Soesanto Amiliana Mardiani, Almazini Prima, Ariani Rina, Rudiktyo Estu, Ardini Tengku Winda, Mumpuni Hasanah, Lefi Achmad, Ghaznawie Aussie Fitriani, Sari Ni Made Ayu Wulan, Yanni Mefri, Purwaningtyas Niniek, Harjoko Rille Puspitoadhi, Hasan Melawati, Nauli Siti Elkana, Laitupa Fitranti Suciati, Muchtar Novita, Karolina Wella, Puspita Indah, Haezer Reppi Gratiani Eben, Syahlul Dyna Evalina, Rahmianti Nia Dyah, Minaswary Rinelia, Hanifah Yasmina, Kuncoro Ario Soeryo
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/Universitas Indonesia Hospital, Depok, Indonesia.
JACC Asia. 2025 Sep;5(9):1171-1183. doi: 10.1016/j.jacasi.2025.03.010. Epub 2025 May 13.
Rheumatic heart disease (RHD) presents a significant public health challenge. Unfortunately, there is a lack of national data regarding the incidence and prevalence of RHD in Indonesia.
The purpose of this study was to evaluate the characteristics, burdens, and problems of RHD in Indonesia.
We collected medical reports of RHD patients over 18 years of age from 21 hospitals. Secondary data about clinical and echocardiography was collected to describe the characteristics, disease conditions, and complications of the disease.
We recruited 3,431 patients, average age was 44 years, and 64.4% (2,209 of 3,431) were women. Dyspnea was found in 85.7% (2,939 of 3,431), and 25% (862 of 3,431) of patients with NYHA functional class III to IV. Isolated mitral stenosis was the most prevalent valve lesion in 1,357 of 3,431 patients (39.6%). A total of 62.5 % (2,146 of 3,431) of patients had atrial fibrillation (AF), with the highest prevalence being in MV lesions. Vitamin K antagonist was prescribed in 2,411 of 3,431 (70.3%) of patients. A history of stroke was reported in 227 of 3,431 (6.6%) of patients and most frequently happened in isolated mitral stenosis patients 128 of 1,357 (9.4%). Finally, secondary prophylaxis was only administered in 1,279 of 3,431 (37.3%) of patients, and only 23.2% (796 of 3,431) had it regularly.
Our patients were predominantly women and had isolated mitral stenosis. Many patients came at a later stage of the disease, with older average age, a high prevalence of AF, pulmonary hypertension, and right heart involvement. The challenges were suboptimal use of anticoagulation despite the high prevalence of AF and underused secondary prophylaxis.
风湿性心脏病（RHD）是一项重大的公共卫生挑战。遗憾的是，印度尼西亚缺乏关于RHD发病率和患病率的全国性数据。
本研究旨在评估印度尼西亚RHD的特征、负担和问题。
我们收集了来自21家医院的18岁以上RHD患者的医学报告。收集了有关临床和超声心动图的二级数据，以描述该疾病的特征、病情和并发症。
我们招募了3431名患者，平均年龄为44岁，64.4%（3431名中的2209名）为女性。85.7%（3431名中的2939名）患者出现呼吸困难，25%（3431名中的862名）患者为纽约心脏协会（NYHA）功能分级III至IV级。单纯二尖瓣狭窄是3431名患者中1357名（39.6%）最常见的瓣膜病变。共有62.5%（3431名中的2146名）患者患有心房颤动（AF），在二尖瓣病变中患病率最高。3431名患者中有2411名（70.3%）使用了维生素K拮抗剂。3431名患者中有227名（6.6%）报告有中风病史，最常发生在单纯二尖瓣狭窄患者中，1357名中有128名（9.4%）。最后，二级预防仅在3431名患者中的1279名（37.3%）中实施，只有23.2%（3431名中的796名）患者定期接受二级预防。
我们的患者以女性为主，并患有单纯二尖瓣狭窄。许多患者在疾病晚期前来就诊，平均年龄较大，房颤、肺动脉高压和右心受累的患病率较高。面临 的挑战是，尽管房颤患病率很高，但抗凝治疗的使用并不理想，二级预防的使用也不足。
