风湿性心脏瓣膜病在当代心力衰竭病因学中的相关性。

Relevance of Rheumatic Valvular Heart Disease in the Aetiology of Heart Failure in Contemporary Times.

机构信息

Department of Medicine, College of Medical Sciences, University of Benin/Teaching Hospital, Benin City, Edo State, Nigeria.

Faculty of Clinical Medicine, Delta State University, Abraka; and Department of Medicine, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria.

出版信息

West Afr J Med. 2021 Mar 22;38(3):241-245.

PMID:33765372

Abstract

BACKGROUND

Rheumatic valvular heart disease (RVHD) is one of the foremost causes of heart failure (HF) in our population, particularly among young adults, but a decline in the prevalence of RVHD has been observed. The effect of this decline on the relevance of RVHD among other causes of HF is not established in our setting.

OBJECTIVE

To determine whether RVHD is still a leading cause of HF in our population or not.

METHODS

This was a retrospective study of HF patients hospitalized between August 2018 and June 2020. The demographic features, blood pressure, aetiology of HF and ejection fraction were retrieved from the unit's HF register. Data were presented as frequencies and medians. Associations were tested as appropriate.

RESULTS

RVHD accounted for 78 (35.5%) of HF, with a median age of 47 years. The young and middle- aged subgroups were 10(12.8%) and 48(61.6%), respectively. The affected valves were all regurgitant and 68 (77.2%) had definite RVHD. Isolated mitral valve, combined mitral and aortic valves were affected in 40 (51.3%) and 22 (28.2%), respectively. The median systolic blood pressure and ejection fraction were 110mmHg and 26% respectively. RVHD was associated with HF with reduced ejection fraction. (P value < 0.001).

CONCLUSION

RVHD remains one of the leading causes of HF (35.5%) among adults in our population. Young adults are now in the minority and most patients present late in the course of the disease. Valve surgery should be made readily accessible. Primary and secondary prevention of acute rheumatic fever should be reinforced.

摘要

背景

风湿性心脏瓣膜病（RVHD）是导致我国人群心力衰竭（HF）的首要原因之一，尤其在年轻人中更为常见，但风湿性心脏瓣膜病的患病率有所下降。在我国，这种下降对风湿性心脏瓣膜病在其他心力衰竭病因中的相关性的影响尚不清楚。

目的

确定风湿性心脏瓣膜病是否仍是我国人群心力衰竭的主要病因。

方法

这是一项回顾性研究，纳入了 2018 年 8 月至 2020 年 6 月期间住院的心力衰竭患者。从该单位的心力衰竭登记处检索人口统计学特征、血压、心力衰竭病因和射血分数。数据以频率和中位数表示。适当进行关联检验。

结果

风湿性心脏瓣膜病占心力衰竭的 78 例（35.5%），中位年龄为 47 岁。年轻和中年亚组分别为 10 例（12.8%）和 48 例（61.6%）。受累瓣膜均为反流性，68 例（77.2%）为明确的风湿性心脏瓣膜病。单独二尖瓣、二尖瓣和主动脉瓣联合受累分别为 40 例（51.3%）和 22 例（28.2%）。中位收缩压和射血分数分别为 110mmHg 和 26%。风湿性心脏瓣膜病与射血分数降低的心力衰竭有关（P 值<0.001）。