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Gustav Smith

Associate professor

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Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study

Author

  • Pontus Andell
  • Xinjun Li
  • Andreas Martinsson
  • Charlotte Andersson
  • Martin Stagmo
  • Bengt Zöller
  • Kristina Sundquist
  • Gustav Smith

Summary, in English

Objective: Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking.Methods: We used nationwide registers to identify all patients with a first diagnosis of VHD at Swedish hospitals between 2003 and 2010. Age-stratified and sex-stratified incidence of each VHD and adjusted comorbidity profiles were assessed.Results: In the Swedish population (n=10 164 211), the incidence of VHD was 63.9 per 100 000 person-years, with aortic stenosis (AS; 47.2%), mitral regurgitation (MR; 24.2%) and aortic regurgitation (AR; 18.0%) contributing most of the VHD diagnoses. The majority of VHDs were diagnosed in the elderly (68.9% in subjects aged ≥65 years), but pulmonary valve disease incidence peaked in newborns. Incidences of AR, AS and MR were higher in men who were also more frequently diagnosed at an earlier age. Mitral stenosis (MS) incidence was higher in women. Rheumatic fever was rare. Half of AS cases had concomitant atherosclerotic vascular disease (48.4%), whereas concomitant heart failure and atrial fibrillation were common in mitral valve disease and tricuspid regurgitation. Other common comorbidities were thoracic aortic aneurysms in AR (10.3%), autoimmune disorders in MS (24.5%) and abdominal hernias or prolapse in MR (10.7%) and TR (10.3%).Conclusions: Clinically diagnosed VHD was primarily a disease of the elderly. Rheumatic fever was rare in Sweden, but specific VHDs showed a range of different comorbidity profiles . Pronounced sex-specific patterns were observed for AR and MS, for which the mechanisms remain incompletely understood.

Department/s

  • Molecular Cardiology
  • Family Medicine, Cardiovascular Epidemiology and Lifestyle
  • Molecular Epidemiology and Cardiology
  • Cardiology Research Group
  • Family Medicine and Clinical Epidemiology
  • Cardiology
  • Cardiovascular Epigenetics
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year

2017-05-20

Language

English

Pages

1696-1703

Publication/Series

Heart

Volume

103

Issue

21

Document type

Journal article

Publisher

BMJ Publishing Group

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • Aortic regurgitation
  • Aortic stenosis
  • Epidemiology
  • Mitral regurgitation
  • valvular heart disease

Status

Published

Research group

  • Molecular Cardiology
  • Family Medicine, Cardiovascular Epidemiology and Lifestyle
  • Molecular Epidemiology and Cardiology
  • Cardiology Research Group
  • Family Medicine and Clinical Epidemiology
  • Cardiovascular Epigenetics

ISBN/ISSN/Other

  • ISSN: 1355-6037