Journal of Occupational
Health and Epidemiology
Rafsanjan university Of medical sciences
Volume 14, Issue 3 (Summer 2025)
J Occup Health Epidemiol 2025, 14(3): 153-161 |
Back to browse issues page
Ethics code: IR.MUMS.MEDICAL.REC.1399.114
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Bigdelu L, Baradaran Firoozabadi M, Dowlatabadi Y, Alimi H, Poorzand H, Emadzadeh M et al . Epidemiological and Demographic Analysis of Rheumatic Heart Diseases in Northeastern Iran: A Cross-Sectional Study. J Occup Health Epidemiol 2025; 14 (3) :153-161
URL: http://johe.rums.ac.ir/article-1-980-en.html
URL: http://johe.rums.ac.ir/article-1-980-en.html
Related article in
Google Scholar
Google Scholar
Similar articles
Leila Bigdelu *1 
, Mohammad Baradaran Firoozabadi2 , Yousef Dowlatabadi3 , Hedieh Alimi4 , Hourak Poorzand5 , Maryam Emadzadeh6 , Fereshteh Ghaderi4
, Mohammad Baradaran Firoozabadi2 , Yousef Dowlatabadi3 , Hedieh Alimi4 , Hourak Poorzand5 , Maryam Emadzadeh6 , Fereshteh Ghaderi4
1- Associate Prof., Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. , bigdelul9706@gmail.com
2- Neurological Surgery Resident, Dept. of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Medical Doctor, Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
4- Associate Prof., Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
5- Professor, Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
6- Associate Prof., Mashhad University of Medical Sciences, Mashhad, Iran
2- Neurological Surgery Resident, Dept. of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Medical Doctor, Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
4- Associate Prof., Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
5- Professor, Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
6- Associate Prof., Mashhad University of Medical Sciences, Mashhad, Iran
Article history
Received: 2024/12/2
Accepted: 2025/05/22
ePublished: 2025/09/28
Accepted: 2025/05/22
ePublished: 2025/09/28
Subject:
Epidemiology
Abstract: (129 Views)
Background: Rheumatic mitral stenosis (MS) remains a significant health concern in developing regions. This study aimed to determine the prevalence and characteristics of rheumatic MS in Northeastern Iran.
Material and Methods: In this cross-sectional study (2016-2020), we analyzed data from 1,035 rheumatic MS patients at two tertiary cardiology centers in Mashhad. Demographic, clinical, and echocardiographic parameters were extracted from the registered echocardiographic database at Mashhad University of Medical Sciences. Statistical analysis was undertaken using SPSSv22 with appropriate tests (Chi-square, ANOVA, Kruskal-Wallis; p<0.05).
Results: The study population (mean age 50.0±13.3 years) revealed 79.3% female predominance. Prevalence was 0.3 per 1,000 population. Concomitant valvular involvement was common: aortic regurgitation (60.4%), mitral regurgitation (43.8%), tricuspid regurgitation (38%), and aortic stenosis (25%). Males exhibited more severe MS (p<0.05) with greater pulmonary artery pressures and greater need for percutaneous transvenous mitral commissurotomy (PTMC).
Conclusion: While rheumatic MS prevalence in Northeastern Iran aligns with global declining trends, the significant female predominance contrasts with greater disease severity in males. These findings highlight the need for: 1) comprehensive echocardiographic evaluation, 2) gender-specific management approaches, and 3) strengthened prevention programs. The persistence of clinically significant MS burden underlines the importance of ameliorating primary and secondary prevention strategies in the region.
Material and Methods: In this cross-sectional study (2016-2020), we analyzed data from 1,035 rheumatic MS patients at two tertiary cardiology centers in Mashhad. Demographic, clinical, and echocardiographic parameters were extracted from the registered echocardiographic database at Mashhad University of Medical Sciences. Statistical analysis was undertaken using SPSSv22 with appropriate tests (Chi-square, ANOVA, Kruskal-Wallis; p<0.05).
