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Cronic non-rheumatic valvular heart disease. An autopsy study
Insights
Chronic non-rheumatic valvular heart disease, particularly calcific aortic stenosis, was studied in Iceland. Bicuspid aortic valves were more common in males, while tricuspid valve calcification was more frequent in females.
Area of Science:
- Cardiology
- Pathology
- Epidemiology
Background:
- Valvular heart disease is a significant cardiovascular condition.
- Understanding the prevalence of specific valvular pathologies is crucial for public health.
- Chronic non-rheumatic valvular heart disease encompasses several distinct conditions.
Purpose of the Study:
- To investigate the frequency and prevalence of chronic non-rheumatic valvular heart disease in Iceland.
- To analyze the specific types of valvular heart disease, including calcific aortic stenosis and bicuspid aortic valves.
- To examine demographic differences in the occurrence of these conditions.
Main Methods:
- Autopsy-based study of Icelandic individuals aged 16 and older.
- Inclusion of approximately 28.8% of deaths occurring between November 1965 and December 1974.
- Detailed examination of heart valves for calcification, bicuspid morphology, and other abnormalities.
Main Results:
- Calcific aortic stenosis occurred in 3.63% of autopsies, with higher prevalence in females (4.50%) than males (3.17%).
- Bicuspid aortic valves were more frequent in males (1.54%) compared to females (0.50%).
- Calcific aortic stenosis was more common in tricuspid valves in females and bicuspid valves in males.
Conclusions:
- Calcific aortic stenosis and bicuspid aortic valves represent significant findings in the Icelandic population studied.
- Sex-based differences in the prevalence of specific aortic valve pathologies were observed.
- The study provides valuable epidemiological data on valvular heart disease in Iceland during the study period.
Abstract:
The frequency of chronic non-rheumatic valvular heart disease in Iceland was investigated via autoposies performed from November 1965 through December 1974. During this period, about 12.400 Icelanders died at the age of 16 years and older and 28.8 per cent of these were included in the study. At autopsy, males outnumbered females by 2:1. The frequency of calcific aortic stenosis was found to be 3.63 per cent and the prevalence was calculated to be 3.17 per cent among males and 4.50 per cent among females. Calcific aortic stenosis in tricuspid valves was more frequent in females and calcific aortic stenosis in bicuspid valves was more frequent in males. Among the hearts with calcific aortic stenosis, 70.8 per cent were found to have normally tricuspid valves, 25.4 per cent bicuspid valves and 3.8 per cent tricuspid valves with an unicommissural fusion. In 0.59 per cent of the hearts the aortic valve was either bicuspid or had an uncommissural fusion without the features of calcific stenosis. However, a functional stenosis was suggested by the increased weight of most of these hearts. The frequency of bicuspid aortic valves was 1.2 per cent with a prevalence in males of 1.54 per cent and in females 0.50 per cent. A calcified mitral annulus was found in 1.98 per cent of the hearts and in most, it was either associated with calcific aortic stenosis in a tricuspid valve, or it was a single valvular disease. Rheumatic valvular disease was found in 1.08 per cent of the heart examined.