.41-1) agreement between physicians and CHWs.</p><p><strong>Conclusions: </strong>In this study based in rural Guatemala, CHWs using a mHealth clinical decision support application were found to screen adult patients for hypertension with similar accuracy to a physician. This approach could be adapted to other low-resource settings to reduce the burden of undiagnosed and untreated hypertension.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"39"},"PeriodicalIF":3.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046442","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":"Clinical Outcomes After Valve Intervention in Rheumatic Mitral Valve Disease.","authors":"Marco Aurélio da Silva Neves, Lucas Leal Fraga, Moises Barbosa de Andrade, Bruno Ramos Nascimento, Cláudio Leo Gelape, Renato Bráulio, Paulo Henrique Nogueira Costa, Marcia Fabrícia Almeida Teixeira, Paulo Henrique Moreira Melo, Guilherme Rafael Sant'Anna Athayde, Lucas Lodi-Junqueira, Robert A Levine, Maria Carmo Pereira Nunes","doi":"10.5334/gh.1420","DOIUrl":"https://doi.org/10.5334/gh.1420","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic heart disease (RHD) remains one of the leading causes of mitral valve (MV) disease in developing countries. Despite the availability of percutaneous and surgical interventions, long-term outcomes remain unclear. This study aims to identify determinants of outcomes following percutaneous or surgical intervention in patients with rheumatic MV disease, addressing critical gaps in treatment selection.</p><p><strong>Methods: </strong>A retrospective, intention-to-treat study was conducted on patients with symptomatic rheumatic MV disease, primarily characterized by mitral stenosis, who underwent either percutaneous mitral valvuloplasty (PMV) or MV replacement (MVR). Demographic, clinical, and echocardiographic variables were collected. The long-term outcome was defined as a composite of death, repeat PMV, need for cardiac surgery, and stroke.</p><p><strong>Results: </strong>A total of 246 patients were enrolled (mean age 43.8 ± 13 years, 80% women, with 45% in New York Heart Association [NYHA] class III/IV). Of these, 90 patients (37%) underwent MVR, while 156 patients (63%) underwent PMV, with similar clinical characteristics at baseline. During a mean follow-up of 2.8 years, ranging from 1 day to 7.8 years, 45 patients (18%) reached the composite outcome, including 11 deaths (4%). Long-term outcomes were comparable between PMV and MVR (P = 0.231). Independent predictors of composite outcomes included baseline NYHA class III/IV (adjusted hazard ratio [HR] 2.10, 95% confidence interval [CI] 1.10-4.11, P = 0.023) and older age (HR 1.03, 95% CI 1.01-1.06, p = 0.020). Predictors of all-cause mortality following either PMV or MVR were older age (HR 1.08, 95% CI 1.03-1.14, P = 0.002) and lower left ventricular ejection fraction (HR 0.93, 95% CI 0.88-0.99, P = 0.021).</p><p><strong>Conclusions: </strong>This study identified older age and higher NYHA functional class as significant predictors of composite outcomes in patients with rheumatic MV disease requiring intervention. Left ventricular systolic dysfunction was independently associated with increased mortality following both percutaneous and surgical intervention. Long-term outcomes were comparable between patients undergoing PMV and MVR, reinforcing PMV as an effective alternative to surgery in appropriately selected patients.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"38"},"PeriodicalIF":3.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998444","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":"Trends and Projections of Burden of Ischemic Heart Disease in China Versus Other G20 Countries: A Comparative Study Based on the 2021 Global Burden of Disease Database.","authors":"Yi Zhang, Hui Li, JingHan Chu, ShuaiShuai Ye, Chun Xiao, BuChun Zhang","doi":"10.5334/gh.1424","DOIUrl":"10.5334/gh.1424","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to analyse the burden of ischemic heart disease (IHD) in China and other G20 countries from 1990-2021 and predict the burden for the next decade.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease (GBD) 2021 study, we evaluated the age-standardised rates (ASRs) of incidence, prevalence, mortality and disability-adjusted life years (DALYs) by estimated annual percentage change (EAPC). The Bayesian age-period-cohort (BAPC) model was used to forecast the incidence, mortality and DALY rates of IHD in China from 2021-2040.