Related Experiment Video
Updated: Oct 14, 2025
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Characteristics, interventions and outcomes of patients with valvular heart disease hospitalised in China: a
Xinghe Huang1,2,3, Sanket S Dhruva4, Xin Yuan5
1Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People's Republic of China.
Insights
Valvular heart disease (VHD) in China is predominantly degenerative, but rheumatic causes are common in moderate to severe cases. Patients with severe VHD, especially those at high risk, may not receive adequate valve intervention.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Valvular heart disease (VHD) poses a significant health burden globally.
- Contemporary data on VHD characteristics and management in China are limited.
- Understanding these aspects is crucial for improving patient care and health policies.
Purpose of the Study:
- To investigate the clinical characteristics, etiology, and type of VHD in hospitalized patients in China.
- To analyze interventions and in-hospital outcomes for VHD patients.
- To identify factors associated with valve intervention in this population.
Main Methods:
- A nationally representative sample of VHD patients hospitalized in China in 2015 was analyzed.
- Data were collected from medical records, including echocardiograms.
- Multivariable logistic regression identified factors influencing valve intervention.
Main Results:
- Degenerative etiology was most common overall (33.3%), while rheumatic etiology predominated in moderate/severe VHD (27.3%-33.6%).
- Mitral regurgitation (79.1%) and tricuspid regurgitation (77.4%) were the most frequent VHD types.
- Only 35.6% of severe VHD patients in capable facilities received intervention, with higher risk correlating with decreased intervention.
Conclusions:
- Degenerative VHD is prevalent, necessitating targeted strategies.
- Rheumatic heart disease remains a significant cause of moderate to severe VHD.
- Severe VHD patients, particularly high-risk individuals, appear undertreated, indicating a need for policy review.
Objectives:
Little is known about contemporary characteristics and management of valvular heart disease (VHD) in China. This study aimed to examine the clinical characteristics, aetiology and type of VHD, interventions and in-hospital outcomes of patients with VHD hospitalised in China.
Methods:
We used a two-stage random sampling design to create a nationally representative sample of patients with VHD hospitalised in 2015 in China and included adult patients with mild, moderate or severe VHD. We abstracted data from medical records, including echocardiogram reports, on patient characteristics, aetiology, type and severity of VHD, interventions and in-hospital outcomes. We weighted our findings to estimate nationally representative hospitalisations. We performed multivariable logistic regression analysis to identify factors associated with valve intervention.
Results:
In 2015, 38 841 patients with VHD were hospitalised in 188 randomly sampled hospitals, representing 662 384 inpatients with VHD in China. We sampled 9363 patients, mean age 68.7 years (95% CI 42.2 to 95.2) and 46.8% (95% CI 45.8% to 47.8%) male, with an echocardiogram. Degenerative origin was the predominant aetiology overall (33.3%, 95% CI 32.3% to 34.3%), while rheumatic origin was the most frequent aetiology among patients with VHD as the primary diagnosis (37.4%, 95% CI 35.9% to 38.8%). Rheumatic origin was also the most common aetiology among patients with moderate or severe VHD (27.3%, 95% CI 25.6% to 29.0% and 33.6%, 95% CI 31.9% to 35.2%, respectively). The most common VHD was mitral regurgitation (79.1%, 95% CI 78.2% to 79.9%), followed by tricuspid regurgitation (77.4%, 95% CI 76.5% to 78.2%). Among patients with a primary diagnosis of severe VHD who were admitted to facilities capable of valve intervention, 35.6% (95% CI 33.1% to 38.1%) underwent valve intervention during the hospitalisation. The likelihood of intervention decreased significantly among patients with higher operative risk.
Conclusions:
Among patients with VHD hospitalised in China, the predominant aetiology was degenerative in origin; among patients with moderate or severe VHD, rheumatic origin was the most common aetiology. Targeted strategies and policies should be promoted to address degenerative VHD. Patients with severe VHD may be undertreated, particularly those with high operative risk.
More Related Videos
Related Concept Videos
01:27Mitral Stenosis IV: Nursing Management
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:20Rheumatic Heart Disease IV: Nursing Management
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:30Acute Coronary Syndrome III: Diagnostic Studies