Valvular disease burden in the modern era of percutaneous and surgical interventions: the UK Biobank

Abstract

BackgroundThe burden of valvular heart disease (VHD) has increased significantly among ageing populations, yet remains poorly understood in the present-day context of percutaneous and surgical interventions.ObjectiveTo define the incidence, clinical correlates and associated mortality of VHD in the UK Biobank cohort.MethodsWe interrogated data collected in the UK Biobank between 1 January 2000 and 30 June 2020. VHD incidence was determined using International Classification of Disease-10 codes for aortic stenosis (AS), aortic regurgitation (AR), mitral stenosis, mitral regurgitation (MR) and mitral valve prolapse. We calculated HRs for incident VHD and all-cause mortality. Clinical correlates of VHD included demographics, coronary artery disease, heart failure and atrial fibrillation. Surgical and percutaneous interventions for mitral and aortic VHD were considered time-dependent variables.ResultsAmong 486 187 participants, the incidence of any VHD was 16 per 10 000 person-years, with highest rates for MR (8.2), AS (7.2) and AR (5.0). Age, heart failure, coronary artery disease and atrial fibrillation were significantly associated with all types of VHD. In our adjusted model, aortic and mitral VHD had an increased risk of all-cause death compared with no VHD (HR 1.62, 95% CI 1.44 to 1.82, p<0.001 and HR 1.25, 95% CI 1.09 to 1.44, p=0.002 for aortic and mitral VHD, respectively).ConclusionVHD continues to constitute a significant public health burden, with MR and AS being the most common. Age and cardiac comorbidities remain strong risk factors for VHD. In the modern era of percutaneous and surgical interventions, mortality associated with VHD remains high.

Mecanismos Fisiopatológicos, Avaliação Clínica E Estratégias De Manejo Da Regurgitação Tricúspide

“…Assim como ocorre com outras valvulopatias, a prevalência da regurgitação tricúspide aumenta com a idade [19][20][21][22][23] . Embora a doença valvar clinicamente significativa seja diagnosticada com mais frequência em homens Mecanismos fisiopatológicos, avaliação clínica e estratégias de manejo da regurgitação tricúspide do que em mulheres, a prevalência global de regurgitação tricúspide significativa pode ser até 4 vezes maior entre as mulheres 19,21 .…”

“…Um estudo sobre desfechos para doença das valvas aórtica, mitral e tricúspide mostrou que a mortalidade por todas as causas foi maior para regurgitação tricúspide do que para regurgitação aórtica ou doença valvar mitral 22 . Os preditores morfológicos de regurgitação tricúspide progressiva dependem da doença cardiovascular primária.…”

Pulmonary heart: A review

“…Так, по данным S. Offen и соавт., M. Taramasso и соавт., годовая смертность у этой категории больных составила от 36 до 42%, т.е. умирал каждый 2-3-й больной с признаками выраженной трикуспидальной недостаточности [17,18].…”

Enhanced Identification of Valvular Heart Diseases through Selective Phonocardiogram Features Driven by Convolutional Neural Networks (SFD-CNN)

“…VHD can result from congenital or birth defects or infections that damage the heart valves [1]. The presence of VHD was found to be independently associated with a 65% increased risk of all-cause mortality and a 72% increased risk of cardiovascular mortality [2]. While electrocardiogram (ECG) technology can identify VHD, it is expensive.…”