Current Research in RHD Global Burden of Rheumatic Heart Disease ECHO Screening for RHD New WHF Criteria for ECHO diagnosis of RHD
Only 30 or 40 years ago: Rheumatic fever was a common topic at NEJM: 1966-1976: Result in 55 Articles at NEJM 1997-2006: Result in 8 Articles only
All Medical Journals: 1966-1976: Result in 516 Articles 1997-2006: Result in 172 Articles
» Decrease in disease incidence in industrialized countries but remained as major health issue in underdeveloped countries.
Middle MiddleEast East&&North NorthAfrica Africa::
1.8 1.8cases cases//1000 1000
15 Million with RHD 280 Thousands New ARF / yr ~ 60% of ARF develop RHD
Middle MiddleEast East&&North NorthAfrica Africa(84 (84Million MillionChild Child5-14 5-14years) years) 154000 154000cases cases
500,000 Death / year Mortality: Heart Failure Infective Endocarditis Strokes
GAS GAS
500000 500000cases/yr cases/yr
The American Society of Echocardiography (ASE) and GE Healthcare (GE) utilized technological innovations 75 board-certified reading physicians US & worldwide such as: Canada Georgia, Bulgaria, Greece and Saudi Arabia.
2012: ECHO 1,030 people (3days)
Studycast™ Web-based transmission solution
NEJM 2007
Card Young 2005
Multi-centric Double blinded Prospective study Strict Jones criterions 452 consecutive Pts. Males 230, Female 222 Age 2-51 yrs Mean Age 11 yrs
International Advisory Group Experts (21) Formulated 2009 Series of Web-Based Seminars 3218 abstracts 170 Full text articles Rapid identification of RHD No history of ARF Not for diagnosis of acute Carditis
NATURE NATUREREVIEWS REVIEWS| |CARDIOLOGY CARDIOLOGY| |May May2012 2012
Jet Length 4 cm
Velocity ≼ 3 m/s
Simple Criteria to differentiate mild RHD from normal ECHO New technique are not utilized (ERO, VC, etc) Loading conditions of ventricle Technical pitfalls in ECHO aquisition and storage Further modifications
Greatest impact: Stimulate interest and advocacy for RHD control
Defining RHD burden Early treatment Secondary prevention program: Definite RHD Borderline RHD: High Vs Low Prevalence Population
Evaluation of natural history: Subclinical RHD