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Liu FZ, Xue YM, Liao HT, et al. Five-year epidemiological survey of valvular heart disease: changes in morbidity, etiological spectrum and management in a cardiovascular center of Southern China. J Thorac Dis. 2014;6(12):1724-30doi: 10.3978/j.issn.2072-1439.2014.11.21.
Liu, F. Z., Xue, Y. M., Liao, H. T., Zhan, X. Z., Guo, H. M., Huang, H. L., Fang, X. H., Wei, W., Rao, F., Deng, H., Liu, Y., Lin, W. D., & Wu, S. L. (2014). Five-year epidemiological survey of valvular heart disease: changes in morbidity, etiological spectrum and management in a cardiovascular center of Southern China. Journal of thoracic disease, 6(12), 1724-30. https://doi.org/10.3978/j.issn.2072-1439.2014.11.21
Liu, Fang-Zhou, et al. "Five-year epidemiological survey of valvular heart disease: changes in morbidity, etiological spectrum and management in a cardiovascular center of Southern China." Journal of thoracic disease vol. 6,12 (2014): 1724-30. doi: https://doi.org/10.3978/j.issn.2072-1439.2014.11.21
Liu FZ, Xue YM, Liao HT, Zhan XZ, Guo HM, Huang HL, Fang XH, Wei W, Rao F, Deng H, Liu Y, Lin WD, Wu SL. Five-year epidemiological survey of valvular heart disease: changes in morbidity, etiological spectrum and management in a cardiovascular center of Southern China. J Thorac Dis. 2014 Dec;6(12):1724-30. doi: 10.3978/j.issn.2072-1439.2014.11.21. PMID: 25589965; PMCID: PMC4283290.
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J Thorac Dis. 2014 Dec;6(12):1724-30. doi: 10.3978/j.issn.2072-1439.2014.11.21.

Five-year epidemiological survey of valvular heart disease: changes in morbidity, etiological spectrum and management in a cardiovascular center of Southern China.

Journal of thoracic disease

Fang-Zhou Liu, Yu-Mei Xue, Hong-Tao Liao, Xian-Zhang Zhan, Hui-Ming Guo, Huan-Lei Huang, Xian-Hong Fang, Wei Wei, Fang Rao, Hai Deng, Yang Liu, Wei-Dong Lin, Shu-Lin Wu

Affiliations

  1. 1 Guangdong Cardiovascular Institute, Guangdong Province Key Laboratory of Structural Heart Disease, 2 Research Center of Medical Science, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.

PMID: 25589965 PMCID: PMC4283290 DOI: 10.3978/j.issn.2072-1439.2014.11.21

Abstract

OBJECTIVE: The objective of the present study is to analyze the epidemiological profile of patients with abnormal valvular structure and function and highlight the etiological spectrum and management of valvular heart disease (VHD) in a single cardiovascular center of Southern China in five years.

METHODS: The retrospective study included 19,428 consecutive patients (9,441 men and 9,987 women with a mean age of 52.03±20.50 years) with abnormal valvular structure and function who were screened by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE) at the in-patient department of Guangdong General Hospital from January 2009 to December 2013. Data on baseline characteristics, potential etiology, treatment strategies and discharge outcomes were collected from electronic medical records.

RESULTS: There were 13,549 (69.7%) patients with relatively definite etiology for VHD. VHD was rheumatic in 7,197 (37.0%) patients, congenital in 2,697 (13.9%), degenerative in 2,241 (11.5%), ischemic in 2,460 (12.7%). The prevalence decreased significantly in rheumatic VHD from 2009 to 2013 (from 42.8% to 32.8%, P<0.001), but increased markedly in congenital VHD (from 9.0% to 12.3%, P<0.001), ischemic VHD (from 9.2% to 11.3%, P=0.003) and degenerative VHD (from 8.8% to 14.5%, P<0.001). Meantime, the prevalence of ischemic VHD increased after the age of 45, similar to that of degenerative VHD. From 2009 to 2013, the proportion of patients with VHD undergoing open cardiac valvular surgery decreased (from 49.5% to 44.3%, P<0.001) and that of patients treated with general medication increased (from 49.2% to 54.1%, P<0.001). However, there was markedly increment in video-assisted thoracoscopic surgery (VATS) from 2009 to 2013 (from 0.3% to 4.4%, P<0.001). Increasing tendencies were showed in aortic mechanical valve replacement (from 32.1% to 34.5%, P=0.001) and double mechanical valve replacement (from 20.9% to 22.3%, P=0.035), especially in mitral valvuloplasty (from 8.5% to 15.7%, P<0.001). However, the proportion of patients undergoing bioprosthetic valve replacement decreased from 2009 to 2013 (from 26.3% to 15.5%, P<0.001).

CONCLUSIONS: Despite a significant shift from rheumatic towards degenerative etiology from 2009 to 2013, rheumatic VHD remains the leading etiology in Southern China, with a significant increase in the prevalence of ischemic, congenital and degenerative VHD. General medication and cardiac valvular surgery remain the main treatment options. The proportion of VATS increased markedly from 2009 to 2013, and mechanical valve replacement and mitral valvuloplasty showed an increasing tendency.

Keywords: Epidemiological; cardiac valvular surgery; etiology; valvular heart disease (VHD)

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