Pulmonic regurgitation epidemiology and demographics
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Pulmonic regurgitation Microchapters |
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Diagnosis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2], Aysha Anwar, M.B.B.S[3]
Overview
The prevalence of mild pulmonary regurgutation is present in 40% to 78% of patients with normal pulmonary valve anatomy.[1][2] There is increased prevalence of pulmonary regurgitation with increasing age.
Epidemiology and Demographics
Prevalence
- The prevalence of valvular heart disease in U.S. population is estimated to be 2.5%. About 13% of U.S population born before 1943 have valvular heart disease.[3]
- The prevalence of mild PR is present in 40% to 78% of patients with normal pulmonary valve anatomy.[4][2][5]
- In 1987, the prevalence of PR in patients with structurally normal hearts was estimated to be 5% in Boston area population, USA.[1]
- In 1990, the prevalence of PR in normal patients (21 - 82 years) was estimated to be 31%.[5]
- In 1992, the prevalence of PR in children (birth- 14 years) with structurally normal hearts was estimated to be 21.9% in Jerusalem, Israel population. Pulmonic regurgitation was the most common of all valvular regurgitations detected among children.[6]
Incidence
- In patients born with congenital heart disease, 20% of patients have associated abnormalities of the pulmonary valve or the right ventricular outlet obstruction.[1]
Case-fatality rate/Mortality rate
- According to CDC, in 2017 24% of deaths due to valvular heart disease were attributed to tricuspid valve and pulmonic valve abnormalities combined.[3]
Age
- Patients of all age groups may develop pulmonic regurgitation (PR) depending on the etiology.
- In the U.S population, the prevalence of valvular heart disease is higher in older adults.[3]
- In 1989, a meta‐analysis reported that 29% of the patients with isolated congenital PR develop symptoms within 40 years. The risk of development of symptoms demonstrated an increase with age, particularly after 40 years.[7]
- In 1990, the incidence of mild degree valvular regurgitation in normal subjects was estimated to increase with age.[5]
Race
- There is no racial or ethnic predilection for pulmonary regurgitation.
Gender
- The prevalence and incidence of PR does not vary by gender.
Developed Countries
- In developed countries such as the United States, Pulmonary hypertension (PAH) is primarily due to left heart disease. Other conditions that cause PAH include sickle cell disease; pulmonary embolus, and chronic obstructive pulmonary disease (COPD).[8]
- Rheumatic heart disease (RHD) is not a common cause of PAH or PR in developed countries. Due to the early detection and development of treatment strategies RHD is rare in developed countries.[9][10]
Developing Countries
- In developing countries Pulmonary hypertension (PAH) is primarily due to rheumatic heart disease (RHD), schistosomiasis, congenital heart disease, hemolytic diseases. PAH is a major cause of secondary PR. The burden of PAH is greater in developing than developed countries.[9][11]
References
- ↑ 1.0 1.1 1.2 Choong CY, Abascal VM, Weyman J, Levine RA, Gentile F, Thomas JD; et al. (1989). "Prevalence of valvular regurgitation by Doppler echocardiography in patients with structurally normal hearts by two-dimensional echocardiography". Am Heart J. 117 (3): 636–42. PMID 2784023.
- ↑ 2.0 2.1 Takao S, Miyatake K, Izumi S, Okamoto M, Kinoshita N, Nakagawa H; et al. (1988). "Clinical implications of pulmonary regurgitation in healthy individuals: detection by cross sectional pulsed Doppler echocardiography". Br Heart J. 59 (5): 542–50. PMC 1276894. PMID 3382565.
- ↑ 3.0 3.1 3.2 "Valvular Heart Disease | cdc.gov".
- ↑ Zoghbi, William A.; Adams, David; Bonow, Robert O.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A.; Hahn, Rebecca T.; Han, Yuchi; Hung, Judy; Lang, Roberto M.; Little, Stephen H.; Shah, Dipan J.; Shernan, Stanton; Thavendiranathan, Paaladinesh; Thomas, James D.; Weissman, Neil J. (2017). "Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation". Journal of the American Society of Echocardiography. 30 (4): 303–371. doi:10.1016/j.echo.2017.01.007. ISSN 0894-7317.
- ↑ 5.0 5.1 5.2 Klein AL, Burstow DJ, Tajik AJ, Zachariah PK, Taliercio CP, Taylor CL; et al. (1990). "Age-related prevalence of valvular regurgitation in normal subjects: a comprehensive color flow examination of 118 volunteers". J Am Soc Echocardiogr. 3 (1): 54–63. PMID 2310593.
- ↑ Brand, Abraham; Dollberg, Shaul; Keren, Andre (1992). "The prevalence of valvular regurgitation in children with structurally normal hearts: A color Doppler echocardiographic study". American Heart Journal. 123 (1): 177–180. doi:10.1016/0002-8703(92)90763-L. ISSN 0002-8703.
- ↑ Shimazaki, Y.; Blackstone, E.; Kirklin, J. (2008). "The Natural History of Isolated Congenital Pulmonary Valve Incompetence: Surgical Implications". The Thoracic and Cardiovascular Surgeon. 32 (04): 257–259. doi:10.1055/s-2007-1023399. ISSN 0171-6425.
- ↑ "Pulmonary Hypertension | NHLBI, NIH".
- ↑ 9.0 9.1 Bhagavatula SK, Idrees MM (July 2014). "Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Challenges in managing pulmonary hypertension in the developing countries". Ann Thorac Med. 9 (Suppl 1): S127–30. doi:10.4103/1817-1737.134059. PMC 4114281. PMID 25076991.
- ↑ Vaideeswar, P.; Butany, J. (2016). "Valvular Heart Disease": 485–528. doi:10.1016/B978-0-12-420219-1.00012-4.
- ↑ Butrous, Ghazwan; Ghofrani, Hossein Ardeschir; Grimminger, Friedrich (2008). "Pulmonary Vascular Disease in the Developing World". Circulation. 118 (17): 1758–1766. doi:10.1161/CIRCULATIONAHA.107.727289. ISSN 0009-7322.