The spectrum of rheumatic heart disease in the southeastern Anatolia endemic region: results from 1900 patients.
OBJECTIVE
Rheumatic heart disease (RHD) continues to affect mainly young adults, and accounts for a major proportion of all cardiovascular diseases in the Southeastern Anatolia region, where the disease is still endemic. The study aim was to determine the echocardiographic profile of RHD in this region, from which no recent data are available.


METHODS
In this retrospective study, transthoracic echocardiographic data acquired between June 2003 and January 2008 were reviewed. Information was gathered from the database of the authors' echocardiography laboratory, which included age, gender, clinical diagnosis and echocardiographic findings. In patients with more than one echocardiographic record, only the first echocardiographic data were included in the study.


RESULTS
A first admission with full echocardiographic data of RHD was found in 1,900 cases among 43,900 subjects screened (4.3%). Of the 1,900 subjects, 537 (28%) were male (mean age: 39.7 +/- 15.7 years) and 1,363 (72%) were female (mean age: 41.3 +/- 13.7 years). There was no gender difference between mixed valvular lesions. Severe mitral stenosis (MS) was identified in 144 subjects. Males were affected more severely than females, provided that adjustments were made according to valve area < or =1 cm2 or >1 cm2. A total of 594 subjects had MS with a valve area < or =1.5 cm2. Severe aortic regurgitation (AR) (grade > or =3) was more common in males than in females. The echocardiographic scores showed 525 subjects (28%) to have mild, 1083 (57%) to have moderate, and 292 (15%) to have severe AR. Among a total of 1163 patients with MS, 385 (33%) had > or =0.5 cm nodular calcification on their valves.


CONCLUSIONS
Currently, RHD remains an alarming and unresolved health problem in the Southeastern Anatolia region. While almost 75% of affected subjects were female, males were more severely affected. In addition, subjects were relatively old, and most were affected by mixed valvular disease of an advanced stage.
Ozer
Orhan
O
Gaziantep University, School of Medicine, Department of Cardiology, Gaziantep, Turkey.
Davutoglu
Vedat
V
Sari
Ibrahim
I
Akkoyun
Dursun C
DC
Sucu
Murat
M
D000328:Adult; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008297:Male; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012737:Sex Factors; D014421:Turkey / Q000453:epidemiology