The Echocardiographic Diagnosis of Rheumatic Heart Disease: A Review of the Performance of the World Heart Federation Criteria 2012-2023.
Autor: | Marangou J; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.; Department of Cardiology, Royal Perth Hospital, Perth, Australia.; Department of Cardiology, Fiona Stanley Hospital, Perth, Australia., Rwebembera J; Uganda Heart Institute, Kampala, Uganda., Mwita J; Department of Internal Medicine, University of Botswana and Princess Marina Hospital, Botswana., Thorup L; Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark., Remenyi B; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.; Department of Paediatrics, Royal Darwin Hospital, Darwin, Australia and NT Cardiac, Darwin, Australia., Nascimento BR; Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.; Serviço de Cardiologia e Cirurgia Cardiovascular, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Beaton A; Department of Pediatrics, School of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.; Division of Cardiology, The Heart Institute, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA., Kumar K; Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India., Okello E; Division of Adult Cardiology, Uganda Heart Institute, Kampala, Uganda., Raltson K; World Heart Federation, Geneva, Switzerland., Sable C; Division of Cardiology, Children's National Hospital, Washington, DC, USA., Wheaton G; Women's and Children's Hospital, Adelaide, South Australia, Australia., Wilson N; Green Lane Paediatric and Congenital Cardiac Services, Auckland, Te Whatu Ora, New Zealand., Zuhlke L; Vice President-Extramural Research & Internal Portfolio, South Africa Medical Research Council, South Africa.; Division of Paediatric Cardiology, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa., Mota C; Departamento de Pediatria, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.; Divisão de Cardiologia Pediátrica e Fetal/Serviço de Cardiologia e Cirurgia Cardiovascular e Serviço de Pediatria, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Mocumbi A; University Eduardo Mondlane, Mozambique. |
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Jazyk: | angličtina |
Zdroj: | Global heart [Glob Heart] 2024 May 13; Vol. 19 (1), pp. 47. Date of Electronic Publication: 2024 May 13 (Print Publication: 2024). |
DOI: | 10.5334/gh.1327 |
Abstrakt: | Background: The World Heart Federation (WHF) published the first evidence-based guidelines on the echocardiographic diagnosis of rheumatic heart disease (RHD) in 2012. These guidelines have since been applied internationally in research and clinical practice. Substantial research has assessed the utility of the 2012 WHF criteria, including its applicability in low-resource settings. This article summarises the evidence regarding the performance of the guidelines. Methods: A scoping review assessing the performance of the guidelines was performed. Cochrane, Embase, Medline, PubMed Lilacs, Sielo, and Portal BVS databases were searched for studies on the performance of the guidelines between January 2012-March 2023, and 4047 manuscripts met the search criteria, of which 34 were included. This included papers assessing the specificity, inter-rater reliability, application using hand-carried ultrasound, and modification of the criteria for simplicity. The review followed the PRISMA Extension for Scoping Reviews guideline. Results: The WHF 2012 criteria were 100% specific for definite RHD when applied in low-prevalence populations. The criteria demonstrated substantial and moderate inter-rater reliability for detecting definite and borderline RHD, respectively. The inter-rater reliability for morphological features was lower than for valvular regurgitation. When applied to hand-carried ultrasound performed by an expert, modified versions of the criteria demonstrated a sensitivity and specificity range of 79-90% and 87-93% respectively for detecting any RHD, performing best for definite RHD. The sensitivity and the specificity were reduced when performed in task-sharing but remains moderately accurate. Conclusion: The WHF 2012 criteria provide clear guidance for the echocardiographic diagnosis of RHD that is reproducible and applicable to a range of echocardiographic technology. Furthermore, the criteria are highly specific and particularly accurate for detecting definite RHD. There are limitations in applying all aspects of the criteria in specific settings, including task-sharing. This summary of evidence can inform the updated version of the WHF guidelines to ensure improved applicability in all RHD endemic regions. Competing Interests: The authors have no competing interests to declare. (Copyright: © 2024 The Author(s).) |
Databáze: | MEDLINE |
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