The natural history of latent rheumatic heart disease in a 5 year follow-up study: a prospective observational study

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dc.contributor.authorZYhlke, Liesl
dc.contributor.authorEngel, Mark E
dc.contributor.authorLemmer, Carolina E
dc.contributor.authorvan de Wall, Marnie
dc.contributor.authorNkepu, Simpiwe
dc.contributor.authorMeiring, Alet
dc.contributor.authorBestawros, Michael
dc.contributor.authorMayosi, Bongani M
dc.date.accessioned2021-10-08T06:20:18Z
dc.date.available2021-10-08T06:20:18Z
dc.date.issued2016
dc.description.abstractBackgroundLatent rheumatic heart disease (RHD) occurs in asymptomatic individuals with echocardiographic evidence of RHD and no history of acute rheumatic fever. The natural history of latent RHD is unclear but has important clinical and economic implications about whether these children should receive penicillin prophylaxis or not. We performed a 5-year prospective study of this question.MethodsIn August 2013 through September 2014, we conducted a follow-up study of latent RHD among school pupils using the World Heart Federation (WHF) echocardiographic criteria. Contingency tables were used to assess progression, persistence or regression of latent RHD.ResultsForty two borderline and 13 definite cases of RHD (n 55) were identified, 44 (80%; mean age 13.8 ± 4.0years; 29 (65.9%) female) of whom were available for echocardiographic examination at a median follow-up of 60.8months (interquartile range 51.3-63.5). Over the follow-up period, half the participants (n = 23; 52.3%) improved to normal or better WHF category (regressors), a third (n = 14, 31.8%) remained in the same category (persistors), while seven others (15.9%) progressed from borderline to definite RHD (progressors). In total, 21 subjects (47.7%) reverted to a normal status, nine (20.4%) either improved from definite to borderline or remained in the borderline category, and 14 (31.8%) either remained definite or progressed from borderline to a definite status. Two cases (20%) progressed to symptomatic disease.ConclusionsLatent RHD has a variable natural history that ranges from regression to normal in nearly half of cases, to persistence, progression or development of symptoms in the remainder of subjects.
dc.identifier.apacitationZYhlke, L., Engel, M. E., Lemmer, C. E., van de Wall, M., Nkepu, S., Meiring, A., ... Mayosi, B. M. (2016). The natural history of latent rheumatic heart disease in a 5 year follow-up study: a prospective observational study. <i>BMC Cardiovascular Disorders</i>, 16(1), 174 - 177. http://hdl.handle.net/11427/34247en_ZA
dc.identifier.chicagocitationZYhlke, Liesl, Mark E Engel, Carolina E Lemmer, Marnie van de Wall, Simpiwe Nkepu, Alet Meiring, Michael Bestawros, and Bongani M Mayosi "The natural history of latent rheumatic heart disease in a 5 year follow-up study: a prospective observational study." <i>BMC Cardiovascular Disorders</i> 16, 1. (2016): 174 - 177. http://hdl.handle.net/11427/34247en_ZA
dc.identifier.citationZYhlke, L., Engel, M.E., Lemmer, C.E., van de Wall, M., Nkepu, S., Meiring, A., Bestawros, M. & Mayosi, B.M. et al. 2016. The natural history of latent rheumatic heart disease in a 5 year follow-up study: a prospective observational study. <i>BMC Cardiovascular Disorders.</i> 16(1):174 - 177. http://hdl.handle.net/11427/34247en_ZA
dc.identifier.issn1471-2261
dc.identifier.ris TY - Journal Article AU - ZYhlke, Liesl AU - Engel, Mark E AU - Lemmer, Carolina E AU - van de Wall, Marnie AU - Nkepu, Simpiwe AU - Meiring, Alet AU - Bestawros, Michael AU - Mayosi, Bongani M AB - BackgroundLatent rheumatic heart disease (RHD) occurs in asymptomatic individuals with echocardiographic evidence of RHD and no history of acute rheumatic fever. The natural history of latent RHD is unclear but has important clinical and economic implications about whether these children should receive penicillin prophylaxis or not. We performed a 5-year prospective study of this question.MethodsIn August 2013 through September 2014, we conducted a follow-up study of latent RHD among school pupils using the World Heart Federation (WHF) echocardiographic criteria. Contingency tables were used to assess progression, persistence or regression of latent RHD.ResultsForty two borderline and 13 definite cases of RHD (n 55) were identified, 44 (80%; mean age 13.8 ± 4.0years; 29 (65.9%) female) of whom were available for echocardiographic examination at a median follow-up of 60.8months (interquartile range 51.3-63.5). Over the follow-up period, half the participants (n = 23; 52.3%) improved to normal or better WHF category (regressors), a third (n = 14, 31.8%) remained in the same category (persistors), while seven others (15.9%) progressed from borderline to definite RHD (progressors). In total, 21 subjects (47.7%) reverted to a normal status, nine (20.4%) either improved from definite to borderline or remained in the borderline category, and 14 (31.8%) either remained definite or progressed from borderline to a definite status. Two cases (20%) progressed to symptomatic disease.ConclusionsLatent RHD has a variable natural history that ranges from regression to normal in nearly half of cases, to persistence, progression or development of symptoms in the remainder of subjects. DA - 2016 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Cardiovascular Disorders LK - https://open.uct.ac.za PY - 2016 SM - 1471-2261 T1 - The natural history of latent rheumatic heart disease in a 5 year follow-up study: a prospective observational study TI - The natural history of latent rheumatic heart disease in a 5 year follow-up study: a prospective observational study UR - http://hdl.handle.net/11427/34247 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34247
dc.identifier.vancouvercitationZYhlke L, Engel ME, Lemmer CE, van de Wall M, Nkepu S, Meiring A, et al. The natural history of latent rheumatic heart disease in a 5 year follow-up study: a prospective observational study. BMC Cardiovascular Disorders. 2016;16(1):174 - 177. http://hdl.handle.net/11427/34247.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceBMC Cardiovascular Disorders
dc.source.journalissue1
dc.source.journalvolume16
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12872-016-0225-3
dc.subject.otherAdolescent
dc.subject.otherAortic Valve Insufficiency
dc.subject.otherChild
dc.subject.otherChild, Preschool
dc.subject.otherDisease Progression
dc.subject.otherEchocardiography
dc.subject.otherFemale
dc.subject.otherFollow-Up Studies
dc.subject.otherHumans
dc.subject.otherMale
dc.subject.otherMitral Valve Insufficiency
dc.subject.otherProspective Studies
dc.subject.otherRemission, Spontaneous
dc.subject.otherRheumatic Heart Disease
dc.subject.otherSex Factors
dc.subject.otherSouth Africa
dc.subject.otherYoung Adult
dc.titleThe natural history of latent rheumatic heart disease in a 5 year follow-up study: a prospective observational study
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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