Liu Cheng, Zhang Shenghui
Department of Cardiology, Guangzhou First People's Hospital, South China University of Technology, 510180 Guangzhou, Guangdong, China.
Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, 510180 Guangzhou, Guangdong, China.
Rev Cardiovasc Med. 2025 Aug 29;26(8):38912. doi: 10.31083/RCM38912. eCollection 2025 Aug.
Valvular heart disease (VHD), including both non-rheumatic valvular heart disease (NRVHD) and rheumatic valvular heart disease (RVHD), is a major global health concern. Moreover, the progression of VHD to heart failure (HF) poses substantial clinical and public health challenges. In light of the global population aging, alongside increasing cardiovascular risk factors, and the additional strain imposed by the COVID-19 pandemic, a timely reassessment of the VHD-related HF burden is urgently needed. Using the most recent data from the Global Burden of Disease (GBD) Study 2021, this study aimed to evaluate the distribution of VHD-related HF burden in 2021, examining the long-term trends from 1990 to 2021, and short-term changes between 2019 and 2021, to provide updated insights to inform future prevention and management strategies.
Using GBD 2021 data, we analyzed the distribution of VHD-related HF burden in age-standardized prevalence rates across the Group of Twenty (G20) countries.
The highest NRVHD-related HF burden in 2021 was observed in the United States (US), Italy, and Russia, while the highest RVHD-related HF burden was noted in India, France, and China. Over the past 30 years (1990-2021), the NRVHD-related HF burden decreased in developed countries (e.g., the US, Canada, Japan) but increased in emerging economies (e.g., India, Brazil, South Africa), with significant increases also observed in Argentina, Mexico, Brazil, among other countries. Notably, nearly all G20 countries exhibited a downward trend in RVHD-related HF burden, with Germany and Australia being the exceptions. During the COVID-19 pandemic (2019-2021), the NRVHD-related HF burden declined in most G20 nations, except for South Africa, India, and a few others, while the RVHD-related HF burden increased slightly in countries such as Mexico, Russia, and Indonesia.
Trends in NRVHD- and RVHD-related HF burden across G20 countries exhibited notable variations, and these became more pronounced under the impact of the COVID-19 pandemic. These findings underscore the importance of developing long-term strategies to enhance the resilience of healthcare systems, improve chronic disease management, and optimize resource allocation to promote cardiovascular health and preparedness for public health challenges.
瓣膜性心脏病（VHD），包括非风湿性瓣膜性心脏病（NRVHD）和风湿性瓣膜性心脏病（RVHD），是全球主要的健康问题。此外，VHD进展为心力衰竭（HF）带来了重大的临床和公共卫生挑战。鉴于全球人口老龄化，以及心血管危险因素的增加，再加上新冠疫情带来的额外压力，迫切需要及时重新评估与VHD相关的HF负担。本研究利用《2021年全球疾病负担（GBD）研究》的最新数据，旨在评估2021年与VHD相关的HF负担分布，研究1990年至2021年的长期趋势，以及2019年至2021年的短期变化，以提供最新见解，为未来的预防和管理策略提供参考。
利用GBD 2021数据，我们分析了二十国集团（G20）国家中按年龄标准化患病率计算的与VHD相关的HF负担分布。
2021年，美国、意大利和俄罗斯的NRVHD相关HF负担最高，而印度、法国和中国的RVHD相关HF负担最高。在过去30年（1990 - 2021年）中，发达国家（如美国、加拿大、日本）的NRVHD相关HF负担有所下降，但新兴经济体（如印度、巴西、南非）有所上升，阿根廷、墨西哥、巴西等其他国家也有显著增加。值得注意的是，几乎所有G20国家的RVHD相关HF负担都呈下降趋势，德国和澳大利亚除外。在新冠疫情期间（2019 - 2021年），除南非、印度等少数国家外，大多数G20国家的NRVHD相关HF负担下降，而墨西哥、俄罗斯和印度尼西亚等国家的RVHD相关HF负担略有增加。
G20国家中与NRVHD和RVHD相关的HF负担趋势存在显著差异，在新冠疫情的影响下这些差异更加明显。这些发现强调了制定长期战略以增强医疗系统的复原力、改善慢性病管理以及优化资源分配以促进心血管健康和应对公共卫生挑战的重要性。
