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PubMed1989

Ethnic differences in mortality from acute rheumatic fever and chronic rheumatic heart disease in New Mexico, 1958-1982.

To examine time trends and differences in mortality rates from acute rheumatic fever and chronic rheumatic heart disease in New Mexico's Hispanic, American Indian, and non-Hispanic white populations, we analyzed vital records data for 1958 through 1982. Age-adjusted mortality rates for acute rheumatic fever were low and showed no consistent temporal trends among the three ethnic groups over the study period. Age-adjusted and age-specific mortality rates for chronic rheumatic heart disease in Hispanic and non-Hispanic whites decreased over the 25-year period, although rates were higher among Hispanics than among non-Hispanics during most of the time period. In American Indians, age-adjusted mortality rates for chronic rheumatic heart disease increased between 1968 and 1977 to twice the non-Indian mortality rates during the same period. Despite this increase in mortality from chronic rheumatic heart disease among New Mexico's American Indians from 1968 to 1977, the New Mexico data generally reflect national trends of decreasing mortality from chronic rheumatic heart disease.

Acute Disease↗
PubMed1997

Immunologic and clinical correlations in rheumatic fever and rheumatic heart disease.

The intimate relationship of Streptococcus pyogenes and rheumatic fever is well-established, but the precise pathogenesis of rheumatic fever and rheumatic heart disease continues to elude intense investigative efforts by students of the disease worldwide. Technologic advances in molecular biology, not thought possible two decades ago, have given additional insight into the immunologic aspects of the disease. On the clinical side echocardiography has proved to be a marvelous, non-invasive technique to evaluate cardiac anatomy and function. We are now able to gain a closer correlation of the clinical presentation and the autoimmune response. The increased understanding acquired both from the "bench" and the "bedside" are making this perplexing disease somewhat less mysterious. We seem tantalizingly close to grasping a complete understanding of the pathogenesis of rheumatic fever and rheumatic heart disease.

Antibodies↗
PubMedDate not supplied

Rheumatic heart disease prevalence among schoolchildren in Ankara, Turkey.

Rheumatic heart disease (RHD) continues to be a common health problem in the developing world. Although little longitudinal data are available, evidence suggests that there has been little if any decline in the occurrence of RHD over the past few decades. There are only a few population surveys available in Turkey for prevalence of RHD. This survey was undertaken to estimate its prevalence among schoolchildren and changes over the last 20 years in the capital, Ankara. In Ankara, 4,086 schoolchildren aged between six and 17 years were screened over a period four months (March 1995-June 1995) by the same pediatrician. Forty-eight percent (n = 1,945) were female and 52 percent (n = 2,141) were male. Three children out of 4,086 (0.73 per 1,000) were noted to have findings consistent with RHD. Fifteen children had an episode of rheumatic fever (RF). Cumulative prevalence rate (prevalence rate for RF history) was 3.7 per 1,000. We concluded that RHD prevalence has decreased in Ankara over the last decades.

Adolescent↗
PubMed1992

Nonconditional logistic regression analysis of risk factors in rheumatic heart disease.

The prognostic risk factors in 4323 patients with rheumatic heart disease, admitted from 1970 to 1990, were analysed. The overall mortality was 31.75% in this group of patients. Single factor analysis indicated that cardiac functional classification, time of death, month of death, cardiothoracic ratio, valvular lesions, cardiogenic shock, digitalis-induced arrhythmias, intercurrent pneumonia, pleurorrhea, and hypotension were related to the overall mortality and cardiac death. Multiple factor logistic analysis indicated that for the overall mortality, the independent prognostic factors included presence of cardiac functional classification, cardiothoracic ratio and cardiogenic shock; for cardiac death, the independent factors included cardiac functional classification, cardiothoracic ratio, cardiogenic shock, digitalis-induced arrhythmias and valvular lesions. The data analysis showed that these five factors were contributory to rheumatic heart disease with synergism.

Adolescent↗
PubMed2003

[Radionuclide pulmonary perfusion imaging in evaluating pulmonary hypertension in patients with rheumatic heart disease].

OBJECTIVE: To evaluate the degree of pulmonary hypertension in patients with rheumatic heart disease using radionuclide pulmonary perfusion imaging. METHODS: The pulmonary perfusion in 25 patients with rheumatic heart disease was examined using scintigram with macroaggregates of (99m)Tc-labeled human serum albumin (PPS) before and 7 days after operation. PPS was analyzed for (1) pulmonary perfusion steady time (PT), right upper and lower lung count ratio (RULR). The results were compared with those of catheterization examination during the operation. RESULTS: The pulmonary arterial systolic pressure (PAs) and total pulmonary resistance (TPR) were (60 +/- 21) mm Hg and (421 +/- 106) dyn if PT > or = 20 seconds and RULR > or = 2; The PAs and TPR were (28 +/- 5) mm Hg and (188 +/- 28) dyn if PT < 20 seconds and RULR < 2. The PPS changed in most of the patients during early operation. CONCLUSION: The degree of injury in pulmonary vascular in patients with rheumatic heart disease could be quantitatively analysed by PPS.

Adult↗
PubMed1995

Controlling rheumatic heart disease in developing countries.

The streptococcal infection that leads to rheumatic heart disease, which accounts for one third to half of the cardiac admissions in developing countries, appears to spread especially rapidly in overcrowded living conditions. Rheumatic fever can be prevented by antibiotic treatment for streptococcal sore throat in children (primary prophylaxis), and its progression towards rheumatic heart disease can also be stopped by antibiotic therapy (secondary prophylaxis). At present, the most cost-effective control strategy appears to be secondary prophylaxis.

Child↗