Clinical Characteristics and Number of Valve Lesion in Rheumatic Heart Disease Severity

Saskia Ratna Desita, Achmad Lefi, Mahrus Rahman, Yudi Her Oktaviono

Abstract


Rheumatic heart disease (RHD) occurs due to sequelae in the form of damage to the heart valves from the failure of acute rheumatic fever (ARF) therapy. Heart valve damage can cause various complications such as congestive heart failure, arrhythmias, pulmonary hypertension, atrial fibrillation, endocarditis, which can cause death. The study aimed to assess the association between clinical characteristics and valve lesion and rheumatic heart disease severity. The study was an analytic observational with a cross-sectional design of 73 patients with definite RHD from September 2019 to March 2020 in Dr. Soetomo Regional General Hospital. The majority of patients were female (80%, p=0.235) 30–39 years old (34%, p=0.157). The mean age was 42.08±12.16 years. The majority of patients have low socioeconomic status (78%, p=0.025) and rural dwelling location (70%, p=0.138) over three-quarters of patients living with more than four people in the same house (75%). Multivalvular lesions (90%, p=0.003) and severe RHD (77%) were present predominantly. In conclusion, low socioeconomic status and multivalvular lesions are associated with rheumatic heart disease severity.

 

KARAKTERISTIK KLINIS DAN JUMLAH LESI KATUP PADA DERAJAT KEPARAHAN PENYAKIT JANTUNG REUMATIK

Penyakit jantung reumatik (PJR) adalah penyakit yang terjadi akibat gejala sisa berupa kerusakan katup jantung dari kegagalan terapi demam reumatik akut (DRA). Kerusakan katup jantung pada PJR dapat menimbulkan berbagai komplikasi seperti gagal jantung kongesti, aritmia, hipertensi pulmonal, atrial fibrilasi, dan endokarditis yang dapat menyebabkan kematian. Penelitian ini bertujuan mencari hubungan karakteristik klinis dan jumlah lesi katup dengan derajat keparahan PJR. Penelitian ini merupakan analitik observasional menggunakan pendekatan cross-sectional. Sampel penelitian ini adalah pasien yang terdiagnosis definitif PJR berdasar atas ekokardiografi pada bulan Sepetember 2019–Maret 2020 di RSUD Dr. Soetomo Surabaya. Didapatkan 73 pasien sesuai dengan kriteria inklusi. Mayoritas pasien berjenis kelamin perempuan (80%; p=0,235), dengan kelompok usia 30–39  (34%; p=0,157). Usia rerata 42,08±12,16 tahun. Sebagian besar pasien berstatus sosial ekonomi rendah (78%, p=0,025) dan lokasi tinggal pedesaan (70%; p=0,138). Lebih dari tiga perempat pasien tinggal dengan ≤4 orang di satu atap (75%). Lesi multivalvular (90%; p=0,003) dan PJR berat (77%) ditemukan secara dominan. Simpulan, status sosial ekonomi rendah dan lesi katup multivalvular berhubungan dengan derajat keparahan penyakit jantung reumatik.


Keywords


Clinical characteristic; derajat keparahan; karakteristik klinis; lesi katup; penyakit jantung reumatik; rheumatic heart disease; severity; valve lesion

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References


Hasnul M, Najirman, Yanwirasti Y. Karakteristik pasien penyakit jantung rematik yang dirawat inap di RSUP Dr. M. Djamil Padang. JKA. 2015;4(3):894–900.

Guilherme L, Sampaio RO, Freschi de Barros S, Köhler KF, Spina GS, Tarasoutchi F, et al. Rheumatic fever and rheumatic heart disease. In: Nussinovitch U, editor. The heart in rheumatic, autoimmune and inflammatory diseases: pathophysiology, clinical aspects and therapeutic approaches. London: Academic Press; 2017. p. 529–51.

Nulu S, Bukhman G, Kwan GF. Rheumatic heart disease: the unfinished global agenda. Cardiol Clin. 2017;35(1):165–80.

Zühlke L, Engel ME, Karthikeyan G, Rangarajan S, Mackie P, Cupido B, et al. Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study). Eur Heart J. 2015;36(18):1115–22.

Okello E, Wanzhu Z, Musoke C, Twalib A, Kakande B, Lwabi P, et al. Cardiovascular complications in newly diagnosed rheumatic heart disease patients at Mulago Hospital, Uganda. Cardiovasc J Afr. 2013;24(3):80–5.

World Health Organization. Global health estimates 2016 summary tables: globals by cause, age and sex, 2000–2016 [Internet]. Geneva: World Health Organization; 2016 [cited 2020 April 26]. Available from: https://www.who.int/healthinfo/global_burden_disease/GHE2016_DALY_Global_2000_2016_.xls.