Results: The study population (mean age 50.0±13.3 years) revealed 79.3% female predominance. Prevalence was 0.3 per 1,000 population. Concomitant valvular involvement was common: aortic regurgitation (60.4%), mitral regurgitation (43.8%), tricuspid regurgitation (38%), and aortic stenosis (25%). Males exhibited more severe MS (p<0.05) with greater pulmonary artery pressures and greater need for percutaneous transvenous mitral commissurotomy (PTMC).
Conclusion: While rheumatic MS prevalence in Northeastern Iran aligns with global declining trends, the significant female predominance contrasts with greater disease severity in males. These findings highlight the need for: 1) comprehensive echocardiographic evaluation, 2) gender-specific management approaches, and 3) strengthened prevention programs. The persistence of clinically significant MS burden underlines the importance of ameliorating primary and secondary prevention strategies in the region.
Keywords: Valvular Heart Disease [MeSH], Mitral Valve Stenosis [MeSH], Aortic Stenosis [MeSH], Aortic Regurgitation [MeSH], Prevalence [MeSH]
References
1. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. J Am Coll Cardiol. 2020;76(25):2982-3021. [DOI] [PMID] [PMCID]
2. Watkins DA, Johnson CO, Colquhoun SM, Karthikeyan G, Beaton A, Bukhman G, et al. Global, Regional, and National Burden of Rheumatic Heart Disease, 1990-2015. N Engl J Med. 2017;377(8):713-22. [DOI] [PMID]
3. Coffey S, Harper AR, Cairns BJ, Roberts IS, Prendergast BD. Clinical information has low sensitivity for postmortem diagnosis of heart valve disease. Heart. 2017;103(13):1031-5. [DOI] [PMID]
4. Marangou J, Beaton A, Aliku TO, Nunes MCP, Kangaharan N, Remenyi B. Echocardiography in Indigenous Populations and Resource Poor Settings. Heart Lung Circ. 2019;28(9):1427-35. [DOI] [PMID]
5. Aluru JS, Barsouk A, Saginala K, Rawla P, Barsouk A. Valvular Heart Disease Epidemiology. Med Sci (Basel). 2022;10(2):32. [DOI] [PMID] [PMCID]
6. Qazizadeh Z, Shahmoradi L, Moosazadeh M, Shahbaznejad L, Rezai MS. Prevalence of rheumatic heart disease in iran: A systematic review and meta-analysis. J Pediatr Rev. 2021;9(2):97-104. [DOI]
7. Kumar A, Siddharth V, Singh SI, Narang R. Cost analysis of treating cardiovascular diseases in a super-specialty hospital. PLoS One. 2022;17(1):e0262190. [DOI] [PMID] [PMCID]
8. Hu Y, Tong Z, Huang X, Qin JJ, Lin L, Lei F, et al. The projections of global and regional rheumatic heart disease burden from 2020 to 2030. Front Cardiovasc Med. 2022;9:941917. [DOI] [PMID] [PMCID]
9. Tumenas A, Tamkeviciute L, Arzanauskiene R, Arzanauskaite M. Multimodality Imaging of the Mitral Valve: Morphology, Function, and Disease. Curr Probl Diagn Radiol. 2021;50(6):905-24. [DOI] [PMID]
10. Kawel-Boehm N, Maceira A, Valsangiacomo-Buechel ER, Vogel-Claussen J, Turkbey EB, Williams R, et al. Normal values for cardiovascular magnetic resonance in adults and children. J Cardiovasc Magn Reson. 2015;17(1):29. [DOI] [PMID] [PMCID]
11. Roth GA, Mensah GA, Fuster V. The global burden of cardiovascular diseases and risks: a compass for global action. Am Coll Cardiol. 2020;76(25):2980-1. [DOI] [PMID]
12. Mensah GA, Roth GA, Fuster V. The global burden of cardiovascular diseases and risk factors: 2020 and beyond. J Am Coll Cardiol. 2019;74(20):2529-32. [DOI] [PMID]
