Characteristics at diagnosis | All N=396 |
---|---|
Age, median (IQR) | 18 (10–40) |
Male, n (%) | 174 (43.9) |
Ethnicity* | |
Indigenous Melanesians | 274 (71.9) |
Polynesians | 85 (22.3) |
Other | 22 (5.8) |
Presentation with ARF | 205 (51.8) |
Family history of RHD or ARF† | 114 (60.6) |
Supra ventricular arrhythmias‡ | 32 (8.1) |
Initial left-sided valve disease on echocardiogram | |
Mitral regurgitation, n (%) | |
Nil | 69 (17.4) |
Grade 1/4 | 162 (40.9) |
Grade 2/4 | 110 (27.8) |
Grade ≥3/4 | 55 (13.9) |
Mitral stenosis, n (%) | |
Nil | 265 (66.9) |
Mild | 42 (10.6) |
Moderate | 30 (7.6) |
Severe | 59 (14.9) |
Aortic regurgitation, n (%) | |
Nil | 201 (50.8) |
Grade 1/4 | 109 (27.5) |
Grade 2/4 | 53 (13.4) |
Grade ≥3/4 | 33 (8.) |
Aortic stenosis, n (%) | |
Nil | 370 (93.4) |
Mild | 10 (2.5) |
Moderate | 9 (2.3) |
Severe | 1 (0.5) |
Multiple left-sided valve disease, n (%) | 223 (56.3) |
Overall severity of RHD§ | |
Mild | 127 (32.1) |
Moderate | 131 (33.1) |
Severe | 138 (34.8) |
Moderate or severe TR¶, n (%) | 17 (4.5) |
LVEF<60%, n (%) | 37 (9.3) |
PASP>35 mm Hg, n (%) | 74 (18.7) |
*Missing data in 15 cases.
†Up to second-degree relatives; missing data in 208 cases.
‡Defined as paroxysmal or persistent atrial fibrillation, flutter or atrial tachycardia.
§Defined as mild RHD if single or multiple left-sided valve disease graded as mild; moderate RHD defined as at least mitral or aortic moderate valve disease (regurgitation or stenosis); severe RHD defined as at least mitral or aortic severe valve disease (regurgitation or stenosis).
¶Missing data in 22 cases.
AR, aortic regurgitation; ARF, acute rheumatic fever; PASP, pulmonary artery systolic pressure; RHD, rheumatic heart disease; TR, tricuspid regurgitation.