Kim Hyung Yoon, Lee Hee Jeong, Kim In-Cheol, Son Jung-Woo, Park Jun-Bean, Lee Sahmin, Kim Eun Kyoung, Park Seong-Mi, Chung Woo-Baek, Cho Jung Sun, Park Jin-Sun, Seo Jeong-Sook, Lee Sun Hwa, Sun Byung Joo, Shim Chi Young, Kim Hyungseop, Kim Kye Hun, Kang Duk-Hyun, Ha Jong-Won
Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea.
J Cardiovasc Imaging. 2024 Nov 22;32(1):37. doi: 10.1186/s44348-024-00036-z.
This study was designed to determine the current status of diagnosis and treatment of valvular heart disease (VHD) in Korea.
A nationwide registry study was conducted in 45 hospitals in Korea involving adult patients with at least moderate VHD as determined by echocardiography carried out between September and October of 2019. Of a total of 4,094 patients with at least moderate VHD, 1,482 had severe VHD (age, 71.3 ± 13.5 years; 49.1% male). Echocardiographic data used for the diagnosis of each case of VHD were analyzed. Experts from each center determined the diagnosis and treatment strategy for VHD based on current guidelines and institutional policy. The clinical outcome was in-hospital mortality.
Each valve underwent surgical or transcatheter intervention in 19.3% cases of severe mitral stenosis, 31.4% cases of severe primary mitral regurgitation (MR), 7.5% cases of severe secondary MR, 43.7% cases of severe aortic stenosis, 27.5% cases of severe aortic regurgitation, and 7.2% cases of severe tricuspid regurgitation. The overall in-hospital mortality rate for patients with severe VHD was 5.4%, and for secondary severe MR and severe tricuspid regurgitation, the rates were 9.0% and 7.5%, respectively, indicating a poor prognosis. In-hospital mortality occurred in 73 of the 1,244 patients (5.9%) who received conservative treatment and in 18 of the 455 patients (4.0%) who received a surgical or transcatheter intervention, which was significantly lower in the intervention group (P = 0.037).
This study provides important information about the current status of VHD diagnosis and treatment through a nationwide registry in Korea and helps to define future changes.
本研究旨在确定韩国心脏瓣膜病（VHD）的诊断和治疗现状。
在韩国45家医院开展了一项全国性登记研究，纳入2019年9月至10月间经超声心动图确诊至少为中度VHD的成年患者。在总共4094例至少为中度VHD的患者中，1482例患有重度VHD（年龄71.3±13.5岁；男性占49.1%）。分析了用于诊断每例VHD的超声心动图数据。各中心的专家根据现行指南和机构政策确定VHD的诊断和治疗策略。临床结局为住院死亡率。
在重度二尖瓣狭窄病例中，19.3%的瓣膜接受了手术或经导管介入治疗；重度原发性二尖瓣反流（MR）病例中为31.4%；重度继发性MR病例中为7.5%；重度主动脉瓣狭窄病例中为43.7%；重度主动脉瓣反流病例中为27.5%；重度三尖瓣反流病例中为7.2%。重度VHD患者的总体住院死亡率为5.4%，继发性重度MR和重度三尖瓣反流患者的死亡率分别为9.0%和7.5%，提示预后较差。在1244例接受保守治疗的患者中，73例（5.9%）发生住院死亡；在455例接受手术或经导管介入治疗的患者中，18例（4.0%）发生住院死亡，干预组的死亡率显著更低（P = 0.037）。
本研究通过韩国的一项全国性登记提供了有关VHD诊断和治疗现状的重要信息，并有助于明确未来的变化。