Okello E, Kakande B, Sebatta E, Kayima J, Kuteesa M, Mutatina B, et al. Socioeconomic and environmental risk factors among rheumatic heart disease patients in Uganda. PLoS ONE. 2012;7(8):e43917.

Kingué S, Ba SA, Balde D, Diarra MB, Anzouan-Kacou JB, Anisubia B, et al. The VALVAFRIC study: a registry of rheumatic heart disease in Western and Central Africa. Arch Cardiovasc Dis. 2016;109(5):321–9.

Melani TA. Karakteristik penderita penyakit jantung rematik (PJR) yang dirawat inap di RSUP H. Adam Malik Medan tahun 2004–2008 [undergraduate thesis]. Medan: Universitas Sumatera Utara; 2010 [cited 2020 April 26]. Available from: https://repository.usu.ac.id/handle/123456789/14616.

Rodriguez-Fernandez R, Amiya R, Wyber R, Widdodow W, Carapetis J. Rheumatic heart disease among adults in a mining community of Papua, Indonesia: findings from an occupational cohort. Heart Asia. 2015;7(2):44–8.

Zhang W, Mondo C, Okello E, Musoke C, Kakande B, Nyakoojo W, et al. Presenting features of newly diagnosed rheumatic heart disease patients in Mulago Hospital: a pilot study. Cardiovasc J Afr. 2013;24(2):28–33.

Lawrence JG, Carapetis JR, Griffiths K, Edwards K, Condon JR. Acute rheumatic fever and rheumatic heart disease: incidence and progression in the Northern Territory of Australia, 1997 to 2010. Circulation. 2013;128(5):492–501.

Sika-Paotonu D, Beaton A, Carapetis J. Epidemiology and global burden of rheumatic heart disease. In: Camm AJ, Lüscher TF, Maurer G, Serruys PW, editors. The ESC textbook of cardiovascular medicine. 3rd Edition. Oxford: Oxford University Press; 2018. p. 314–22.

Carapetis JR, Beaton A, Cunningham MW, Guilherme L, Karthikeyan G, Mayosi BM, et al. Acute rheumatic fever and rheumatic heart disease. Nat Rev Dis Primers. 2016;2:15084.

Laudari S, Subramanyam G. A study of spectrum of rheumatic heart disease in a tertiary care hospital in Central Nepal. Int J Cardiol Heart Vasc. 2017;15:26–30.

Xiao F, Zheng R, Yang D, Cao K, Zhang S, Wu B, et al. Sex-dependent aortic valve pathology in patients with rheumatic heart disease. PLoS ONE. 2017;12(6):e0180230.

Lubega S, Aliku T, Lwabi P. Echocardiographic pattern and severity of valve dysfunction in children with rheumatic heart disease seen at Uganda Heart Institute, Mulago hospital. Afr Health Sci. 2014;14(3):617–25.

Zühlke L, Beaton A, Engel ME, Hugo-Hamman CT, Karthikeyan G, Katzenellenbogen J, et al. Group A streptococcus, acute rheumatic fever and rheumatic heart disease: epidemiology and clinical considerations. Curr Treat Options Cardiovasc Med. 2017;19(2):15.

Sriharibabu M, Himabindu Y, Kabir Z. Rheumatic heart disease in rural south India: a clinico-observational study. J Cardiovasc Dis Res. 2013;4(1):25–9.

Sharma N, Toor D. Impact of socio-economic factors on increased risk and progression of rheumatic heart disease in developing nations. Curr Infect Dis Rep. 2019;21(6):21.

Islam AKMM, Majumder AAS. Rheumatic fever and rheumatic heart disease in Bangladesh: a review. Indian Heart J. 2016;68(1):88–98.

Camara EJN, dos Santos JM, Alves-Silva LS, Latado AL. Rheumatic fever recurrence: risk factors and clinical characteristics. Clin Trials Regul Sci Cardiol. 2016;19:5–8.

Beg A, Younas M, Touseef A. Rheumatic heart disease (RHD); socio-economic and environmental risk factors for acute rheumatic fever (ARF) and rheumatic heart disease (RHD) patients in Pakistan. TPMJ. 2016;23(3):324–7.

Baro L, Sharma N, Toor D, Chaliha MS, Kusre G, Baruah SM, et al. A hospital-based study of socioeconomic status and clinical spectrum of rheumatic heart disease patients of Assam, North-East India. Eur J Prev Cardiol. 2018;25(12):1303–6.

Riaz BK, Selim S, Karim MN, Chowdhury KN, Chowdhury SH, Rahman MR. Risk factors of rheumatic heart disease in Bangladesh: a case-control study. J Health Popul Nutr. 2013;31(1):70–7.




DOI: https://doi.org/10.29313/gmhc.v9i1.6609

pISSN 2301-9123 | eISSN 2460-5441


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