Aortic regurgitation epidemiology and demographics: Difference between revisions

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{{Aortic insufficiency}}
{{Aortic insufficiency}}
 
{{CMG}}; '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.; [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]
{{CMG}}; '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S., [[Lakshmi Gopalakrishnan]], M.B.B.S., [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]


==Overview==
==Overview==
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===Age===
===Age===
The prevalence of aortic insufficiency increases with age.<ref name="pmid10190406">{{cite journal |author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ |title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) |journal=[[The American Journal of Cardiology]] |volume=83 |issue=6 |pages=897–902 |year=1999 |month=March |pmid=10190406 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(98)01064-9 |accessdate=2011-03-02}}</ref><ref name="pmid10933358">{{cite journal |author=Lebowitz NE, Bella JN, Roman MJ, Liu JE, Fishman DP, Paranicas M, Lee ET, Fabsitz RR, Welty TK, Howard BV, Devereux RB |title=Prevalence and correlates of aortic regurgitation in American Indians: the Strong Heart Study |journal=[[Journal of the American College of Cardiology]] |volume=36 |issue=2 |pages=461–7 |year=2000 |month=August |pmid=10933358 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(00)00744-0 |accessdate=2011-03-02}}</ref><ref name="pmid10199882">{{cite journal |author=Dujardin KS, Enriquez-Sarano M, Schaff HV, Bailey KR, Seward JB, Tajik AJ |title=Mortality and morbidity of aortic regurgitation in clinical practice. A long-term follow-up study |journal=[[Circulation]] |volume=99 |issue=14 |pages=1851–7 |year=1999 |month=April |pmid=10199882 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=10199882 |accessdate=2011-03-02}}</ref> It is infrequent in young patients, and occurs in < 1% of subjects under the age of 70. However people with congenital aortic valve/root defects such as [[bicuspid aortic valve]] disease and [[Marfan syndrome]] may develop aortic insufficiency much earlier in life.<ref name="pmid17078910">{{cite journal |author=Ortiz JT, Shin DD, Rajamannan NM |title=Approach to the patient with bicuspid aortic valve and ascending aorta aneurysm |journal=[[Current Treatment Options in Cardiovascular Medicine]] |volume=8 |issue=6 |pages=461–7 |year=2006 |month=December |pmid=17078910 |doi= |url= |accessdate=2011-04-13}}</ref><ref name="pmid18506019">{{cite journal |author=Keane MG, Pyeritz RE |title=Medical management of Marfan syndrome |journal=[[Circulation]] |volume=117 |issue=21 |pages=2802–13 |year=2008 |month=May |pmid=18506019 |doi=10.1161/CIRCULATIONAHA.107.693523 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18506019 |accessdate=2011-04-13}}</ref>
The prevalence of aortic insufficiency increases with age.<ref name="pmid10190406">{{cite journal |author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ |title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) |journal=[[The American Journal of Cardiology]] |volume=83 |issue=6 |pages=897–902 |year=1999 |month=March |pmid=10190406 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(98)01064-9 |accessdate=2011-03-02}}</ref><ref name="pmid10933358">{{cite journal |author=Lebowitz NE, Bella JN, Roman MJ, Liu JE, Fishman DP, Paranicas M, Lee ET, Fabsitz RR, Welty TK, Howard BV, Devereux RB |title=Prevalence and correlates of aortic regurgitation in American Indians: the Strong Heart Study |journal=[[Journal of the American College of Cardiology]] |volume=36 |issue=2 |pages=461–7 |year=2000 |month=August |pmid=10933358 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(00)00744-0 |accessdate=2011-03-02}}</ref><ref name="pmid10199882">{{cite journal |author=Dujardin KS, Enriquez-Sarano M, Schaff HV, Bailey KR, Seward JB, Tajik AJ |title=Mortality and morbidity of aortic regurgitation in clinical practice. A long-term follow-up study |journal=[[Circulation]] |volume=99 |issue=14 |pages=1851–7 |year=1999 |month=April |pmid=10199882 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=10199882 |accessdate=2011-03-02}}</ref> It is infrequent in young patients, and occurs in < 1% of subjects under the age of 70. However people with congenital aortic valve/root defects such as [[bicuspid aortic valve]] disease and [[Marfan syndrome]] may develop aortic insufficiency much earlier in life.<ref name="pmid17078910">{{cite journal |author=Ortiz JT, Shin DD, Rajamannan NM |title=Approach to the patient with bicuspid aortic valve and ascending aorta aneurysm |journal=[[Current Treatment Options in Cardiovascular Medicine]] |volume=8 |issue=6 |pages=461–7 |year=2006 |month=December |pmid=17078910 |doi= |url= |accessdate=2011-04-13}}</ref><ref name="pmid18506019">{{cite journal |author=Keane MG, Pyeritz RE |title=Medical management of Marfan syndrome |journal=[[Circulation]] |volume=117 |issue=21 |pages=2802–13 |year=2008 |month=May |pmid=18506019 |doi=10.1161/CIRCULATIONAHA.107.693523 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18506019 |accessdate=2011-04-13}}</ref>
