Measuring and reporting disease progression in subclinical rheumatic heart disease

Echocardiography is a sensitive test for detecting subclinical rheumatic heart disease (RHD) in asymptomatic individuals. However, it also detects a large number of minor abnormalities which may overlap with the normal range of variability in valve morphology and function in the population. These abnormalities do not fulfil criteria for the diagnosis of RHD and have been variously termed ‘possible’ or ‘borderline’ by different guidelines.1 2 The utility of routine screening echocardiography in endemic populations hinges on two critical parameters: (1) the rate of disease progression and (2) the impact of secondary antibiotic prophylaxis in stemming this progression. Data on disease progression from the earliest echocardiographic screening studies are now becoming available. But, these studies are generally limited by the small number of cases, short follow-up times, substantial attrition rates, and in the studies which preceded the World Heart Federation (WHF) recommendations, inconsistent diagnostic criteria.
Source: Heart Asia - Category: Cardiology Authors: Tags: Editorial Source Type: research