Rheumatic Heart Disease in the Developing World

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Structural Heart Pub Date : 2023-11-01 DOI:10.1016/j.shj.2023.100219

Michael T. Simpson MD , Mateusz Kachel MD , Robert C. Neely MD , W. Clinton Erwin MD , Aleena Yasin MD , Amisha Patel MD , Dasari Prasada Rao MBBS, MS, MCh , Kaushal Pandey MBBS, MCh , Isaac George MD

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Abstract

Despite recent public policy initiatives, rheumatic heart disease (RHD) remains a major source of morbidity worldwide. Rheumatic heart disease occurs as a sequela of Streptococcus pyogenes (group A streptococcal [GAS]) infection in patients with genetic susceptibility. Strategies for prevention of RHD or progression of RHD include prevention of GAS infection with community initiatives, effective treatment of GAS infection, and secondary prophylaxis with intramuscular penicillin. The cardiac surgical community has attempted to improve the availability of surgery in RHD-endemic areas with some success, and operative techniques and outcomes of valve repair continue to improve, potentially offering patients a safer, more durable operation. Innovation offers hope for a more scalable solution with improved biomaterials and transcatheter delivery technology; however, cost remains a barrier.

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发展中国家的风湿性心脏病

尽管最近的公共政策举措，风湿性心脏病(RHD)仍然是世界范围内发病率的主要来源。风湿性心脏病是遗传易感性患者感染化脓性链球菌(a组链球菌[GAS])的后遗症。预防RHD或RHD进展的策略包括通过社区倡议预防GAS感染，有效治疗GAS感染，以及肌肉注射青霉素进行二级预防。心脏外科医学界已经尝试在一些rhd流行地区提高手术的可获得性，并取得了一些成功，手术技术和瓣膜修复的结果也在不断改善，可能为患者提供更安全、更持久的手术。通过改进生物材料和经导管输送技术，创新为更可扩展的解决方案提供了希望;然而，成本仍然是一个障碍。

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来源期刊

Structural Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

1.60

自引率

0.00%

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