</p><p><strong>Results: </strong>The ASRs of incidence, mortality and DALYs of IHD in China increased with EAPCs of 0.66 (95% CI: 0.50, 0.82), 0.97 (95% CI: 0.63, 1.31) and 0.51 (95% CI: 0.24, 0.78), respectively. Compared with other G20 countries, China was ranked 14th for the ASR of incidence in 1990 and then rose to 7th in 2021. The ASR of prevalence for IHD in China jumped from 8th in 1990 to 5th in 2021, and both the ASR of mortality and DALYs for IHD in China ranked 7th in 2021. The top five risk factors affecting mortality in China in 2021 were high systolic blood pressure, dietary risk, air pollution, high LDL cholesterol and tobacco. Over the next 20 years, the ASR of incidence, mortality and DALYs for IHD will increase continuously in males.</p><p><strong>Conclusion: </strong>The burden of IHD is expected to increase steadily in China, highlighting the urgency for early monitoring and preventative strategies, particularly focusing on the elderly and male populations.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"37"},"PeriodicalIF":3.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782127","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":"Climate, Air Quality and Their Contribution to Cardiovascular Disease Morbidity and Mortality in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.","authors":"Stephaney Gyaase, Solomon Nyame, Kerstin Klipstein-Grobusch, Kwaku Poku Asante, George S Downward","doi":"10.5334/gh.1409","DOIUrl":"10.5334/gh.1409","url":null,"abstract":"<p><strong>Background: </strong>Increasing exposure to climatic features is strongly linked to various adverse health outcomes and mortality. While the link between these features and cardiovascular outcomes is well established, most studies are from high-income countries.</p><p><strong>Objectives: </strong>This review synthesizes evidence as well as research gaps on the relationship between climate indicators, household/ambient air pollution, and all-cause cardiovascular disease (CVD) morbidity and mortality in low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>Seven electronic databases were searched up to June 15, 2024. Articles were included if they focused on LMICs, addressed all-cause CVD morbidity and/or mortality, and studied climate or environmental exposures. Studies were selected using ASReview LAB, extracted and analyzed with random effect meta-analysis performed if sufficient articles were identified.</p><p><strong>Results & conclusion: </strong>Out of 7,306 articles, 58 met the inclusion criteria: 26 on morbidity, 29 on mortality, and 3 on both. Exposures included PM₁₀, PM_2.5, NO₂, SO₂, BC, O₃, CO, solid fuel usage, and temperature variation. Short-term exposure to PM_2.5 was significantly associated with CVD morbidity (RR per 10 µg/m³ increase:1.006, 95% CI 1.003-1.009) and mortality (RR:1.007, 95% CI 1.002-1.012). Short-term exposure to NO₂ and O₃ also increased CVD mortality risk. Long-term exposure to PM_2.5 elevated CVD morbidity (RR per 10 µg/m³ increase:1.131, 95% CI 1.057-1.210) and mortality (RR:1.092, 95% CI 1.030-1.159). High and low temperatures and long-term solid fuel use were linked to CVD deaths. The bulk of studies were from mainland China (72%), which may not accurately reflect the situation in other LMICs. Sub-Saharan Africa was particularly lacking, representing a major research gap.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"35"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755966","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":"Optimizing Cardiovascular Assessment: Reducing Unnecessary Cardiac Troponin I Testing.","authors":"Ariana Fernandes, Aline C T Wisnivesky, Raíssa Rezende, Francisco A M Cardozo, Danielle M Gualandro, Daniela Calderaro, Luciana Fornari, Leila Antonangelo, Nairo Sumita, Celia Strunz, Luciana D Bichuette, Marcos P Lottenberg, Bruno Caramelli","doi":"10.5334/gh.1421","DOIUrl":"10.5334/gh.1421","url":null,"abstract":"","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"34"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755974","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":"Rheumatic Valvulopathy in Sub-Saharan Africa: A Cross-Sectional Study of Cameroonian Urban Schools.","authors":"Chris Nadège Nganou-Gnindjio, Anicet Gakdang Ladibe, Joël Marie Obama Nyaga, Sandrine Laure Ngambono, Loic Alban Tasong, Jules Thierry Elong, Hursul Geffried Nzongang, Félicité Kamdem, David Chelo","doi":"10.5334/gh.1414","DOIUrl":"10.5334/gh.1414","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic heart disease is a post-infectious sequelae of acute rheumatic fever resulting from an abnormal immune response to streptococcal pharyngitis that triggers valvular damage. It is the most commonly acquired heart disease in children, particularly in developing countries.