13. Guan C, Xu W, Wu S, Zhang J. Rheumatic heart disease burden, trends, and inequalities in Asia, 1990-2019. Glob Health Action. 2023;16(1):2215011. [DOI] [PMID] [PMCID]
14. Abdu SM, Kassaw AB, Tareke AA, Mankelkl G, Belete M, Bihonegn MD, et al. Prevalence and pattern of rheumatic valvular heart disease in Africa: Systematic review and meta-analysis, 2015–2023, population based studies. PLoS One. 2024;19(7):e0302636. [DOI] [PMID] [PMCID]
15. Gedefaw A, Yabebal YY, Wudie G, Tefera A, Kassa AK, Demilew T. Prevalence of pulmonary hypertension and associated factors among rheumatic heart disease patients in Ethiopia. BMC Cardiovasc Disord. 2025;25(1):20. [DOI] [PMID] [PMCID]
16. Zuhlke L, Karthikeyan G, Engel ME, Rangarajan S, Mackie P, Cupido-Katya Mauff B, et al. Clinical Outcomes in 3343 Children and Adults With Rheumatic Heart Disease From 14 Low- and Middle-Income Countries: Two-Year Follow-Up of the Global Rheumatic Heart Disease Registry (the REMEDY Study). Circulation. 2016;134(19):1456-66. [DOI] [PMID]
17. Kumar RK, Antunes MJ, Beaton A, Mirabel M, Nkomo VT, Okello E, et al. Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap: A Scientific Statement From the American Heart Association. Circulation. 2020;142(20):e337-57. [DOI] [PMID]
18. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020;76(25):2982-3021. [DOI] [PMID] [PMCID]
19. Napoli F, Vella C, Ferri L, Ancona MB, Bellini B, Russo F, et al. Rheumatic and Degenerative Mitral Stenosis: From an Iconic Clinical Case to the Literature Review. J Cardiovasc Dev Dis. 2024;11(5):153. [DOI] [PMID] [PMCID]
20. Baumgartner H, Hung J, Bermejo J, Chambers JB, Evangelista A, Griffin BP, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. Eur J Echocardiogr. 2009;10(1):1-25. [DOI] [PMID]
21. Dwigustiningrum NK, Rahimah AF, Karolina W, Martini H. Echocardiography Features in Patient Rheumatic Mitral Stenosis. Heart Sci J. 2024;5(2):23-30. [DOI]
22. Mansouritorghabeh H, Bagherimoghaddam A, Eslami S, Raouf-Rahmati A, Hamer DH, Kiani B, et al. Spatial epidemiology of COVID-19 infection through the first outbreak in the city of Mashhad, Iran. Spat Inf Res. 2022;30(5):585-95. [DOI] [PMCID]
23. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis. 2005;5(11):685-94. [DOI] [PMID]
24. Ginting Munte FA, Ahmadi AP, Fauziah M, Hasanah DY. Mitral facies-a classic feature of chronic mitral stenosis: A case report. SAGE Open Med Case Rep. 2023;11:2050313X231200965. [DOI] [PMID] [PMCID]
25. Movahed MR, Ahmadi-Kashani M, Kasravi B, Saito Y. Increased prevalence of mitral stenosis in women. J Am Soc Echocardiogr. 2006;19(7):911-3. [DOI] [PMID]
26. Stassen J, Butcher SC, Namazi F, Ajmone Marsan N, Bax JJ, Delgado V. Left Atrial Deformation Imaging and Atrial Fibrillation in Patients with Rheumatic Mitral Stenosis. J Am Soc Echocardiogr. 2022;35(5):486-94.e2. [DOI] [PMID]
27. Baqai L, Rasheed S, Nasim N, Balouch IJ, Gurmani S, Kubra G. Tricupsid valve involvement in chronic rheumatic mitral stenosis: An observational study. Prof Med J. 2021;28(09):1315-21. [DOI]
28. Pasca I, Dang P, Tyagi G, Pai RG. Survival in Patients with Degenerative Mitral Stenosis: Results from a Large Retrospective Cohort Study. J Am Soc Echocardiogr. 2016;29(5):461-9. [DOI] [PMID]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution 4.0 International License. |
