Doppler echocardiography distinguishes between physiologic and pathologic “silent” mitral regurgitation in patients with rheumatic fever

Minich, L. LuAnn; Tani, Lloyd Y.; Pagotto, Luciana T.; Shaddy, Robert E.; Veasy, L. George

doi:10.1002/clc.4960201105

Cited by 83 publications

(68 citation statements)

References 5 publications

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“…Doppler criteria to distinguish physiological from pathological mitral regurgitation have been proposed by investigators who care for large numbers of patients with acute rheumatic fever. [23][24][25][26] At present, however, these criteria have not been universally accepted.…”

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confidence: 99%

Proceedings of the Jones Criteria Workshop

Ferrieri¹

2002

Circulation

128

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confidence: 99%

Proceedings of the Jones Criteria Workshop

Ferrieri¹

2002

Circulation

128

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“…Only echocardiography revealed the mild AR. Brand, et al 15) and Minich, et al 16) reported that trivial AR is frequently observed echocardiographically in the normal population. However, in our case, repeat Doppler echocardiography clearly indicated changes in the grade and direction of the AR.…”

Section: Discussionmentioning

confidence: 99%

A Case of Acute Rheumatic Fever Accompanied by Transient Aortic Regurgitation.

et al. 2003

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SUMMARYThough acute rheumatic fever (RF) is now rare in Japan, it continues to be an important disease condition that physicians should be prepared to diagnose and treat. We describe a patient with acute RF accompanied by transient aortic regurgitation (AR). The AR was detected only by echocardiography. There were no other indications, and it disappeared after treatment with prednisolone. The changes in cardiac valves in the early phase of RF have been the subject of only a few case studies. Echocardiography is quite valuable in the workup of patients with acute RF and should be performed even if there are no signs of cardiac involvement. (Jpn Heart J 2003; 44: 291-297)

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“…Grades for valvar regurgitation were as follows: nil (including physiological or trivial valvar regurgitation), 13,14 mild (including subclinical but pathological regurgitation), [15][16][17][18] moderate, and severe. 12,19 The minimal criteria to allow a diagnosis of pathological regurgitation included a substantial color jet seen in 2 planes extending well beyond the valve leaflets with continuous-wave or pulsed Doppler holodiastolic (aortic regurgitation) or holosystolic (mitral regurgitation) with well-defined, high-velocity spectral envelope.…”

Section: Methodsmentioning

confidence: 99%

Intravenous Immunoglobulin in Acute Rheumatic Fever

et al. 2001

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Background-Acute rheumatic fever (ARF) remains the leading cause of acquired heart disease in children worldwide. No therapeutic agent has been shown to alter the clinical outcome of the acute illness. Immunological mechanisms appear to be involved in the pathogenesis of ARF. Intravenous immunoglobulin (IVIG), a proven immunomodulator, may benefit cardiac conditions of an autoimmune nature. We investigated whether IVIG modified the natural history of ARF by reducing the extent and severity of carditis. Methods and Results-This prospective, double-blind, randomized, placebo-controlled trial evaluated IVIG in patients with a first episode of rheumatic fever, stratifying patients by the presence and severity of carditis before randomization. Patients were randomly allocated to receive 1 g/kg IVIG on days 1 and 2 and 0.4 g/kg on days 14 and 28, or they received a placebo infusion. Clinical, laboratory, and echocardiographic evaluation was performed at 0, 2, 4, 6, 26, and 52 weeks. Fifty-nine patients were treated, of whom 39 had carditis (including 4 subclinical) and/or migratory polyarthritis (nϭ39). There was no difference between groups in the rate of normalization of the erythrocyte sedimentation rate or acute-phase proteins at the 6-week follow-up. On echocardiography, 59% in the IVIG group and 69% in the placebo group had carditis at baseline. There was no significant difference in the cardiac outcome, including the proportion of valves involved, or in the severity of valvar regurgitation at 1 year. At 1 year, 41% of the IVIG and 50% of the placebo group had carditis. Conclusions-IVIG

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Doppler echocardiography distinguishes between physiologic and pathologic “silent” mitral regurgitation in patients with rheumatic fever

Cited by 83 publications

References 5 publications

Proceedings of the Jones Criteria Workshop

Proceedings of the Jones Criteria Workshop

A Case of Acute Rheumatic Fever Accompanied by Transient Aortic Regurgitation.

Intravenous Immunoglobulin in Acute Rheumatic Fever

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