Prevalence of asymptomatic valvular heart disease in the elderly population: A community-based echocardiographic study

Vasiliki Tsampasian, Cristian Militaru, Sathish Kumar Parasuraman, Brodie L. Loudon, Crystal Lowery, Amelia Rudd, Janaki Srinivasan, Satnam Singh, Girish Dwivedi, Gnanadevan Mahadavan, Dana Dawson, Allan Clark, Vassilios S. Vassiliou, Michael P. Frenneaux

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Abstract

Aims: With an ageing population, the presence of asymptomatic valvular heart disease (VHD) in the community remains unknown. The aim of this study is to determine the prevalence and associated factors of asymptomatic VHD in individuals ≥60 years old and to evaluate the feasibility of echocardiographic screening for VHD in this population.  

Methods and results: This was a prospective cohort study conducted between 2007 and 2016 in the UK. Asymptomatic patients with no prior indication for echocardiography were invited to participate and evaluated with a health questionnaire, clinical examination, and transthoracic echocardiography. A total of 10,000 individuals were invited through their general practices. A total of 5429 volunteered to participate, of whom 4237 were eligible for inclusion. VHD was diagnosed in more than a quarter of patients (28.2%). The most common types of VHD were regurgitation of the tricuspid (13.8%), mitral (12.8%), and aortic (8.3%) valves (trivial regurgitation was not included). The rate of prevalence of clinically significant VHD was 2.4% (2.2% moderate and 0.2% severe), with mitral and aortic regurgitation being the most common. The only parameter associated with significant VHD was age (odds ratio 1.07 per 1 year increment, 95% confidence interval 1.05-1.09, P < 0.001). The number needed to scan to diagnose one clinically significant case of VHD is 42 for individuals ≥60 and 15 for those ≥75 years old.  
 
Conclusion: Asymptomatic VHD is present in a significant proportion of otherwise healthy individuals without known VHD over 60 years old. Age is strongly associated with an increased incidence of significant VHD.  
Original languageEnglish
Pages (from-to)1051–1058
Number of pages8
JournalEuropean Heart Journal-Cardiovascular Imaging
Volume25
Issue number8
Early online date26 Jun 2024
DOIs
Publication statusPublished - Aug 2024

Keywords

  • asymptomatic
  • echocardiography
  • epidemiology
  • silent
  • valvular heart disease

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