Peters Ferande, Karthikeyan Ganesan, Abrams Jessica, Muhwava Lorrein, Zühlke Liesl
Cardiovascular pathophysiology and Genomic Unit, University of the Witwatersrand, Johannesburg, South Africa.
Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi, India.
Cardiovasc Diagn Ther. 2020 Apr;10(2):305-315. doi: 10.21037/cdt.2019.10.07.
Rheumatic heart disease (RHD) is the only preventable cardiovascular disease which causes significant morbidity and mortality particularly in low- and middle-income countries. Early clinical diagnosis is key, the updated Jones criteria increases the likelihood of diagnosis in endemic settings, including the echo diagnosis of sub-clinical carditis, polyarthralgia and monoarthritis as well as amended thresholds of minor criteria. The mainstay of rheumatic heart valve disease (RHVD) is a thorough clinical and echocardiographic investigation while severe disease is managed with medical, interventional and surgical treatment. In this report we detail some of the more recent epidemiological findings and focus on the diagnostic and interventional elements of the specific valve lesions. Finally, we discuss some of the recent efforts to improve medical and surgical management for this disease. As we are already more than a year from the historic 2018 World Heart Organization Resolution against Rheumatic Fever and Rheumatic Heart Disease, we advocate strongly for renewed efforts to prioritize this disease across the endemic regions of the world.
风湿性心脏病（RHD）是唯一可预防的心血管疾病，尤其在低收入和中等收入国家会导致严重的发病和死亡。早期临床诊断是关键，更新后的琼斯标准提高了在流行地区的诊断可能性，包括亚临床心肌炎、多关节痛和单关节炎的超声心动图诊断以及次要标准的修订阈值。风湿性心脏瓣膜病（RHVD）的主要诊断方法是全面的临床和超声心动图检查，而严重疾病则采用药物、介入和手术治疗。在本报告中，我们详细介绍了一些最新的流行病学研究结果，并重点关注特定瓣膜病变的诊断和介入因素。最后，我们讨论了最近为改善该疾病的药物和手术治疗所做的一些努力。自具有历史意义的2018年世界心脏组织抗风湿热和风湿性心脏病决议通过已过去一年多时间，我们强烈主张重新做出努力，将该疾病列为世界流行地区的优先事项。
