Prevalence of asymptomatic valvular heart disease in Italian elderly subjects living in Rome communities: insight from PREVASC II study
M A Amico, G Cortis, A Taddei, S Orellana, G Giacalone, R E Strachinariu, A Agresti, G Dutti, R Morandini, N Marchionni, A Boccanelli, N CarrabbaAbstract
Aims
Valvular heart disease (VHD) is the third most common cause of cardiovascular morbidity, and its incidence is expected to rise substantially. In older adults, VHD has clinical, social, and economic consequences, leading to significant loss of public health and high costs for the National Health Service. This study explores VHD prevalence in elderly subjects living in a series of communities (parishes and senior centers) belonging to a populous (259.000 inhabitants) in the VI district of the municipality of Rome.
Methods
We conducted an observational, cross-sectional study in 7 parishes and senior centers in Rome. Subjects aged ≥65y, asymptomatic, and without a previous history of VHD were enrolled by voluntary participation . All participants underwent a comprehensive evaluation including a cardiological examination, an electrocardiogram and an echocardiogram according to ESC guideline, focusing on presence and grading of VHD.
Results
We enrolled 2,600 subjects, with a mean age of 73 ± 6 years and a balanced gender distribution (53.1% female); the most common cause of VHD was degenerative, while the rheumatic VHD was not detected. Notably, 94.1% of entire population had at least one left valvular defect: specifically, 11.2% exhibit a moderate or severe valvulopathies, with a low prevalence of aortic valve stenosis and high prevalence of mitral regurgitation (1.07% and 4.69% of moderate or severe forms, respectively). Overall, the prevalence of any degree of right-sided valvulopathies was 55.9%, being the prevalence of 5% for moderate or severe tricuspid regurgitation and of 2.1% for trivial/mild pulmonary regurgitation.
Conclusions
Our registry demonstrated that the prevalence of VHD in asymptomatic individuals aged more than 65 years, residing in Rome parishes and senior centers, is not negligible in both left and right side of the heart, although higher in left side. In the contemporary era of cardiac structural intervention, the interception of unknown VHD is mandatory. A standardized national screening echocardiographic program could be suggested for early detection of VHD to plan their most appropriate and convenient management in individuals who are asymptomatic.