Valvular heart disease in the community: a European experience.
The Euro Heart Survey on valvular heart disease included 5001 patients from 92 centers in 25 European countries in 2001: 71.9% had native valve disease and 28.1% had previously undergone valve surgery. Aortic stenosis (AS) and mitral regurgitation (MR) accounted for 43.1 and 33.6%, respectively, of single-valve diseases and were mostly caused by degenerative diseases. Mean age was 69 and 65 years, respectively, and at least one comorbidity was present in 36.3% of patients with AS and 41.7% with MR. Analysis of the therapeutic decision in patients with severe valve diseases showed that symptomatic patients were frequently denied surgery (32.3% in AS after the age of 75 and 51.3% in MR), more on the basis of age and left ventricular function than comorbidities. There was a better concordance between practice and guidelines concerning interventions in asymptomatic patients. These findings underline the need for better implementation of guidelines.
Iung
Bernard
B
Bichat Hospital, Cardiology Department, Paris, France. bernard.iung@bch.aphp.fr
Baron
Gabriel
G
Tornos
Pilar
P
Gohlke-Bärwolf
Christa
C
Butchart
Eric G
EG
Vahanian
Alec
A
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000628:therapy; D013504:Cardiovascular Surgical Procedures / Q000706:statistics & numerical data; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000628:therapy; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D044465:White People