风湿性心脏病在指标病例一级亲属中的患病率：一项系统回顾和荟萃分析

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Global Heart Pub Date : 2025-03-10 eCollection Date: 2025-01-01 DOI:10.5334/gh.1417

Antonio Mutarelli, Guilherme Paes Gonçalves Nogueira, Alexandre Negrao Pantaleao, Alleh Nogueira, Bruna Giavina-Bianchi, Isabella M Gonzalez Fonseca, Bruno R Nascimento, Walderez O Dutra, Robert A Levine, Maria C P Nunes

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引用次数: 0

摘要

背景：风湿性心脏病（RHD）是儿童心脏死亡的主要原因，每年有超过30万人死亡。免疫、遗传和环境因素会增加RHD的风险。一级亲属是否比同一地区的一般人群有更高的RHD患病率尚不清楚。方法：我们对报告RHD患者或急性风湿热患者家庭成员中RHD患病率的超声心动图筛查研究进行了系统回顾和荟萃分析。检索PubMed、Embase、Cochrane和Lilacs数据库。RHD被归类为2012年世界心脏联合会的标准。随机效应模型评估了研究组中RHD的明确患病率。结果：纳入1160项研究中的4项，筛选了776名一级亲属。两项研究来自非洲，一项来自南美洲，一项来自大洋洲。在指示病例的一级亲属中，RHD患病率为7%（95%可信区间[CI] 3.7-13）。对照组，即家庭中没有已知RHD病例的个体，其患病率低于一级亲属（风险比[RR] 0.44, 95% CI 0.26-0.75）。在病例的兄弟姐妹和父母中，RHD的患病率没有差异。结论：该地区非亲属的总体患病率表明遗传易感性可能起作用。在未来的RHD研究中，一级亲属的系统筛查应考虑与更好的对照组——社会经济、地区、年龄和性别匹配。

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Prevalence of Rheumatic Heart Disease in First-Degree Relatives of Index-Cases: A Systematic Review and Meta-Analysis.

Background: Rheumatic heart disease (RHD) is the leading cause of cardiac death in children, with over 300,000 annual fatalities. Immunological, genetic, and environmental factors contribute to an increased risk of RHD. It remains unclear whether first-degree relatives have a higher prevalence of RHD compared to the general population in the same region.

Methods: We performed a systematic review and meta-analysis of echocardiographic screening studies reporting the prevalence of RHD in family members of individuals with RHD or acute rheumatic fever. PubMed, Embase, Cochrane, and Lilacs databases were searched. RHD was classified as per the 2012 World Heart Federation criteria. Random-effects models assessed definite RHD prevalence in study groups.

Results: Four of the 1,160 studies were included, with 776 first-degree relatives screened. Two studies were from Africa, one from South America, and one from Oceania. In the first-degree relatives of index cases, the prevalence of RHD was 7% (95% confidence interval [CI] 3.7-13). The control group, individuals screened with no known RHD cases in their family, had a lower prevalence than first-degree relatives (risk ratio [RR] 0.44, 95% CI 0.26-0.75). There was no difference in the prevalence of RHD among siblings and parents of cases.

Conclusion: There is an overall prevalence of non-relatives from the respective region, which suggests that genetic predisposition may play a role. In future studies of RHD, the systematic screening of first-degree relatives should be considered with a better control group-socioeconomic, region, age, and sex-matched.

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.