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      Etiologies and Patterns of Valvular Heart Disease Among Cardiac Patients at the Cardiac Center of Ethiopia During February 2000 to April 2022

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          Abstract

          Background

          The leading global contributor to cardiovascular morbidity and mortality is valvular heart disease. It is on the rise worldwide, including in the developing countries. However, the prevalence, patterns, and etiologies of valvular heart disease have not been well studied in Ethiopia. Hence, the purpose of this study was to evaluate the prevalence, patterns, and etiologies of valvular heart disease at the Cardiac Center of Ethiopia from February 2000 to April 2022.

          Methods

          This institution-based retrospective cross-sectional study was conducted between February 2000 and April 2022. Data from three thousand two hundred fifty-seven VHD were extracted from the electronic medical records and analyzed using SPSS version 25. Descriptive statistics, such as the frequency, mean ± standard deviation, and cross tabulations, were used to summarize the data.

          Results

          Of 10,588 total cardiac cases registered and treated at the Cardiac Centre of Ethiopia from February 2000 to April 2022, 30.8% (3257) were diagnosed with VHD. The most typical diagnosis for VHD was multi-valvular involvement, which accounted for 49.5% of cases (1612), followed by pulmonary stenosis (15%) and mitral regurgitation (14.3%). Females were more likely to develop valve diseases than males, being at the highest risk for each identified etiology of valve disease 1928 (59.2%). The majority percentages of the population affected by VHD were between 18 and 44 age category 1473 (45.2%). The most common etiology of VHD was rheumatic 2015 (61.87%), followed by congenital origin 828 (25.42%).

          Conclusion

          VHD affects nearly one-third of all cardiac cases admitted to the hospital. Multi-valvular involvement is the most commonly diagnosed form of VHD. Rheumatic causes were more prevalent in this study. As found in this study, VHD affects a significant percentage of the population, which in turn could have an impact on the country’s economy and deserve attention as a possible means of intervention.

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          Most cited references38

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          Burden of valvular heart diseases: a population-based study.

          Valvular heart diseases are not usually regarded as a major public-health problem. Our aim was to assess their prevalence and effect on overall survival in the general population. We pooled population-based studies to obtain data for 11 911 randomly selected adults from the general population who had been assessed prospectively with echocardiography. We also analysed data from a community study of 16 501 adults who had been assessed by clinically indicated echocardiography. In the general population group, moderate or severe valve disease was identified in 615 adults. There was no difference in the frequency of such diseases between men and women (p=0.90). Prevalence increased with age, from 0.7% (95% CI 0.5-1.0) in 18-44 year olds to 13.3% (11.7-15.0) in the 75 years and older group (p<0.0001). The national prevalence of valve disease, corrected for age and sex distribution from the US 2000 population, is 2.5% (2.2-2.7). In the community group, valve disease was diagnosed in 1505 (1.8% adjusted) adults and frequency increased considerably with age, from 0.3% (0.2-0.3) of the 18-44 year olds to 11.7% (11.0-12.5) of those aged 75 years and older, but was diagnosed less often in women than in men (odds ratio 0.90, 0.81-1.01; p=0.07). The adjusted mortality risk ratio associated with valve disease was 1.36 (1.15-1.62; p=0.0005) in the population and 1.75 (1.61-1.90; p<0.0001) in the community. Moderate or severe valvular diseases are notably common in this population and increase with age. In the community, women are less often diagnosed than are men, which could indicate an important imbalance in view of the associated lower survival. Valve diseases thus represent an important public-health problem.
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            Epidemiology of valvular heart disease in the adult.

            Valvular heart disease remains common in industrialized countries, because the decrease in prevalence of rheumatic heart diseases has been accompanied by an increase in that of degenerative valve diseases. Aortic stenosis and mitral regurgitation are the two most common types of valvular disease in Europe. The prevalence of valvular disease increases sharply with age, owing to the predominance of degenerative etiologies. The burden of heart valve disease in the elderly has an important impact on patient management, given the high frequency of comorbidity and the increased risk associated with intervention in this age group. Endocarditis is an important etiology of valvular disease and is most commonly caused by Staphylococci. Rheumatic heart disease remains prevalent in developing countries.
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              Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study).

              Rheumatic heart disease (RHD) accounts for over a million premature deaths annually; however, there is little contemporary information on presentation, complications, and treatment.
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                Author and article information

                Journal
                Int J Gen Med
                Int J Gen Med
                ijgm
                International Journal of General Medicine
                Dove
                1178-7074
                04 July 2023
                2023
                : 16
                : 2849-2856
                Affiliations
                [1 ]Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University , Addis Ababa, Ethiopia
                [2 ]Department of Adult Cardiology, Cardiac Center of Ethiopia , Addis Ababa, Ethiopia
                Author notes
                Correspondence: Ashete Adere, Email ashelove039@gmail.com
                Author information
                http://orcid.org/0000-0001-5542-2786
                Article
                420591
                10.2147/IJGM.S420591
                10329463
                f71c1d4d-270f-46d5-9cb0-00d5ba38622b
                © 2023 Adere et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 25 May 2023
                : 23 June 2023
                Page count
                Figures: 1, Tables: 3, References: 38, Pages: 8
                Categories
                Original Research

                Medicine
                cardiac center of ethiopia,etiology,patterns,valvular heart disease
                Medicine
                cardiac center of ethiopia, etiology, patterns, valvular heart disease

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