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Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study

Andell, Pontus LU ; Li, Xinjun LU ; Martinsson, Andreas LU ; Andersson, Charlotte LU ; Stagmo, Martin LU ; Zöller, Bengt LU ; Sundquist, Kristina LU and Smith, Gustav LU (2017) In Heart
Abstract

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... (More)

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.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Aortic regurgitation, Aortic stenosis, Epidemiology, Mitral regurgitation, valvular heart disease
in
Heart
publisher
BMJ Publishing Group
external identifiers
  • scopus:85026301922
ISSN
1355-6037
DOI
10.1136/heartjnl-2016-310894
language
English
LU publication?
yes
id
f4aa10ae-46b0-4144-a44f-5ca0c7b3622f
date added to LUP
2017-08-30 09:56:50
date last changed
2017-08-31 03:00:02
@article{f4aa10ae-46b0-4144-a44f-5ca0c7b3622f,
  abstract     = {<p>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.</p>},
  author       = {Andell, Pontus and Li, Xinjun and Martinsson, Andreas and Andersson, Charlotte and Stagmo, Martin and Zöller, Bengt and Sundquist, Kristina and Smith, Gustav},
  issn         = {1355-6037},
  keyword      = {Aortic regurgitation,Aortic stenosis,Epidemiology,Mitral regurgitation,valvular heart disease},
  language     = {eng},
  month        = {05},
  publisher    = {BMJ Publishing Group},
  series       = {Heart},
  title        = {Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study},
  url          = {http://dx.doi.org/10.1136/heartjnl-2016-310894},
  year         = {2017},
}