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Echocardiographic Screening for Subclinical Rheumatic Heart Disease Remains a Research Tool Pending Studies of Impact on Prognosis

  • Valvular Heart Disease (V Nkomo, Section Editor)
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Abstract

The application of portable echocardiography to the screening of asymptomatic children and young adults for rheumatic heart disease (RHD) in developing countries indicates that the disease may affect 62 million to 78 million individuals worldwide, which could potentially result in 1.4 million deaths per year from RHD and its complications. The World Heart Federation has developed a guideline for the echocardiographic diagnosis of RHD in asymptomatic individuals without a history of acute rheumatic fever (ARF) in order to ensure the reliability, comparability, and reproducibility of findings of the echocardiographic screening studies. Early studies suggest that a third of individuals with asymptomatic subclinical RHD revert to normal echocardiographic findings on repeat testing after 6–12 months, suggesting that repeat echocardiography may be necessary to confirm the findings prior to consideration of interventions such as antibiotic prophylaxis. It is not known, however, whether echocardiographic screening for asymptomatic subclinical RHD or the introduction of antibiotic prophylaxis for affected individuals improves the prognosis of RHD. Furthermore, the cost-effectiveness of this screening method has not been established in the vast majority of affected countries. Therefore, echocardiographic screening for asymptomatic subclinical RHD remains a research tool until studies of impact on prognosis and cost-effectiveness are conducted.

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Disclosure

Conflicts of interest: L. Zühlke: none; B.M. Mayosi: has received grant support from World Heart Federation Else Krone Award, Medical Research Council of South Africa, Lily and Ernst Hausmann Research Trust, Lifehealthcare Foundation, and Thrasher Foundation.

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Correspondence to Bongani M. Mayosi.

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This article is part of the Topical Collection on Valvular Heart Disease

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Zühlke, L., Mayosi, B.M. Echocardiographic Screening for Subclinical Rheumatic Heart Disease Remains a Research Tool Pending Studies of Impact on Prognosis. Curr Cardiol Rep 15, 343 (2013). https://doi.org/10.1007/s11886-012-0343-1

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