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[Chronological changes in the annual incidence of valvular heart disease based on autopsies performed in Japan]
1Research Laboratory for Cardiovascular Pathology, Juntendo University School of Medicine, Tokyo.
Insights
Valvular heart disease (VHD) incidence in Japan decreased overall, with rheumatic and congenital types declining. However, sclerotic, inflammatory, and mitral valve prolapse cases increased, possibly due to an aging population and medical advancements.
Area of Science:
- Cardiovascular Pathology
- Epidemiology of Heart Disease
Context:
- Analysis of autopsy data from Japan spanning 1968 and 1985.
- Focus on chronological changes in valvular heart disease (VHD) incidence.
Purpose:
- To investigate temporal trends in the occurrence of different types of VHD.
- To compare the incidence of rheumatic (RVD), sclerotic (SVD), inflammatory (IE), congenital (CVD), and other valvular diseases (OVDs) between two distinct time points.
Summary:
- Total VHD cases increased from 697 (2.8%) in 1968 to 987 (2.5%) in 1985.
- Incidence of RVD (0.96% to 0.92%) and CVD (0.36% to 0.21%) decreased.
- Incidence of SVD (0.15% to 0.27%), IE (0.16% to 0.27%), and mitral valve prolapse (MVP) (0.004% to 0.045%) increased.
Impact:
- The rise in IE, despite antibiotic availability, suggests factors like immunocompromised hosts and artificial heart valves.
- Increased SVD incidence is linked to Japan's growing elderly population.
- Findings highlight evolving VHD patterns in Japan, necessitating updated public health strategies.
Abstract:
Chronological changes in the incidence of valvular heart disease (VHD) in Japan were studied. The VHD data were obtained from the 1969 and 1986 editions of the Annual of Pathological Autopsy Cases in Japan and were categorized in 5 groups: rheumatic (RVD), sclerotic (SVD), inflammatory including infection (IE), congenital (CVD), and other valvular diseases (OVDs). Comparison of actual autopsy data for 1968 and 1985 revealed that total numbers of VHD were 697 in 1968 and 987 in 1985. The percentage incidences of VHD for all autopsy cases were 2.8% and 2.5%, respectively. Changes in VHD incidence were as follows: RVD 0.96% in 1968/0.92% in 1985; CVD 0.36%/0.21%; SVD 0.15%/0.27%; IE 0.16%/0.27%; mitral valve prolapse (MVP) 0.004%/0.045%. The total numbers of VHD, and the incidence of RVD and CVD decreased, while the incidence of SVD, IE, and MVP increased. The RVD decrease is compatible with previous reports. In contrast, the increase in the incidence of IE is paradoxical since there was an increase in the variety of antibiotics available in 1985. The higher incidence might be due partially to immune compromised host, artificial heart valves, and other similar factors. The increase in SVD may be due to the steady increase in the elderly population.