Clinical features of rheumatic heart disease in Bangladesh.
The clinical features of 205 cases of rheumatic heart disease in Bangladesh, including unique two-dimensional echocardiographic findings, were reported, and these were compared with those of 387 Japanese cases. The percentage of mitral stenosis (MS), aortic valvular diseases including both aortic stenosis and aortic regurgitation (A), mitral stenosis with aortic valvular diseases (MS + A) were almost the same between the two countries, but that of mitral regurgitation (MR) was higher, mitral stenosis and regurgitation (MSR) was lower in Bangladesh. The mean age of the patients with mitral valvular diseases was very young and the incidence of atrial fibrillation was very low in Bangladesh. Males predominated over females in MS (male/female = 1.2/1) and the incidence of pulmonary hypertension in MS was higher in Bangladesh. A two-dimensional echocardiographic examination showed that the rough zone was heavily involved in the rheumatic process with having a narrow mitral valve orifice while the clear zone was relatively spared and pliable in many patients with MS in Bangladesh. In MR, posterior mitral leaflets were shortened and made immobile by its submitral complex which were also thickened, fused and shortened, and these resulted in a gap or non-coaptation of the two leaflets in many patients.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001022:Aortic Valve Insufficiency / Q000503:physiopathology; D001281:Atrial Fibrillation / Q000453:epidemiology; D001459:Bangladesh; D002648:Child; D004452:Echocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology; D007564:Japan; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000503:physiopathology; D008946:Mitral Valve Stenosis / Q000503:physiopathology; D012214:Rheumatic Heart Disease / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D012737:Sex Factors