Vascular Health and Risk Management (Apr 2024)
Echocardiographic Parameters and Complication Profiles Among Adult Patients with Rheumatic Heart Disease at Jimma Medical Center
Abstract
Hiwot Berhanu,1 Andualem Mossie,1 Sudhakar Narayan Morankar,2 Tadesse Dukessa Gemechu,3 Elsah Tegene3 1Department of Biomedical Sciences, Faculty of Medical Science, Jimma Institute of Health, Jimma University, Jimma, Ethiopia; 2Ethiopian Evidence Based Health Care Center, Department of Health, Behavior and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia; 3Department of Internal Medicine, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Hiwot Berhanu, Department of Biomedical-sciences, Faculty of Medical Sciences, Jimma Institute of Health, Jimma University, P.O.Box: Jimma University378, Jimma, Ethiopia, Tel +251917324642, Email [email protected]: Despite the fact that patients with rheumatic heart disease (RHD) need early medical attention and follow-up, most patients in developing countries tend to present with debilitating complications. The objective of this study was to evaluate the echocardiographic features of adult individuals diagnosed with RHD and examine the associated complications among patients who started follow-up at Jimma Medical Center’s (JMC) cardiac follow-up clinic.Methods: A prospective cross-sectional study was conducted at JMC between January 5 and April 15, 2023. Echocardiographic patterns were taken by senior cardiologists; socio-demographic variables, anthropometric measurements, and behavioral factors were collected through a structured questioner.Results: The study recruited a total of 115 participants, of whom 86 (74.8%) were female and 29 (25.2%) were male. The mean age of the patients was 32.31 (SD± 12.16) years. The mitral valve was affected in 98.26% of cases, while the aortic and tricuspid valve abnormalities were diagnosed in 49.5% and 21.7%, respectively. The most frequent combinations of valve lesions were mitral regurgitation (MR) + mitral stenosis (MS) + aortic regurgitation (AR) (15.7%), followed by MR + AR + TR (8.7%). The occurrence of MR+MS+AR was higher in females (17.4%) compared to males (10.3%), whereas the occurrence of MS+MR was higher in males (24.1%) compared to females (20.9%). Females have a severely reduced ejection fraction compared to males (84.8% vs 15.2%, P = 0.044). Nearly two-thirds (63.5%) of individuals experienced RHD-related complications; the most commonly encountered complications were pulmonary hypertension (26.1%) and atrial fibrillation (19.1%).Conclusion: RHD predominantly affects individuals in their active and productive years, particularly females. Most patients have multiple-valve lesions.Keywords: rheumatic heart disease, echocardiography, complication, Ethiopia