</p><p><strong>Objective: </strong>This study aimed to describe rheumatic valvulopathy among schoolchildren and adolescents in Yaoundé, Cameroon.</p><p><strong>Methods: </strong>A cross-sectional echocardiography study was conducted from December 2022 to May 2023 among students aged 5 to 19 in primary and secondary schools in Yaoundé, Cameroon. All students with informed parental consent and who agreed to participate in the study were included. The data collected were entered and analysed using SPSS statistics software version 23.0. The association between the qualitative variables was verified using Odd-Ratio with a 95% confidence interval and a significance level of 5%.</p><p><strong>Results: </strong>Of the 1020 children recruited, 133 (13.03%) had rheumatic heart disease with a mean age of 11.69 ± 4.09 years. The sex ratio (M/F) was 0.56. Most of the participants lived in urban slums (60.9%). Cardiac murmurs were detected in 23 (17.3%) participants during auscultation, with the majority (78.3%) being located at the mitral focus. The definitive form of rheumatic heart disease was observed in 69 (51.9%) children. Mitral involvement was observed in all participants. Mitral valve abnormalities were primarily characterized by mitral insufficiency in 124 (93.2%) participants, valvular thickening (74.4%), and restriction of movement (42.9%). Age between 10 and 14 years [OR = 2.36; CI = (1.11-5.01)] and residence in urban slums [OR = 2.14; CI = (1.05-4.36)] were significantly associated with an increase in the occurrence of definitive rheumatic valve disease.</p><p><strong>Conclusion: </strong>Rheumatic heart disease is common among schoolchildren in this setting. It systematically affects the mitral valve. The clinical presentation is usually silent at first.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"36"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756110","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":"Global, Regional, and National Burden of Non-Rheumatic Valvular Heart Diseases in Women: A Systematic Analysis of Global Burden of Disease 1990-2021.","authors":"Liu Chenyu, Li Haochao, Chen Pengfei, Chen Mingjian, Zhao Diming, Wang Liqing","doi":"10.5334/gh.1422","DOIUrl":"10.5334/gh.1422","url":null,"abstract":"<p><strong>Background: </strong>The incidence of non-rheumatic valvular heart diseases (NRVHD) has shown an increasing trend. However, most studies have overlooked the impact of gender on the disease. Female patients, as a specific subgroup, have rarely been discussed independently. It is essential to conduct separate epidemiological studies to understand the latest epidemiological data for female NRVHD patients and to raise awareness among researchers and clinicians.</p><p><strong>Methods: </strong>Data from the Global Burden of Disease (GBD) 2021 database were retrieved to obtain epidemiological data on female NRVHD from both global and regional perspectives, covering 204 countries and territories. Joinpoint regression, age-period-cohort analysis, decomposition, and predictive analyses were employed to further examine the epidemiological data.</p><p><strong>Results: </strong>The incidence of female NRVHD patients has shown a continuous upward trend and is expected to persist in the future, particularly in regions with high and high-middle Socio-Demographic Index (SDI). However, in low and lower-middle SDI regions, patients experience relatively higher Disability-Adjusted Life Years (DALYs) and Years Lived with Disability (YLDs), with a greater number of heart failure cases attributed to NRVHD. Decomposition analysis indicates that the increase in the incidence of NRVHD and its subtypes is primarily driven by population growth and aging.</p><p><strong>Conclusions: </strong>With economic development and population aging, female NRVHD remains a significant healthcare burden for countries worldwide. Low- and middle-SDI regions should implement tertiary prevention strategies to address the impending shift in the spectrum of valvular heart diseases. Further clinical research should focus on female patients as a distinct subgroup of NRVHD, exploring the unique aspects of the disease in this population.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"33"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755971","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}