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Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study
OBJECTIVE: Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking. METHODS: We used nationwide registers to identify all patients with a firs...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Heart
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749343/ https://www.ncbi.nlm.nih.gov/pubmed/28432156 http://dx.doi.org/10.1136/heartjnl-2016-310894 |
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author | Andell, Pontus Li, Xinjun Martinsson, Andreas Andersson, Charlotte Stagmo, Martin Zöller, Bengt Sundquist, Kristina Smith, J Gustav |
author_facet | Andell, Pontus Li, Xinjun Martinsson, Andreas Andersson, Charlotte Stagmo, Martin Zöller, Bengt Sundquist, Kristina Smith, J Gustav |
author_sort | Andell, Pontus |
collection | PubMed |
description | OBJECTIVE: Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking. METHODS: We used nationwide registers to identify all patients with a first diagnosis of VHD at Swedish hospitals between 2003 and 2010. Age-stratified and sex-stratified incidence of each VHD and adjusted comorbidity profiles were assessed. RESULTS: In the Swedish population (n=10 164 211), the incidence of VHD was 63.9 per 100 000 person-years, with aortic stenosis (AS; 47.2%), mitral regurgitation (MR; 24.2%) and aortic regurgitation (AR; 18.0%) contributing most of the VHD diagnoses. The majority of VHDs were diagnosed in the elderly (68.9% in subjects aged ≥65 years), but pulmonary valve disease incidence peaked in newborns. Incidences of AR, AS and MR were higher in men who were also more frequently diagnosed at an earlier age. Mitral stenosis (MS) incidence was higher in women. Rheumatic fever was rare. Half of AS cases had concomitant atherosclerotic vascular disease (48.4%), whereas concomitant heart failure and atrial fibrillation were common in mitral valve disease and tricuspid regurgitation. Other common comorbidities were thoracic aortic aneurysms in AR (10.3%), autoimmune disorders in MS (24.5%) and abdominal hernias or prolapse in MR (10.7%) and TR (10.3%). CONCLUSIONS: Clinically diagnosed VHD was primarily a disease of the elderly. Rheumatic fever was rare in Sweden, but specific VHDs showed a range of different comorbidity profiles . Pronounced sex-specific patterns were observed for AR and MS, for which the mechanisms remain incompletely understood. |
format | Online Article Text |
id | pubmed-5749343 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Heart |
record_format | MEDLINE/PubMed |
spelling | pubmed-57493432018-02-12 Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study Andell, Pontus Li, Xinjun Martinsson, Andreas Andersson, Charlotte Stagmo, Martin Zöller, Bengt Sundquist, Kristina Smith, J Gustav Heart Valvular Heart Disease OBJECTIVE: Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking. METHODS: We used nationwide registers to identify all patients with a first diagnosis of VHD at Swedish hospitals between 2003 and 2010. Age-stratified and sex-stratified incidence of each VHD and adjusted comorbidity profiles were assessed. RESULTS: In the Swedish population (n=10 164 211), the incidence of VHD was 63.9 per 100 000 person-years, with aortic stenosis (AS; 47.2%), mitral regurgitation (MR; 24.2%) and aortic regurgitation (AR; 18.0%) contributing most of the VHD diagnoses. The majority of VHDs were diagnosed in the elderly (68.9% in subjects aged ≥65 years), but pulmonary valve disease incidence peaked in newborns. Incidences of AR, AS and MR were higher in men who were also more frequently diagnosed at an earlier age. Mitral stenosis (MS) incidence was higher in women. Rheumatic fever was rare. Half of AS cases had concomitant atherosclerotic vascular disease (48.4%), whereas concomitant heart failure and atrial fibrillation were common in mitral valve disease and tricuspid regurgitation. Other common comorbidities were thoracic aortic aneurysms in AR (10.3%), autoimmune disorders in MS (24.5%) and abdominal hernias or prolapse in MR (10.7%) and TR (10.3%). CONCLUSIONS: Clinically diagnosed VHD was primarily a disease of the elderly. Rheumatic fever was rare in Sweden, but specific VHDs showed a range of different comorbidity profiles . Pronounced sex-specific patterns were observed for AR and MS, for which the mechanisms remain incompletely understood. Heart 2017-11 2017-04-21 /pmc/articles/PMC5749343/ /pubmed/28432156 http://dx.doi.org/10.1136/heartjnl-2016-310894 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Valvular Heart Disease Andell, Pontus Li, Xinjun Martinsson, Andreas Andersson, Charlotte Stagmo, Martin Zöller, Bengt Sundquist, Kristina Smith, J Gustav Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study |
title | Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study |
title_full | Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study |
title_fullStr | Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study |
title_full_unstemmed | Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study |
title_short | Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study |
title_sort | epidemiology of valvular heart disease in a swedish nationwide hospital-based register study |
topic | Valvular Heart Disease |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749343/ https://www.ncbi.nlm.nih.gov/pubmed/28432156 http://dx.doi.org/10.1136/heartjnl-2016-310894 |
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