ORGANIC TRICUSPID VALVE DISEASE IN CHRONIC RHEUMATIC HEART DISEASE: A PROSPECTIVE ECHOCARDIOGRAPHY STUDY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 13
Abstract
BACKGROUND Tricuspid valve disease (TV) in chronic rheumatic heart disease is relatively less prevalent, is almost always of rheumatic in origin, and generally accompanies mitral valve disease. Majority of studies on prevalence of tricuspid valve involvement are mainly based on tertiary care hospital, pathological or autopsy study and hence may not reflect the true prevalence because of inherent bias of more symptomatic and severe disease. Asymptomatic and less severe form of chronic RHD are not represented. In rheumatic TV involvement, the cusps are thickened, and commissures are fused, there is narrowing of valve area, can be evaluated by Echocardiography even in clinically silent RHD. Echocardiography can result in detection of higher prevalence of disease. We wanted to determine the prevalence of tricuspid valve involvement in patients with chronic RHD by echocardiography study in a tertiary care hospital and peripheral centers to include symptomatic as well as asymptomatic chronic RHD. METHODS This long-term prospective study was conducted at VSSIMSAR, Burla and recognized diagnostic centre in nearby district headquarter to include and cover representative population of this part of our country including people coming for different routine cardiac evaluations from October 2016 to November 2018. Around 679 patients in the age group of less than 10 yrs. to more than 70 years were evaluated by echocardiography study. RESULTS Out of 679 patients of RHD 458 (67%) were female and 221 (33%) were male. 36 patients (5.1%) had organic TV involvement. Tricuspid valve involvement was always combined with either mitral valve in 2.6% of cases and both mitral and aortic valves in 2.5% of cases in varying combinations. The most common lesion associated with organic TV disease was Severe MS Mild MR Mild AR followed by Severe MS Mild MR, Mild MR Mod AR, Mod MS Severe MR Mild AR and Mild MR. No isolated organic tricuspid valve disease was observed. 24% of cases had evidence of hypertensive TR along with other significant valvular lesions and around 32% had Mild to Moderate functional TR. Associated organic pulmonary valve disease was detected in 0.14% of cases. CONCLUSIONS Prevalence of organic tricuspid valve disease in chronic RHD was 5.1% across the whole spectrum of symptomatic and asymptomatic RHD which is lower compared to earlier study and was always involved in combination with other multi-valvular lesions. Isolated rheumatic tricuspid lesion does not occur and most of the patients had combined valvular lesions.
Authors and Affiliations
Sunil Kumar Sharma, Anuj Kumar Padhy, Pradeep Kumar Mohanty, Sagnika Tripathy
Keywords
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- EP ID EP615900
- DOI 10.18410/jebmh/2019/228
- Views 66
- Downloads 0
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