Iung Bernard
Département de cardiologie, hô6pital Bichat, 75577 Paris cedex 18, France.
Rev Prat. 2009 Feb 20;59(2):173-7.
Valvular heart diseases remain frequent in Western countries since the decrease in the frequency of rheumatic heart diseases has been replaced by degenerative valve diseases. Thus, there is an important increase in the prevalence of valvular heart diseases after the age of 65. The frequency of heart valve disease in the elderly has an important impact on patient management, given the frequency of comorbidity and the increase in the risk of interventions. The two other most frequent causes of heart valve disease are rheumatic fever and infective endocarditis. In Europe, the two most frequent heart valve diseases are calcified aortic stenosis and mitral regurgitation, while aortic regurgitation and mitral stenosis are rare. Rheumatic heart diseases remain frequent in developing countries. Their prevalence is underestimated by clinical screening alone. Systematic echocardiographic screening estimates the prevalence of rheumatic heart valve disease to be between 20 and 30 per 1000 in children of school age.
在西方国家,由于风湿性心脏病发病率的下降已被退行性瓣膜疾病所取代,心脏瓣膜疾病仍然很常见。因此,65岁以后心脏瓣膜疾病的患病率显著增加。鉴于合并症的发生率以及干预风险的增加,老年人心脏瓣膜疾病的发生率对患者管理具有重要影响。心脏瓣膜疾病的另外两个最常见病因是风湿热和感染性心内膜炎。在欧洲,最常见的两种心脏瓣膜疾病是钙化性主动脉瓣狭窄和二尖瓣反流,而主动脉瓣反流和二尖瓣狭窄则较为罕见。风湿性心脏病在发展中国家仍然很常见。仅通过临床筛查会低估其患病率。系统性超声心动图筛查估计,学龄儿童风湿性心脏瓣膜疾病的患病率为每1000人中有20至30例。