吉马医疗中心风湿性心脏病成人患者的超声心动图参数和并发症概况

Hiwot Berhanu, Andualem Mossie, S. Morankar, Tadesse Gemechu, E. Tegene
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摘要

背景 尽管风湿性心脏病(RHD)患者需要早期治疗和随访,但发展中国家的大多数患者往往会出现使人衰弱的并发症。本研究旨在评估被诊断为风湿性心脏病的成人患者的超声心动图特征,并检查在吉马医疗中心(JMC)心脏随访门诊开始随访的患者的相关并发症。方法 在 2023 年 1 月 5 日至 4 月 15 日期间,在吉马医疗中心开展了一项前瞻性横断面研究。由资深心脏病专家绘制超声心动图;通过结构化问卷收集社会人口变量、人体测量数据和行为因素。结果 该研究共招募了 115 名参与者,其中 86 名(74.8%)为女性,29 名(25.2%)为男性。患者的平均年龄为 32.31(SD± 12.16)岁。98.26%的病例受二尖瓣影响,49.5%和21.7%的病例被诊断为主动脉瓣和三尖瓣异常。最常见的瓣膜病变组合是二尖瓣反流(MR)+二尖瓣狭窄(MS)+主动脉瓣反流(AR)(15.7%),其次是MR+AR+TR(8.7%)。女性发生 MR+MS+AR 的比例(17.4%)高于男性(10.3%),而男性发生 MS+MR 的比例(24.1%)高于女性(20.9%)。与男性相比,女性的射血分数严重降低(84.8% vs 15.2%,P = 0.044)。近三分之二(63.5%)的患者出现过与 RHD 相关的并发症;最常见的并发症是肺动脉高压(26.1%)和心房颤动(19.1%)。结论 RHD 主要影响活跃期和生产期的人群,尤其是女性。大多数患者有多瓣膜病变。
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Echocardiographic Parameters and Complication Profiles Among Adult Patients with Rheumatic Heart Disease at Jimma Medical Center
Background Despite the fact that patients with rheumatic heart disease (RHD) need early medical attention and follow-up, most patients in developing countries tend to present with debilitating complications. The objective of this study was to evaluate the echocardiographic features of adult individuals diagnosed with RHD and examine the associated complications among patients who started follow-up at Jimma Medical Center’s (JMC) cardiac follow-up clinic. Methods A prospective cross-sectional study was conducted at JMC between January 5 and April 15, 2023. Echocardiographic patterns were taken by senior cardiologists; socio-demographic variables, anthropometric measurements, and behavioral factors were collected through a structured questioner. Results The study recruited a total of 115 participants, of whom 86 (74.8%) were female and 29 (25.2%) were male. The mean age of the patients was 32.31 (SD± 12.16) years. The mitral valve was affected in 98.26% of cases, while the aortic and tricuspid valve abnormalities were diagnosed in 49.5% and 21.7%, respectively. The most frequent combinations of valve lesions were mitral regurgitation (MR) + mitral stenosis (MS) + aortic regurgitation (AR) (15.7%), followed by MR + AR + TR (8.7%). The occurrence of MR+MS+AR was higher in females (17.4%) compared to males (10.3%), whereas the occurrence of MS+MR was higher in males (24.1%) compared to females (20.9%). Females have a severely reduced ejection fraction compared to males (84.8% vs 15.2%, P = 0.044). Nearly two-thirds (63.5%) of individuals experienced RHD-related complications; the most commonly encountered complications were pulmonary hypertension (26.1%) and atrial fibrillation (19.1%). Conclusion RHD predominantly affects individuals in their active and productive years, particularly females. Most patients have multiple-valve lesions.
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