Article (Scientific journals)
Contemporary Presentation and Management of Valvular Heart Disease: The EURObservational Research Programme Valvular Heart Disease II Survey.
Iung, Bernard; Delgado, Victoria; Rosenhek, Raphael et al.
2019In Circulation, 140 (14), p. 1156-1169
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Keywords :
Aged; Aged, 80 and over; Cardiologists/trends; Clinical Decision-Making; Europe/epidemiology; Female; Guideline Adherence/trends; Health Care Surveys; Healthcare Disparities/trends; Heart Valve Diseases/diagnosis/epidemiology/therapy; Humans; Male; Middle Aged; Practice Guidelines as Topic; Practice Patterns, Physicians'/trends; Prospective Studies; Referral and Consultation/trends; Time Factors; Time-to-Treatment/trends; echocardiography; guidelines as topic; heart valve diseases; transcatheter aortic valve replacement
Abstract :
[en] BACKGROUND: Valvular heart disease (VHD) is an important cause of mortality and morbidity and has been subject to important changes in management. The VHD II survey was designed by the EURObservational Research Programme of the European Society of Cardiology to analyze actual management of VHD and to compare practice with guidelines. METHODS: Patients with severe native VHD or previous valvular intervention were enrolled prospectively across 28 countries over a 3-month period in 2017. Indications for intervention were considered concordant if the intervention was performed or scheduled in symptomatic patients, corresponding to Class I recommendations specified in the 2012 European Society of Cardiology and in the 2014 American Heart Association/American College of Cardiology VHD guidelines. RESULTS: A total of 7247 patients (4483 hospitalized, 2764 outpatients) were included in 222 centers. Median age was 71 years (interquartile range, 62-80 years); 1917 patients (26.5%) were ≥80 years; and 3416 were female (47.1%). Severe native VHD was present in 5219 patients (72.0%): aortic stenosis in 2152 (41.2% of native VHD), aortic regurgitation in 279 (5.3%), mitral stenosis in 234 (4.5%), mitral regurgitation in 1114 (21.3%; primary in 746 and secondary in 368), multiple left-sided VHD in 1297 (24.9%), and right-sided VHD in 143 (2.7%). Two thousand twenty-eight patients (28.0%) had undergone previous valvular intervention. Intervention was performed in 37.0% and scheduled in 26.8% of patients with native VHD. The decision for intervention was concordant with Class I recommendations in symptomatic patients with severe single left-sided native VHD in 79.4% (95% CI, 77.1-81.6) for aortic stenosis, 77.6% (95% CI, 69.9-84.0) for aortic regurgitation, 68.5% (95% CI, 60.8-75.4) for mitral stenosis, and 71.0% (95% CI, 66.4-75.3) for primary mitral regurgitation. Valvular interventions were performed in 2150 patients during the survey; of them, 47.8% of patients with single left-sided native VHD were in New York Heart Association class III or IV. Transcatheter procedures were performed in 38.7% of patients with aortic stenosis and 16.7% of those with mitral regurgitation. CONCLUSIONS: Despite good concordance between Class I recommendations and practice in patients with aortic VHD, the suboptimal number in mitral VHD and late referral for valvular interventions suggest the need to improve further guideline implementation.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Iung, Bernard;  AP-HP, Cardiology Department, DHU Fire, Bichat Hospital, Université de Paris,
Delgado, Victoria;  Department of Cardiology, Leiden University Medical Center, The Netherlands
Rosenhek, Raphael;  Department of Cardiology, Medical University of Vienna, Austria (R.R.).
Price, Susanna;  Unit of Critical Care, Royal Brompton & Harefield NHS Trust, London, UK (S.P.).
Prendergast, Bernard;  Department of Cardiology, St. Thomas' Hospital, London UK (B.P.).
Wendler, Olaf;  Department of Cardiothoracic Surgery, King's College Hospital, London, UK (O.W.).
De Bonis, Michele;  Vita-Salute San Raffaele University, Department of Cardiac Surgery, IRCCS San
Tribouilloy, Christophe;  Department of Cardiology, University Hospital Amiens, France (C.T.).
Evangelista, Arturo;  Department of Cardiology, Hospital Vall d'Hebron, Barcelona, Spain (A.E.).
Bogachev-Prokophiev, Alexander;  Heart Valves Surgery Department, Meshalkin National Medical Research Center,
Apor, Astrid;  Heart and Vascular Center, Budapest, Hungary (A.A.).
Ince, Hüseyin;  Department of Cardiology, Rostock University Medical Center, Germany (H.I.).
Laroche, Cécile;  EURObservational Research Programme, European Society of Cardiology,
Popescu, Bogdan A;  University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Institute of
Piérard, Luc;  Cardiology Department, University Hospital of Liege, Sart Tilman University
Haude, Michael;  Medical Clinic I, Städtische Kliniken Neuss, Lukaskrankenhaus, Germany (M.H.).
Hindricks, Gerhard;  Department of Electrophysiology, University Leipzig-Heart Center, Germany (G.H.).
Ruschitzka, Frank;  Clinic of Cardiology, University Heart Centre, University Hospital, Zurich,
Windecker, Stefan;  Cardiology Department, Bern University Hospital, Switzerland (S.W.).
Bax, Jeroen J;  Department of Cardiology, Leiden University Medical Center, The Netherlands
Maggioni, Aldo;  EURObservational Research Programme, European Society of Cardiology,
Vahanian, Alec;  Université de Paris, France (A.V.).
EORP VHD II, Investigators
More authors (13 more) Less
Other collaborator :
Goda, Artan
Mascherbauer, Julia
Samadov, Fuad
Linhartova, Katerina
Ihlemann, Nikolaj
Abdelhamid, Magdy
Saraste, Antti
Tribouilloy, Christophe
Kostovska, Elizabeta Srbinovska
Bajraktari, Gani
Mirrakhimov, Erkin
Sorbets, Emmanuel
Charbonnier, Arthur
Bauer, Fabrice
Menager-Gangloff, Clarisse
Gjerakorska-Radovikj, Marija
Jordanova, Slavica
Caglayan, Evren
Hambrecht, Rainer
Lehnert, Kristin
Akin, Ibrahim
Erglis, Andrejs
Maier, Lars
Nickenig, Georg
Scholtz, Werner
Schulze, