Roberts, Kathryn

Maguire, Graeme

Brown, Alex

Atkinson, David

Reményi, Bo

Wheaton, Gavin

Kelly, Andrew

Kumar, Raman K

Su, Jiunn-Yih

Carapetis, Jonathan R

2014-05-13

Echocardiographic screening for rheumatic heart disease (RHD) is becoming more widespread, but screening studies to date have used different echocardiographic definitions. The World Heart Federation has recently published new criteria for the echocardiographic diagnosis of RHD. We aimed to establish the prevalence of RHD in high-risk Indigenous Australian children using these criteria and to compare the findings with a group of Australian children at low risk for RHD. Portable echocardiography was performed on high-risk Indigenous children aged 5 to 15 years living in remote communities of northern Australia. A comparison group of low-risk, non-Indigenous children living in urban centers was also screened. Echocardiograms were reported in a standardized, blinded fashion. Of 3946 high-risk children, 34 met World Heart Federation criteria for definite RHD (prevalence, 8.6 per 1000 [95% confidence interval, 6.0-12.0]) and 66 for borderline RHD (prevalence, 16.7 per 1000 [95% confidence interval, 13.0-21.2]). Of 1053 low-risk children, none met the criteria for definite RHD, and 5 met the criteria for borderline RHD. High-risk children were more likely to have definite or borderline RHD than low-risk children (adjusted odds ratio, 5.7 [95% confidence interval, 2.3-14.1]; P<0.001). The prevalence of definite RHD in high-risk Indigenous Australian children approximates what we expected in our population, and no definite RHD was identified in the low-risk group. This study suggests that definite RHD, as defined by the World Heart Federation criteria, is likely to represent true disease. Borderline RHD was identified in children at both low and high risk, highlighting the need for longitudinal studies to evaluate the clinical significance of this finding.

Circulation 2014-05-13; 129(19): 1953-61

https://pubmed.ncbi.nlm.nih.gov/24622384/?otool=iaurydwlib

https://hdl.handle.net/10137/5608

echocardiography

mass screening

pediatrics

rheumatic heart disease

Adolescent

Australia

Child

Child, Preschool

Cohort Studies

Echocardiography

Female

Humans

Male

Mass Screening

Observer Variation

Prevalence

Retrospective Studies

Rheumatic Heart Disease

Risk Factors

Population Groups

Echocardiographic screening for rheumatic heart disease in high and low risk Australian children.

Comparative Study

Journal Article

Publication