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Prevalence of Structural Heart Diseases Detected by Handheld Echocardiographic Device in School-Age Children in Iran:
Saeid Hosseini1, Niloufar Samiei1, Avisa Tabib1
1Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR.
Insights
This study found structural heart disease (SHD) prevalence in Iranian children and adolescents is comparable to prior research, with parental consanguinity a key risk factor. Echocardiography is a feasible screening tool for early detection in this population.
Area of Science:
- Cardiology
- Public Health
- Pediatrics
Background:
- Structural heart disease (SHD) poses significant public health challenges.
- Data on the prevalence of SHD in pediatric populations are limited.
- Understanding SHD burden is crucial for healthcare planning.
Purpose of the Study:
- To determine the prevalence of SHD in children and adolescents in Iran.
- To identify risk factors associated with different types of SHD.
- To assess the feasibility of echocardiographic screening for SHD.
Main Methods:
- A population-based study utilizing multistage cluster-random sampling in Tehran.
- Echocardiographic examinations using a handheld Vscan device on 15,130 students (ages 6-18).
- Expert cardiologist supervision, interpretation, and hospital reevaluation of findings.
Main Results:
- Prevalence rates: Congenital heart disease (CHD) 10.046/1,000, Rheumatic heart disease (RHD) 2-7.5/1,000, Valvular heart disease (VHD) 30.7/1,000.
- Parental consanguinity was the strongest predictor for CHD and overall SHD.
- Female sex and low paternal literacy predicted non-rheumatic VHD and RHD, respectively.
Conclusions:
- Echocardiography is a feasible method for detecting SHD in young populations.
- SHD prevalence in this Iranian cohort is comparable to international reports.
- Further research into economic aspects of community-based screening is recommended.
Background:
Structural heart disease (SHD) has great impacts on healthcare systems, creating further public health concerns. Proper data are scant regarding the magnitude of the affected population by SHD.
Objectives:
This study aimed to determine the prevalence of SHD among children and adolescents in an Iranian population.
Methods:
In this population-based study, a multistage cluster-random sampling was used to choose schools from the Tehran urban area. All students were examined using a handheld Vscan device by echocardiographer, and the results were concurrently supervised and interpreted by cardiologists. All the major findings were reevaluated in hospital clinics.
Results:
Of 15,130 students (6-18 years, 52.2% boys) who were examined, the prevalence of individuals with congenital heart disease (CHD) and cardiomyopathy was 152 (10.046 per 1,000 persons) and 9 (0.595 per 1,000 persons), respectively. The prevalence of definite and borderline rheumatic heart disease (RHD) was 30 (2 per 1,000 persons) and 113 (7.5 per 1,000 persons), correspondingly. Non-rheumatic valvular heart disease (VHD) was also detected in 465 (30.7 per 1,000 persons) students. Of all the pathologies, only 39 (25.6%) cases with CHD and 1 (0.007%) cases with RHD had already been diagnosed. Parental consanguinity was the strongest predictor of CHD and SHD (odds ratio [OR]: 1.907, 95% CI, 1.358 to 2.680; P < 0.001 and OR, 1.855, 95% CI, 1.334 to 2.579; P < 0.001, respectively). The female sex (OR, 1.262, 95% CI, 1.013 to 1.573; P = 0.038) and fathers' low literacy (OR, 1.872, 95% CI, 1.068 to 3.281; P = 0.029) were the strongest predictors of non-rheumatic VHD and RHD, correspondingly.
Conclusions:
The implementation of echocardiographic examinations for detecting SHD among young population is feasible which detected SHD prevalence in our population comparable to previous reports. Further studies are required to delineate its economic aspects for community-based screening.
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