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The Global Impact of Rheumatic Heart Disease

  • Global Cardiovascular Health (L Sperling and D Gaita, Section Editors)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Rheumatic heart disease (RHD) is a neglected disease of poverty, which presents challenges for patients, communities, and health systems. These effects are magnified in low resource countries, which bear the highest disease burden. When considering the impact of RHD, it is imperative that we widen our lens in order to better understand how RHD impacts the over 40 million people currently living with this preventable condition and their communities. We aimed to perform an updated literature review on the global impact of RHD, examining a broad range of aspects from disease burden to impact on healthcare system to socioeconomic implications.

Recent Findings

RHD accounts for 1.6% of all cardiovascular deaths, resulting in 306,000 deaths yearly, with a much higher contribution in low- and middle-income countries, where 82% of the deaths occurred in 2015. RHD can result in severe health adverse outcomes, markedly heart failure, arrhythmias, stroke and embolisms, and ultimately premature death. Thus, preventive, diagnostic and therapeutic interventions are required, although insufficiently available in undersourced settings. As examples, anticoagulation management is poor in endemic regions – and novel oral anticoagulants cannot be recommended – and less than 15% of those in need have access to interventional procedures and valve replacement in Africa.

Summary

RHD global impact remains high and unequally distributed, with a marked impact on lower resourced populations. This preventable disease negatively affects not only patients, but also the societies and health systems within which they live, presenting broad challenges and high costs along the pathway of prevention, diagnosis, and management.

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Funding

This study has no specific funding. Dr. Nascimento was supported in part by CNPq (Bolsa de produtividade em pesquisa, 312382/2019–7), by the Edwards Lifesciences Foundation (Improving the Prevention and Detection of Heart Valve Disease Across the Lifespan, 2021), and by FAPEMIG (grant APQ-000627–20).

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Authors and Affiliations

  1. Uganda Heart Institute, Kampala, Uganda

    Joselyn Rwebembera, Nakagaayi Doreen, Isaac Ssinabulya & Emmy Okello

  2. Cincinnati Children’s Hospital Medical Center, The Heart Institute, University of Cincinnati School of Medicine, Cincinnati, OH, USA

    Andrea Z. Beaton & Sarah R. de Loizaga

  3. Serviço de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaúde, Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 110, 1st floor, 30130100, Belo Horizonte, Brasil

    Rodrigo T. L. Rocha, Clara L. Fraga, Bruno F. Galdino, Maria Carmo P. Nunes & Bruno R. Nascimento

  4. Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil

    Rodrigo T. L. Rocha, Clara L. Fraga, Bruno F. Galdino, Maria Carmo P. Nunes & Bruno R. Nascimento

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  1. Joselyn Rwebembera
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Correspondence to Bruno R. Nascimento.

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Rwebembera, J., Beaton, A.Z., de Loizaga, S.R. et al. The Global Impact of Rheumatic Heart Disease. Curr Cardiol Rep 23, 160 (2021). https://doi.org/10.1007/s11886-021-01592-2

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