[Chronological changes in the annual incidence of valvular heart disease based on autopsies performed in Japan].

Chronological changes in the incidence of valvular heart disease (VHD) in Japan were studied. The VHD data were obtained from the 1969 and 1986 editions of the Annual of Pathological Autopsy Cases in Japan and were categorized in 5 groups: rheumatic (RVD), sclerotic (SVD), inflammatory including infection (IE), congenital (CVD), and other valvular diseases (OVDs). Comparison of actual autopsy data for 1968 and 1985 revealed that total numbers of VHD were 697 in 1968 and 987 in 1985. The percentage incidences of VHD for all autopsy cases were 2.8% and 2.5%, respectively. Changes in VHD incidence were as follows: RVD 0.96% in 1968/0.92% in 1985; CVD 0.36%/0.21%; SVD 0.15%/0.27%; IE 0.16%/0.27%; mitral valve prolapse (MVP) 0.004%/0.045%. The total numbers of VHD, and the incidence of RVD and CVD decreased, while the incidence of SVD, IE, and MVP increased. The RVD decrease is compatible with previous reports. In contrast, the increase in the incidence of IE is paradoxical since there was an increase in the variety of antibiotics available in 1985. The higher incidence might be due partially to immune compromised host, artificial heart valves, and other similar factors. The increase in SVD may be due to the steady increase in the elderly population.