RT Journal Article
SR Electronic
T1 Community prevalence, mechanisms and outcome of mitral or tricuspid regurgitation
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1003
OP 1009
DO 10.1136/heartjnl-2020-318482
VO 107
IS 12
A1 Thomas J Cahill
A1 Anthony Prothero
A1 Jo Wilson
A1 Andrew Kennedy
A1 Jacob Brubert
A1 Megan Masters
A1 James D Newton
A1 Sam Dawkins
A1 Maurice Enriquez-Sarano
A1 Bernard D Prendergast
A1 Saul G Myerson
YR 2021
UL http://heart.bmj.com/content/107/12/1003.abstract
AB Objective The study aims were (1) to identify the community prevalence of moderate or greater mitral or tricuspid regurgitation (MR/TR), (2) to compare subjects identified by population screening with those with known valvular heart disease (VHD), (3) to understand the mechanisms of MR/TR and (4) to assess the rate of valve intervention and long-term outcome.Methods Adults aged ≥65 years registered at seven family medicine practices in Oxfordshire, UK were screened for inclusion (n=9504). Subjects with known VHD were identified from hospital records and those without VHD invited to undergo transthoracic echocardiography (TTE) within the Oxford Valvular Heart Disease Population Study (OxVALVE). The study population ultimately comprised 4755 subjects. The severity and aetiology of MR and TR were assessed by integrated comprehensive TTE assessment.Results The prevalence of moderate or greater MR and TR was 3.5% (95% CI 3.1 to 3.8) and 2.6% (95% CI 2.3 to 2.9), respectively. Primary MR was the most common aetiology (124/203, 61.1%). Almost half of cases were newly diagnosed by screening: MR 98/203 (48.3%), TR 69/155 (44.5%). Subjects diagnosed by screening were less symptomatic, more likely to have primary MR and had a lower incidence of aortic valve disease. Surgical intervention was undertaken in six subjects (2.4%) over a median follow-up of 64 months. Five-year survival was 79.8% in subjects with isolated MR, 84.8% in those with isolated TR, and 59.4% in those with combined MR and TR (p=0.0005).Conclusions Moderate or greater MR/TR is common, age-dependent and is underdiagnosed. Current rates of valve intervention are extremely low.Data are available on reasonable request to saul.myerson@cardiov.ox.ac.uk.