===Gender===
===Gender===
Aortic insufficiency is more common in men than in women.<ref name="pmid10190406">{{cite journal |author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ |title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) |journal=[[The American Journal of Cardiology]] |volume=83 |issue=6 |pages=897–902 |year=1999 |month=March |pmid=10190406 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(98)01064-9 |accessdate=2011-03-02}}</ref><ref name="pmid10933358">{{cite journal |author=Lebowitz NE, Bella JN, Roman MJ, Liu JE, Fishman DP, Paranicas M, Lee ET, Fabsitz RR, Welty TK, Howard BV, Devereux RB |title=Prevalence and correlates of aortic regurgitation in American Indians: the Strong Heart Study |journal=[[Journal of the American College of Cardiology]] |volume=36 |issue=2 |pages=461–7 |year=2000 |month=August |pmid=10933358 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(00)00744-0 |accessdate=2011-03-02}}</ref><ref name="pmid10199882">{{cite journal |author=Dujardin KS, Enriquez-Sarano M, Schaff HV, Bailey KR, Seward JB, Tajik AJ |title=Mortality and morbidity of aortic regurgitation in clinical practice. A long-term follow-up study |journal=[[Circulation]] |volume=99 |issue=14 |pages=1851–7 |year=1999 |month=April |pmid=10199882 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=10199882 |accessdate=2011-03-02}}</ref> In the  Framingham heart population cohort study, aortic regurgitation (more than or equal to trace severity on [[echocardiography]]) was observed in 13 percent of men and 8.5 percent of women.<ref name="pmid10190406">{{cite journal |author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ |title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) |journal=[[The American Journal of Cardiology]] |volume=83 |issue=6 |pages=897–902 |year=1999 |month=March |pmid=10190406 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(98)01064-9 |accessdate=2011-12-27}}</ref> The higher prevalence of [[marfan syndrome]] and [[bicuspid aortic valve]] in males could explain in part the greater prevalence of aortic insufficiency in men.<ref name="pmid17078910">{{cite journal |author=Ortiz JT, Shin DD, Rajamannan NM |title=Approach to the patient with bicuspid aortic valve and ascending aorta aneurysm |journal=[[Current Treatment Options in Cardiovascular Medicine]] |volume=8 |issue=6 |pages=461–7 |year=2006 |month=December |pmid=17078910 |doi= |url= |accessdate=2011-04-13}}</ref><ref name="pmid18506019">{{cite journal |author=Keane MG, Pyeritz RE |title=Medical management of Marfan syndrome |journal=[[Circulation]] |volume=117 |issue=21 |pages=2802–13 |year=2008 |month=May |pmid=18506019 |doi=10.1161/CIRCULATIONAHA.107.693523 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18506019 |accessdate=2011-04-13}}</ref>
Aortic insufficiency is more common in men than in women.<ref name="pmid10190406">{{cite journal |author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ |title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) |journal=[[The American Journal of Cardiology]] |volume=83 |issue=6 |pages=897–902 |year=1999 |month=March |pmid=10190406 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(98)01064-9 |accessdate=2011-03-02}}</ref><ref name="pmid10933358">{{cite journal |author=Lebowitz NE, Bella JN, Roman MJ, Liu JE, Fishman DP, Paranicas M, Lee ET, Fabsitz RR, Welty TK, Howard BV, Devereux RB |title=Prevalence and correlates of aortic regurgitation in American Indians: the Strong Heart Study |journal=[[Journal of the American College of Cardiology]] |volume=36 |issue=2 |pages=461–7 |year=2000 |month=August |pmid=10933358 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(00)00744-0 |accessdate=2011-03-02}}</ref><ref name="pmid10199882">{{cite journal |author=Dujardin KS, Enriquez-Sarano M, Schaff HV, Bailey KR, Seward JB, Tajik AJ |title=Mortality and morbidity of aortic regurgitation in clinical practice. A long-term follow-up study |journal=[[Circulation]] |volume=99 |issue=14 |pages=1851–7 |year=1999 |month=April |pmid=10199882 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=10199882 |accessdate=2011-03-02}}</ref> In the  Framingham heart population cohort study, aortic regurgitation (more than or equal to trace severity on [[echocardiography]]) was observed in 13 percent of men and 8.5 percent of women.