title: Predictors of chronic valvular disease in patients with rheumatic carditis.
abstract: This study investigated the predictors of chronic valvular disease in children with rheumatic carditis. The short- to mid-term follow-up records of 88 patients (mean age, 10.68 ± 2.5 years) with chronic rheumatic heart disease were reviewed. The mean follow-up period was 2.95 ± 1.4 years. Valvular involvement completely improved for 24 of the patients (27%) during the follow-up period. The multivariate logistic regression analysis found initial left ventricular dilation to be a significant independent risk factor associated with the persistence of either valvular involvement or mitral regurgitation. Furthermore, persistence of mitral regurgitation was found to be strongly correlated with cardiac murmur at admission. No significant correlation was detected between age, gender, severity of valvular involvements at initial evaluation, and chronic valvular disease. The majority of patients with rheumatic carditis had normal left ventricular systolic function. However, a significant proportion of patients had left ventricular dilation, reported in the medical literature to be associated with the severity of valve involvement. This study found no relation between initial severity of valve involvements and chronic valvular disease. For this reason, increased left ventricular end-diastolic diameter may be secondary to myocardial involvement independent of valvular regurgitation. The findings in this study also suggest that subclinic carditis had a better outcome than clinically evident carditis.
authors.affiliation: Department of Pediatric Cardiology, Izmir Dr. Behçet Uz Children's Hospital, Izmir, Turkey. drmuratmuhtar@hotmail.com
authors.forename: Murat Muhtar
authors.initials: MM
authors.lastname: Yilmazer
authors.forename: Taliha
authors.initials: T
authors.lastname: Oner
authors.forename: Vedide
authors.initials: V
authors.lastname: Tavlı
authors.forename: Ozgül Vupa
authors.initials: OV
authors.lastname: Cilengiroğlu
authors.forename: Barış
authors.initials: B
authors.lastname: Güven
authors.forename: Timur
authors.initials: T
authors.lastname: Meşe
authors.forename: Ayça
authors.initials: A
authors.lastname: Vitrinel
authors.forename: Ilker
authors.initials: I
authors.lastname: Devrim
mesh_terms: D000293:Adolescent; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology; D009205:Myocarditis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012008:Recurrence; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology