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Echocardiographic screening for rheumatic heart disease in Turkish schoolchildren

Published online by Cambridge University Press:  02 September 2019

Semra Atalay ,
Ercan Tutar ,
Tayfun Uçar ,
Seda Topçu Open the ORCID record for Seda Topçu [Opens in a new window] ,
Serdal K. Köse  and
Melih T. Doğan
Semra Atalay
Affiliation:
Division of Pediatrics Cardiology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
Ercan Tutar
Affiliation:
Division of Pediatrics Cardiology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
Tayfun Uçar
Affiliation:
Division of Pediatrics Cardiology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
Seda Topçu*
Affiliation:
Division of Social Pediatrics, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
Serdal K. Köse
Affiliation:
Division of Pediatrics Cardiology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
Melih T. Doğan
Affiliation:
Division of Pediatrics Cardiology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
*
Author for Correspondence: Seda Topçu, MD, Associate Professor, Division of Social Pediatrics, Department of Pediatrics, Ankara University School of Medicine, 1549. Cadde, Hardem Apartmanı, B Blok, Daire 12. Çiğdem-Çankaya, Ankara, Turkey. Tel.: +90 505 706 46 32; Fax: +90 312 306 59 17; E-mail: [email protected]
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Abstract

Background:

The aim of this study is to investigate the prevalence of subclinical rheumatic heart disease in schoolchildren aged 5–18 by using portable echocardiography in Ankara, Turkey.

Methods:

The portable echocardiography screening was performed by a paediatric cardiologist for all of the cases. The mean age of 2550 healthy students was 11.09 ± 2.91 years (1339 females, 1211 males) in three private and three public schools. Echocardiographic studies were assessed according to 2012 World Heart Federation criteria for rheumatic heart disease.

Results:

After reviewing the echocardiographic images, 73 students were reevaluated by an advanced echocardiography device in the university hospital. Evidence of definite subclinical rheumatic heart disease was found in 39 students (15/1000) and borderline rheumatic heart disease in 20 students (8/1000). No children had any clinical symptoms. The mean age of children diagnosed with rheumatic heart disease and borderline rheumatic heart disease is 12.4 and 11.4 years, respectively. The risk of rheumatic heart disease was found to be increased sevenfold in girls between 14 and 18 years. We surprisingly observed that the prevalence of definite rheumatic heart disease in private schools located in high-income areas of Ankara was higher than that in public schools.

Conclusions:

This is the first and largest single-centred echocardiographic screening study for subclinical rheumatic heart disease in Turkish schoolchildren. The frequency of rheumatic heart disease has been found to be 15/1000. This finding is similar to those of recent echocardiographic screening studies performed in middle and high-risk populations. We conclude that to decrease the burden of rheumatic heart disease, echocardiographic screening studies are necessary, and long-term follow-up of children with echocardiographically diagnosed subclinical rheumatic heart disease is needed.

Keywords

Echocardiographypaediatricsrheumatic heart diseasescreening
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 10 , October 2019 , pp. 1272 - 1277
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Copyright
© Cambridge University Press 2019 

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