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A hospital-based survey of patients with severe valvular heart disease in China.

A hospital-based survey of patients with severe valvular heart disease in China.
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Hu P, Liu XB, Liang J, Zhu QF, Pu CX, Tang MY, Wang JA,


Hu P, Liu XB, Liang J, Zhu QF, Pu CX, Tang MY, Wang JA, (click to view)

Hu P, Liu XB, Liang J, Zhu QF, Pu CX, Tang MY, Wang JA,

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International journal of cardiology 2016 11 25231() 244-247 pii S0167-5273(16)32382-8
Abstract
OBJECTIVES
Due to increasing aging, the epidemiology of VHD may have changed in China. This study aimed to provide contemporary information on the prevalence, distribution patterns, and etiology of severe VHD in China.

METHODS
This was a retrospective survey at Second Affiliated Hospital of Zhejiang University, which included all consecutive patients between 2010 and 2015.

RESULTS
In all, 139,496 patients were enrolled. Among severe valve diseases, MR was the most frequent (n=946, 0.68%) followed by MS (n=524, 0.38%), AS (n=392, 0.28%), and AR (n=371, 0.27%). Severe MR and AS prevalence rates increased strikingly with age. Rheumatic heart disease had an prevalence of 1.56% (n=2179), and remained one of the most common causes of severe VHD in patients younger than 65years old (99.5% of MS with rheumatic; 27.6% of MR with rheumatic; 25.7% of AS with rheumatic; 31.6% of AR with rheumatic). Aortic valve calcification was the predominant AS etiology, and its prevalence greatly increased with age. In severe AR, rheumatic fever was the most common etiology in patients below 65; in those above 65, etiology was mostly degenerative. In severe primary MR, mitral valve prolapse was the most common cause. Prevalence of secondary MR increased with age, from 16.4% in 18-44years old to 51.7% in individuals ≥75.

CONCLUSIONS
Severe valvular diseases are very common; rheumatic fever and degenerative valvular changes remain predominant causes in patients below 65 and older ones, respectively. Young adults present mainly with primary MR, while secondary MR is more common in elderly ones.

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