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At least 109 records · Page 6Linked to original sources
PubMed2004

Mitral valve repair with aortic valve replacement in rheumatic heart disease.

From 1992 to 2001, 609 patients with rheumatic heart disease underwent aortic valve replacement with either mitral valve repair (n = 201) or mitral valve replacement (n = 408). Follow-up extended to 10 years. Thirty-day mortality was 1.4% for mitral valve repair and 0.7% for mitral valve replacement (p = 0.4). Survival at 9 years was 96.5 +/- 1.4% after mitral valve repair and 89.7 +/- 7.8% after mitral valve replacement (p = 0.73). Freedom from major bleeding at 9 years was 94.8 +/- 2.4% after mitral valve repair and 81 +/- 7.2% after mitral valve replacement (p = 0.03). Freedom from other valve-related complications and from mitral valve re-operation was similar for the two groups. This study showed that in patients with rheumatic heart disease the results of mitral valve repair with aortic valve replacement were comparable to those of double valve replacement. Major bleeding was less frequent after mitral valve repair with aortic valve replacement. Therefore, whenever feasible, mitral valve repair should be attempted in patients with rheumatic heart disease who need concomitant aortic valve replacement.

Aortic Valve↗
PubMed1992

Hemoptysis in rheumatic heart disease.

107 Consecutive patients with rheumatic valvular heart disease (41 males, 66 females, average age 24.2 years) being followed at an Ethiopian cardiology referral clinic were examined and questioned about their experience of hemoptysis. 51 Patients (48%) gave a history of hemoptysis; 11 described their usual hemoptysis as frank blood, 40 as blood-streaked sputum. 29 patients had frequent hemoptysis, 13 had several episodes, and 9 only 1 occurrence. Prevalence of hemoptysis did not vary significantly by sex, physical findings, New York Heart Association classification, or valvular lesion, including the presence or absence of mitral stenosis. A majority (64) had been tested for tuberculosis, with 5 having been treated for active disease. Hemoptysis is a common manifestation of rheumatic heart disease, and is usually well tolerated.

Adolescent↗
PubMed1989

Lymphocyte subsets in acute rheumatic fever and rheumatic heart disease.

Lymphocyte subsets in 53 patients with acute rheumatic fever and 78 patients with chronic rheumatic heart disease were compared with 20 normal control subjects and 39 patients suffering from uncomplicated streptococcal pharyngitis to obtain information about the pathogenesis of the disease. Twenty patients with rheumatic fever were followed for 24 weeks to evaluate changes occurring over the course of the disease. Total leukocyte and lymphocyte counts were increased in patients with rheumatic fever and to a lesser extent in those with rheumatic heart disease, when compared with controls. The difference between the two groups was significant. Patients with acute rheumatic fever had an increased number of B cells and a smaller increase in total T and T-helper-inducer (CD-4) cells. The proportion of B cells increased, while that of T-suppressor-cytotoxic (CD-8) cells fell. An increased number and proportion of B cells was also seen in patients with rheumatic heart disease. Total T and T-helper lymphocyte percentages and numbers were significantly higher in patients with rheumatic fever compared with those of patients with rheumatic heart disease. Follow-up studies at 6, 12, and 24 weeks revealed no significant differences from the entry point studies, although there was a trend toward reduction in the degree of derangement from normal values. Patients with uncomplicated streptococcal pharyngitis, however, did not show perturbations in the T-cell and T-subset counts. Our study suggests that the immunoregulatory defect in acute rheumatic fever is characterized by a relative reduction of suppressor T cells with an absolute increase in helper T cells and B cells, resulting in an increased cellular as well as humoral immune response.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1985

Prognosis of subjects in the Framingham Study with rheumatic heart disease.

One hundred thirteen of the original Framingham Heart Study cohort, aged 30 to 62 years, were identified as having valvular heart disease of presumed rheumatic etiology. All of these subjects, and a sample of age- and sex-matched controls, were accounted for during 34 years between 1950 and 1984. Although subjects with rheumatic heart disease had significantly higher mortality and serious morbidity than did those in the control group, 36 of the 113 (31.9%) rheumatic heart disease subjects survived at the end of this period as compared with 52.7% of the control subjects.

Adult↗
PubMed1984

Rheumatic fever and rheumatic heart disease in Serbia Proper, Yugoslavia, 1970-1979.

The occurrence of rheumatic fever and rheumatic heart disease in the period 1970-1979 is analysed on the basis of morbidity and mortality data. It was found that: Rheumatic fever first attacks rate and rheumatic fever recurrent attacks rate in 1979 were by 80% and 91% lower respectively, compared with 1970 rates; The disease became milder and the number of RF with heart involvement decreased especially in population over 19 years old; In the ten year period mortality rate from rheumatic fever and rheumatic heart disease decreased 2.8 times; In the age group 15-24 mortality did not decline so noticeable and mortality rate in this age group is still ten times higher than the same rate in the most developed countries; Among all defined causes of death (except accidents), in the age group 15-24, rheumatic fever and rheumatic heart disease (taken together) fell from first or second place to the eleventh or tenth place in the last years under review; One can expect that the declining trend of morbidity and mortality from rheumatic fever and rheumatic heart disease will continue though probably slower then in the preceding period.

Adolescent↗
PubMed1981

Follow up study of rheumatic heart disease.

The follow up study on rheumatic heart disease was carried out over a 20 year period by the questionaire method. Two hundreds and seventy-nine patients were analyzed and the following results were obtained. 1) Sixteen cases (5.5%) died, 20 cases (6.8%) showed deterioration, 155 cases (53.1%) were unchanged, 35 cases (12.0%) were improved, 12 cases (4.1%) were announced that their valvular lesions disappeared and 22 cases (7.2%) underwent cardiac surgery. The more severe the findings at the final examination under our program, the poorer the courses. 2) The cases having a severe status index showed a tendency for poor prognoses. Mitral steno-regurgitation revealed the poorest prognoses. 3) 84.3 per cent of the living cases were found to be leading normal daily lives without any restriction. 4) The average death rate was 1.0% per year during the 20 years between 1958 and 1978. The death rate for age group between 9 and 17 years old was the highest (1.34% per year). 5) The leading cause of death in every group including all the cases under our program was a recurrence of rheumatic fever. However in groups older than 18 years of age chronic congestive heart failure and unsuccessful cardiac surgery were leading causes.

Adolescent↗