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[A quantitative evaluation of rheumatism activity in chronic rheumatic heart disease]
Insights
This study developed a mathematical formula to identify active rheumatic heart disease (RHD) using clinical factors. The formula accurately predicted active rheumatism in 85.5% of patients, aiding diagnosis before surgery.
Area of Science:
- Cardiology
- Rheumatology
- Pathology
Context:
- Rheumatic heart disease (RHD) diagnosis relies on identifying active rheumatic carditis.
- Accurate assessment of active rheumatism is crucial for guiding treatment and surgical decisions in RHD patients.
Purpose:
- To develop and validate a mathematical formula for judging the activity of rheumatism in patients with rheumatic heart disease (RHD).
- To identify key clinical predictors of active rheumatism in RHD.
Summary:
- Clinical data from 185 RHD patients were analyzed using stepwise regression analysis of multi-factors (SRAM).
- A formula prioritizing factors like reduced cardiac function, atrial fibrillation, and murmur changes was derived.
- The formula correctly identified active rheumatism in 85.5% of 310 tested RHD cases, verified by pathological examination for Aschoff's bodies.
Impact:
- Provides a validated clinical tool for assessing active rheumatism in RHD.
- Improves diagnostic accuracy for active rheumatic carditis, potentially optimizing patient management.
- Highlights key clinical indicators for active rheumatic heart disease.
Abstract:
The clinical data of 185 patients with rheumatic heart disease (RHD) proved by pathological biopsies were recorded before operations, and analysed using the stepwise regression analysis of multi-factors (SRAM). A mathematical formula to judge the activities of rheumatism in RHD was applied. The multi-factors were put in order according to their importance in effect: progressive reduction of cardiac function (age less than 30), sustained atrial fibrillation, recent changes in heart murmur or onset of a new murmur, paroxysmal atrial fibrillation, speed-up of erythrocyte sedimentation rate and acute pulmonary edema (age less than 30). 310 cases of RHD were tested and verified by this formula, 85.5% of them were diagnosed correctly in comparison with Aschoff's bodies observed by pathological biopsies in left cardiac atrial appendages. All cases were operated and confirmed by pathological examination. The presence of Aschoff's bodies in atrial appendages was considered the index of active rheumatism pathologically.