Article Impact Level: HIGH Data Quality: STRONG Summary of European Heart Journal - Cardiovascular Imaging, jeae127. https://doi.org/10.1093/ehjci/jeae127 Dr. Vasiliki Tsampasian et al.
Points
- The UK study (2007-2016) assessed the prevalence and associated factors of asymptomatic valvular heart disease (VHD) in individuals aged 60 and above, involving 4,237 eligible participants from 10,000 invitations.
- VHD was diagnosed in 28.2% of participants, with tricuspid, mitral, and aortic valve regurgitation being the most common types.
- The clinically significant prevalence of VHD was 2.4%, with mitral and aortic regurgitation being predominant; age was the only significant parameter associated with VHD, showing an odds ratio of 1.07 per year increment.
- The number needed to scan to diagnose one clinically significant VHD case was 42 for those aged 60 and above and 15 for those aged 75 and above, indicating a strong correlation between age and significant VHD incidence.
- The study highlights the importance of screening for asymptomatic VHD in older adults to enable early detection and intervention, suggesting that echocardiographic screening could reduce the burden of undiagnosed VHD in the community.
Summary
This prospective cohort study in the UK between 2007 and 2016 aimed to assess the prevalence and associated factors of asymptomatic valvular heart disease (VHD) in individuals aged 60 and above. The research involved inviting asymptomatic patients with no prior indication for echocardiography to participate, undergoing evaluation through a health questionnaire, clinical examination, and transthoracic echocardiography. Out of 10,000 individuals invited, 5429 volunteered, with 4237 meeting the eligibility criteria for inclusion in the study. The study revealed that VHD was diagnosed in more than a quarter of the participants (28.2%), with regurgitation of the tricuspid, mitral, and aortic valves being the most common types.
The prevalence of clinically significant VHD was found to be 2.4%, with mitral and aortic regurgitation being the predominant types. Age emerged as the sole parameter significantly associated with significant VHD, with an odds ratio of 1.07 per year increment. The study also calculated the number needed to scan to diagnose one clinically significant case of VHD, which was 42 for individuals aged 60 and above and 15 for those aged 75 and above. These findings underscore the presence of asymptomatic VHD in a notable proportion of individuals aged 60 years and older, highlighting the strong correlation between age and the incidence of significant VHD.
The study’s results emphasize screening for asymptomatic VHD in older individuals, particularly those aged 60 and above, to facilitate early detection and intervention. The association between age and significant VHD underscores this population’s need for targeted monitoring and management strategies. The findings suggest that echocardiographic screening for VHD in asymptomatic individuals could be a feasible approach to identifying and addressing valvular abnormalities promptly, potentially reducing the burden of undiagnosed VHD in the community. Further research and clinical guidelines may be warranted to optimize screening protocols and improve outcomes for individuals at risk of asymptomatic VHD.
Link to the article: https://academic.oup.com/ehjcimaging/advance-article/doi/10.1093/ehjci/jeae127/7698004
References Tsampasian, V., Militaru, C., Parasuraman, S. K., Loudon, B. L., Lowery, C., Rudd, A., Srinivasan, J., Singh, S., Dwivedi, G., Mahadavan, G., Dawson, D., Clark, A., Vassiliou, V. S., & Frenneaux, M. P. (2024). Prevalence of asymptomatic valvular heart disease in the elderly population: A community-based echocardiographic study. European Heart Journal - Cardiovascular Imaging, jeae127. https://doi.org/10.1093/ehjci/jeae127
