Dataset Information

Validation of a simplified score for predicting latent rheumatic heart disease progression using a prospective cohort of Brazilian schoolchildren.

ABSTRACT:

Objectives

Echocardiographic (echo) screening is an important tool to estimate rheumatic heart disease (RHD) prevalence, but the natural history of screen-detected RHD remains unclear. The PROVAR+ (Programa de RastreamentO da VAlvopatia Reumática) study, which uses non-experts, telemedicine and portable echo, pioneered RHD screening in Brazil. We aimed to assess the mid-term evolution of Brazilian schoolchildren (5-18 years) with echocardiography-detected subclinical RHD and to assess the performance of a simplified score consisting of five components of the World Heart Federation criteria, as a predictor of unfavourable echo outcomes.

Setting

Public schools of underserved areas and private schools in Minas Gerais, southeast Brazil.

Participants

A total of 197 patients (170 borderline and 27 definite RHD) with follow-up of 29±9 months were included. Median age was 14 (12-16) years, and 130 (66%) were woman. Only four patients in the definite group were regularly receiving penicillin.

Primary and secondary outcome measures

Unfavourable outcome was based on the 2-year follow-up echo, defined as worsening diagnostic category, remaining with mild definite RHD or development/worsening of valve regurgitation/stenosis.

Results

Among patients with borderline RHD, 29 (17.1%) progressed to definite, 49 (28.8%) remained stable, 86 (50.6%) regressed to normal and 6 (3.5%) were reclassified as other heart diseases. Among those with definite RHD, 13 (48.1%) remained in the category, while 5 (18.5%) regressed to borderline, 5 (18.5%) regressed to normal and 4 (14.8%) were reclassified as other heart diseases. The simplified echo score was a significant predictor of RHD unfavourable outcome (HR 1.197, 95% CI 1.098 to 1.305, p<0.001).

Conclusion

The simple risk score provided an accurate prediction of RHD status at 2-year follow-up, showing a good performance in Brazilian schoolchildren, with a potential value for risk stratification and monitoring of echocardiography-detected RHD.

SUBMITTER: Bechtlufft BM

PROVIDER: S-EPMC7223287 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Publications

Validation of a simplified score for predicting latent rheumatic heart disease progression using a prospective cohort of Brazilian schoolchildren.

Bechtlufft Bárbara Martins BM Nascimento Bruno Ramos BR Sable Craig C Fraga Clara Leal CL Barbosa Márcia Melo MM Reis Susana Drumond SD Diamantino Adriana Costa AC Meira Zilda Maria Alves ZMA Castilho Sandra Regina Tolentino SRT Arantes Nayana Flamini NF Oliveira Kaciane Krauss KK Silva José Luiz Padilha JLP Rezende Breno De Filippo BF Costa Waydder Antônio Aurélio WAA Mata Mariana Duarte MD Pereira Augusto Ferreira AF Ribeiro Antonio Luiz Pinho ALP Beaton Andrea Zawacki AZ Pereira Nunes Maria Carmo MC

BMJ open 20200510 5

<h4>Objectives</h4>Echocardiographic (echo) screening is an important tool to estimate rheumatic heart disease (RHD) prevalence, but the natural history of screen-detected RHD remains unclear. The PROVAR+ (<i>Programa de RastreamentO da VAlvopatia Reumática</i>) study, which uses non-experts, telemedicine and portable echo, pioneered RHD screening in Brazil. We aimed to assess the mid-term evolution of Brazilian schoolchildren (5-18 years) with echocardiography-detected subclinical RHD and to as ...[more]

PMID: 32393615

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Dataset Information

Validation of a simplified score for predicting latent rheumatic heart disease progression using a prospective cohort of Brazilian schoolchildren.

Objectives

Setting

Participants

Primary and secondary outcome measures

Results

Conclusion

Publications

Validation of a simplified score for predicting latent rheumatic heart disease progression using a prospective cohort of Brazilian schoolchildren.

Similar Datasets

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