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Prevalence of rheumatic heart disease in adults from the Brazilian Amazon Basin

Alma Wegener1, Anna Engell Holm1, Laura C Gomes2

  • 1Multidisciplinary Center, Federal University of Acre, Câmpus Floresta, Cruzeiro do Sul, Acre, Brazil; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark.

International Journal of Cardiology
|January 22, 2022
PubMed

Insights

Rheumatic heart disease (RHD) affects 39/1000 adults in the Brazilian Amazon, highlighting the need for screening in remote areas. A simplified RHD risk score identified less than half of cases as high-risk.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Rheumatic heart disease (RHD) remains a significant health burden, particularly in low- and middle-income countries.
  • Prevalence data for RHD are scarce in South America, necessitating regional studies.

Purpose of the Study:

  • To determine the prevalence of RHD in adults residing in the Brazilian Amazon Basin.
  • To evaluate a simplified risk score algorithm for RHD screening.

Main Methods:

  • Echocardiographic screening of a random adult population sample (≥18 years) in the Brazilian Amazon.
  • Analysis of echocardiographic images using 2012 World Heart Federation criteria and a validated simplified risk score algorithm.

Main Results:

  • The prevalence of RHD was found to be 39/1000 adults (17 definite, 2 borderline cases).
  • Pathological mitral regurgitation was the most common finding (74%), followed by mitral stenosis (21%).
  • A simplified risk score algorithm identified only 47% of RHD cases as high-risk.

Conclusions:

  • The RHD prevalence of 39/1000 in the Brazilian Amazon underscores the need for targeted screening programs in underserved remote regions.
  • Simplified screening models require external validation to improve their clinical feasibility and accuracy in identifying RHD.
  • A significant proportion of RHD cases were undiagnosed prior to the study, indicating a gap in healthcare surveillance.
Abstract

Keywords:
Amazon BasinCross-sectionalEchocardiographyRheumatic heart disease

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