<ref name="pmid10190406">{{cite journal |author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ |title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) |journal=[[The American Journal of Cardiology]] |volume=83 |issue=6 |pages=897–902 |year=1999 |month=March |pmid=10190406 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(98)01064-9 |accessdate=2011-12-27}}</ref> The higher prevalence of [[marfan syndrome]] and [[bicuspid aortic valve]] in males could explain in part the greater prevalence of aortic insufficiency in men.<ref name="pmid17078910">{{cite journal |author=Ortiz JT, Shin DD, Rajamannan NM |title=Approach to the patient with bicuspid aortic valve and ascending aorta aneurysm |journal=[[Current Treatment Options in Cardiovascular Medicine]] |volume=8 |issue=6 |pages=461–7 |year=2006 |month=December |pmid=17078910 |doi= |url= |accessdate=2011-04-13}}</ref><ref name="pmid18506019">{{cite journal |author=Keane MG, Pyeritz RE |title=Medical management of Marfan syndrome |journal=[[Circulation]] |volume=117 |issue=21 |pages=2802–13 |year=2008 |month=May |pmid=18506019 |doi=10.1161/CIRCULATIONAHA.107.693523 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18506019 |accessdate=2011-04-13}}</ref>
===Race===
===Race===
The prevalence of aortic insufficiency does not show any variation by race in United States. However, internationally there is significant variation in the prevalence of predisposing conditions such as [[rheumatic heart disease]] which is more common in the Asia, the Middle East, and the North Africa.<ref name="pmid21386976">{{cite journal |author=Seckeler MD, Hoke TR |title=The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease |journal=[[Clinical Epidemiology]] |volume=3 |issue= |pages=67–84 |year=2011 |pmid=21386976 |pmc=3046187 |doi=10.2147/CLEP.S12977 |url= |accessdate=2011-04-13}}</ref>
The prevalence of aortic insufficiency does not show any variation by race in United States. However, internationally there is significant variation in the prevalence of predisposing conditions such as [[rheumatic heart disease]] which is more common in the Asia, the Middle East, and the North Africa.<ref name="pmid21386976">{{cite journal |author=Seckeler MD, Hoke TR |title=The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease |journal=[[Clinical Epidemiology]] |volume=3 |issue= |pages=67–84 |year=2011 |pmid=21386976 |pmc=3046187 |doi=10.2147/CLEP.S12977 |url= |accessdate=2011-04-13}}</ref>
===Developed Countries===
===Developed Countries===
In developed countries where [[rheumatic heart disease]] is rare, [[aortic insufficiency]] may be due to [[bicuspid aortic valve]] disease or [[senile]] degenerative [[calcific aortic valve disease]] which may present in the fourth to sixth decade. [[Endocarditis]] and [[aortic dissection]] are other causes. The prevalence of any aortic insufficiency in the Framingham study was reported to be 4.9%, with regurgitation of moderate or greater severity occurring in 0.5%.<ref name="pmid10190406">{{cite journal |author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ |title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) |journal=[[The American Journal of Cardiology]] |volume=83 |issue=6 |pages=897–902 |year=1999 |month=March |pmid=10190406 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(98)01064-9 |accessdate=2011-04-13}}</ref>
In developed countries where [[rheumatic heart disease]] is rare, [[aortic insufficiency]] may be due to [[bicuspid aortic valve]] disease or [[senile]] degenerative [[calcific aortic valve disease]] which may present in the fourth to sixth decade. [[Endocarditis]] and [[aortic dissection]] are other causes. The prevalence of any aortic insufficiency in the Framingham study was reported to be 4.9%, with regurgitation of moderate or greater severity occurring in 0.5%.<ref name="pmid10190406">{{cite journal |author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ |title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) |journal=[[The American Journal of Cardiology]] |volume=83 |issue=6 |pages=897–902 |year=1999 |month=March |pmid=10190406 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(98)01064-9 |accessdate=2011-04-13}}</ref>
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
 
