Prevalence of organic tricuspid valve disease and pattern of valvular involvement in rheumatic heart disease: An echocardiographic study

Abstract

Background: Rheumatic fever and rheumatic heart disease are still a major public health problem in developing countries. There is a growing interest in tricuspid valve disease because of its clinical outcome, difficulty in treating it, and upcoming interventional therapeutic options. The aim of the present study is to assess the organic involvement of tricuspid valve and echocardiographic pattern of other valvular involvement in rheumatic heart disease in a tertiary care center located in South India. Materials and Methods: This is a prospective observational study which was carried out over a period of 1 year. Transthoracic echocardiography data of patients, diagnosed with rheumatic heart disease during the study period, were reviewed for type and degree of valvular involvement. Results: During the study period, a total of 6612 patients were found to have rheumatic heart disease, and 4129 (62.45%) were female. The average age was 33.96 ± 12.21 years. On echocardiography, organic tricuspid valve involvement was seen in 684 (10.34%) patients. Mitral valve is the most common valve involved, both in isolation and in totality. Five thousand and thirty (76.07%) patients were diagnosed with mitral regurgitation, and 4497 (68.01%) patients were diagnosed with mitral stenosis. Two thousand nine hundred and ninety-three (45.27%) patients were diagnosed with aortic regurgitation, and 1085 (16.41%) patients were diagnosed with aortic stenosis. Conclusion: Mitral valve was most commonly affected, whereas isolated aortic valve was least commonly affected valve. A considerable number of patients showed involvement of organic rheumatic tricuspid valve disease. With the growing awareness of tricuspid valve disease causing significant morbidity and mortality, and therapeutic options under research, identifying organic tricuspid valve disease is of foremost important.