Mitral regurgitation epidemiology and demographics: Difference between revisions
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==Prevalence== | ==Prevalence== | ||
The Framingham Heart Study, a prospective epidemiologic study, evaluated the [[prevalence]] and severity of MR and other valvular diseases by color [[Doppler]] examinations in 1,696 men and 1,893 women. The study revealed that MR is the most common valvular regurgitation in the general population, followed by [[tricuspid regurgitation]] and then [[aortic regurgitation]]. The prevalence of MR (with a severity ranging from trace to moderate regurgitation) was 87.7% in men and 91.5% in women. When trace regurgitation is excluded, the prevalence of MR of a severity ≥ mild was 19.0% in men and 19.1% in women. The elevated prevalence of trace regurgitation can be a normal finding related to an artifact or an anatomic characteristic of the closure of the [[mitral valve]].<ref name="pmid10190406">{{cite journal| author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL et al.| title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) | journal=Am J Cardiol | year= 1999 | volume= 83 | issue= 6 | pages= 897-902 | pmid=10190406 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10190406 }} </ref> | The Framingham Heart Study, a prospective epidemiologic study, evaluated the [[prevalence]] and severity of MR and other valvular diseases by color [[Doppler]] examinations in 1,696 men and 1,893 women. The study revealed that MR is the most common valvular regurgitation in the general population, followed by [[tricuspid regurgitation]] and then [[aortic regurgitation]]. The prevalence of MR (with a severity ranging from trace to ≥ moderate regurgitation) was 87.7% in men and 91.5% in women. When trace regurgitation is excluded, the prevalence of MR of a severity ≥ mild was 19.0% in men and 19.1% in women. The elevated prevalence of trace regurgitation can be a normal finding related to an artifact or an anatomic characteristic of the closure of the [[mitral valve]].<ref name="pmid10190406">{{cite journal| author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL et al.| title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) | journal=Am J Cardiol | year= 1999 | volume= 83 | issue= 6 | pages= 897-902 | pmid=10190406 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10190406 }} </ref> | ||
==Age== | ==Age== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.
Overview
Epidemiology and Demographics
The incidence of mitral regurgitation is approximately 2% in a modern Western population. In the past, rheumatic heart disease was the leading cause of mitral regurgitation in Western countries, but now mitral valve prolapse is the leading cause and accounts for 45% of cases in Western countries.[1] In Asia, North Africa, and the Middle East, and among some immagrant populations in the US, rheumatic heart disease remains the leading cause of mitral regurgitation. Coronary artery disease resulting ischemia injury is responsible for 3% to 25% of MR cases.
Prevalence
The Framingham Heart Study, a prospective epidemiologic study, evaluated the prevalence and severity of MR and other valvular diseases by color Doppler examinations in 1,696 men and 1,893 women. The study revealed that MR is the most common valvular regurgitation in the general population, followed by tricuspid regurgitation and then aortic regurgitation. The prevalence of MR (with a severity ranging from trace to ≥ moderate regurgitation) was 87.7% in men and 91.5% in women. When trace regurgitation is excluded, the prevalence of MR of a severity ≥ mild was 19.0% in men and 19.1% in women. The elevated prevalence of trace regurgitation can be a normal finding related to an artifact or an anatomic characteristic of the closure of the mitral valve.[2]
Age
The prevalence of MR increases with age. MR is one of the most common valvular heart disease in the elderly. Shown below are tables depicting the prevalence of MR by age and severity in men and women according the results of the Framingham Heart Study.[2]
| Severity of MR | Prevalence of MR by age in men | ||||
| 26-29 | 40-49 | 50-59 | 60-69 | 70-83 | |
| No MR (%) | 14.4 | 13.3 | 11.3 | 12.7 | 9.0 |
| Trace (%) | 76.7 | 72.9 | 74.6 | 60.3 | 51.7 |
| Mild (%) | 8.9 | 13.5 | 12.5 | 24.6 | 28.1 |
| Moderate or severe (%) | 0 | 0.3 | 1.6 | 2.4 | 11.2 |
| Severity of MR | Prevalence of MR by age in women | ||||
| 26-29 | 40-49 | 50-59 | 60-69 | 70-83 | |
| No MR (%) | 14.0 | 8.6 | 9.0 | 7.2 | 5.6 |
| Trace (%) | 76.3 | 75 | 74 | 66.5 | 70.8 |
| Mild (%) | 9.7 | 15.5 | 16 | 24 | 23.6 |
| Moderate or severe (%) | 0 | 0.9 | 1 | 2.3 | 0 |
Gender
Overall, mitral regurgitation affects both males and females equally. However, there are some minor imbalances when age is considered. In patients younger than 20 years, there is a male preponderance, and the severity of involvement is greater in males over the age of 50. MVP is a common cause. However, most patients with MVP do not develop severe mitral regurgitation. Older age, male gender, and auscultatory evidence of severe MR are prognostic clues that identify patients with mitral valve prolapse who are at a relatively high risk of complications), myxomatous degeneration.
References
- ↑ Kulick, Daniel. "Mitral Valve Prolapse (MVP)". MedicineNet.com. MedicineNet, Inc. Retrieved 2010-01-18.
- ↑ 2.0 2.1 Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL; et al. (1999). "Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study)". Am J Cardiol. 83 (6): 897–902. PMID 10190406.