Abstract
Aim The present study was aimed at investigating the prevalence, incidence, progression, and prognosis of degenerative valvular heart disease (DVHD) in permanent residents aged ≥65 years from Guangzhou, China. Methods This was a prospective study based on community population. Over a 3-year span, we conducted repeated questionnaires, blood tests, and echocardiographic and electrocardiogram examinations (2018) of a random sample of initially 3538 subjects. Results The prevalence of DVHD increased with age, average values being 30.6%, 49.2%, and 62.9% in 65-74, 75-84, and ≥85 years of age, respectively. The incidence rate was 1.7%/year. Aortic stenosis was the result of DVHD, and the mean transvalvular pressure gradient increased by 5.6 mmHg/year. The increase of mild aortic stenosis was lower than that of more severe disease, showing a nonlinear development of gradient, but with great individual variations. Mortality was significantly increased in the DVHD group (HR = 2.49). Risk factors for higher mortality included age (χ2 = 1.9, P < 0.05), renal insufficiency (χ2 = 12.5, P < 0.01), atrial fibrillation (χ2 = 12.2, P < 0.01), mitral regurgitation (χ2 = 1.8, P < 0.05), and tricuspid regurgitation (χ2 = 6.7, P < 0.05) in a DVHD population. Conclusions DVHD was highly prevalent among residents in southern China. With the progression of the disease, the mean transvalvular pressure gradient accelerated. DVHD was an independent predictor of death, and the mortality was higher in those with older age, renal insufficiency, atrial fibrillation, mitral regurgitation, and tricuspid regurgitation.
Highlights
Degenerative valvular heart disease (DVHD), characterized macroscopically as increased leaflet thickness, stiffening, and calcification, without commissural fusion, is a common heart disease among the elderly [1]
We used the following equation to calculate incidence rate: incidence rate/year = X/ð N – 1/2C – 1/2XÞ, where X is the number of incident cases with DVHD, N is the number in the study population, and C is the censored participants
Most of them had valvular regurgitation; aortic regurgitation (AR) was present in 67.5%, tricuspid regurgitation (TR) in 67.4%, and Mitral regurgitation (MR) in 60.7%. 1355 subjects were diagnosed with DVHD; the mean age was 73:9 ± 6:2 years of age
Summary
Degenerative valvular heart disease (DVHD), characterized macroscopically as increased leaflet thickness, stiffening, and calcification, without commissural fusion, is a common heart disease among the elderly [1]. In the Euro Heart Survey, degenerative valvular calcification was found by echocardiography in 63% of cases [2]. DVHD progresses over years with a long asymptomatic phase, with symptoms occurring only at an advanced stage of disease [4]. Echocardiography is the preferred method to confirm the diagnosis of DVHD and to evaluate its severity [5, 6]. BioMed Research International progression of the disease, these data can never give a full picture of the prevalence, progression, and prognosis of DVHD. The Guangzhou (China) Heart Study was a prospective community population-based study that includes complete questionnaires, blood tests, and echocardiographic and electrocardiogram data, and was aimed at investigating the prevalence, incidence, progression, and prognosis of DVHD in permanent residents aged ≥65 years from Guangzhou, China
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