[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Valvular heart disease]]
[[Category:Congenital heart disease]]
[[Category:Surgery]]
[[Category:Cardiac surgery]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
 
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date]]
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Revision as of 17:18, 28 January 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.; Mohammed A. Sbeih, M.D. [2]

Overview

The prevalence of aortic regurgitation varies with age, geographic location, and gender.[1] Aortic insufficiency is unusual before the age of 50 and then increases progressively later in life. Worldwide the most common cause of aortic insufficiency is the rheumatic heart disease, particularly in the Asia, the Middle East, and the North Africa. In the United States, senile degenerative calcific aortic valve disease and bicuspid aortic valve disease are the most common causes.

Epidemiology and Demographics

Age

The prevalence of aortic insufficiency increases with age.[1][2][3] It is infrequent in young patients, and occurs in < 1% of subjects under the age of 70. However people with congenital aortic valve/root defects such as bicuspid aortic valve disease and Marfan syndrome may develop aortic insufficiency much earlier in life.[4][5]

Gender

Aortic insufficiency is more common in men than in women.[1][2][3] In the Framingham heart population cohort study, aortic regurgitation (more than or equal to trace severity on echocardiography) was observed in 13 percent of men and 8.5 percent of women.[1] The higher prevalence of marfan syndrome and bicuspid aortic valve in males could explain in part the greater prevalence of aortic insufficiency in men.[4][5]

Race

The prevalence of aortic insufficiency does not show any variation by race in United States. However, internationally there is significant variation in the prevalence of predisposing conditions such as rheumatic heart disease which is more common in the Asia, the Middle East, and the North Africa.[6]

Developed Countries

In developed countries where rheumatic heart disease is rare, aortic insufficiency may be due to bicuspid aortic valve disease or senile degenerative calcific aortic valve disease which may present in the fourth to sixth decade. Endocarditis and aortic dissection are other causes. The prevalence of any aortic insufficiency in the Framingham study was reported to be 4.9%, with regurgitation of moderate or greater severity occurring in 0.5%.[1]

Developing Countries

In developing countries, rheumatic heart disease is the most common cause of aortic insufficiency and may present in second or third decade of life.

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ (1999). "Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study)". The American Journal of Cardiology. 83 (6): 897–902. PMID 10190406. Retrieved 2011-12-27. Unknown parameter |month= ignored (help)
  2. ↑ 2.0 2.1 Lebowitz NE, Bella JN, Roman MJ, Liu JE, Fishman DP, Paranicas M, Lee ET, Fabsitz RR, Welty TK, Howard BV, Devereux RB (2000). "Prevalence and correlates of aortic regurgitation in American Indians: the Strong Heart Study". Journal of the American College of Cardiology. 36 (2): 461–7. PMID 10933358. Retrieved 2011-03-02. Unknown parameter |month= ignored (help)
  3. ↑ 3.0 3.1 Dujardin KS, Enriquez-Sarano M, Schaff HV, Bailey KR, Seward JB, Tajik AJ (1999). "Mortality and morbidity of aortic regurgitation in clinical practice. A long-term follow-up study". Circulation. 99 (14): 1851–7. PMID 10199882. Retrieved 2011-03-02. Unknown parameter |month= ignored (help)
  4. ↑ 4.0 4.1 Ortiz JT, Shin DD, Rajamannan NM (2006). "Approach to the patient with bicuspid aortic valve and ascending aorta aneurysm". Current Treatment Options in Cardiovascular Medicine. 8 (6): 461–7. PMID 17078910. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  5. ↑ 5.0 5.1 Keane MG, Pyeritz RE (2008). "Medical management of Marfan syndrome". Circulation. 117 (21): 2802–13. doi:10.1161/CIRCULATIONAHA.107.693523. PMID 18506019. Retrieved 2011-04-13. Unknown parameter |month= ignored (help)
  6. ↑ Seckeler MD, Hoke TR (2011). "The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease". Clinical Epidemiology. 3: 67–84. doi:10.2147/CLEP.S12977. PMC 3046187. PMID 21386976. |access-date= requires |url= (help)

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