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Outcomes of borderline rheumatic heart disease: A prospective cohort study

Geneviève Bertaina1, Bernard Rouchon2, Bertrand Huon2

  • 1INSERMU970, Paris Cardiovascular Research Centre-PARCC, Paris, France.

International Journal of Cardiology
|November 25, 2016
PubMed

Insights

Borderline rheumatic heart disease (RHD) in children often remains stable over two years. Consistent diagnosis of borderline RHD may require review by two specialists.

Area of Science:

  • Cardiology
  • Pediatrics
  • Public Health

Background:

  • Systematic echocardiography screening for rheumatic heart disease (RHD) in endemic areas identifies a new category: borderline RHD.
  • The clinical significance and natural progression of borderline RHD require further investigation.

Purpose of the Study:

  • To evaluate the outcomes of children diagnosed with borderline RHD through echocardiographic screening.
  • To understand the natural history and clinical course of borderline RHD in a pediatric population.

Main Methods:

  • Prospective echocardiographic screening for RHD was conducted in 4th-grade schoolchildren (aged 9-10 years) in New Caledonia.
  • Children with borderline RHD, confirmed by two independent cardiologists, were included and followed up for a median of 23 months.

Main Results:

  • Of 8684 screened children, 25 were diagnosed with borderline RHD and followed up.
  • After a median of 23 months, 60% showed stable valvular lesions, and 32% had normal findings.
  • Two children (8%) progressed to definite RHD, with no clinical events reported during the follow-up period.

Conclusions:

  • Borderline RHD identified through systematic screening in high-risk populations generally shows stability over two years.
  • Consistent diagnosis of borderline RHD may necessitate a consensus review by two independent cardiologists.
Abstract

Keywords:
Adolescent healthEchocardiographyHeart valve diseaseRheumatic heart disease

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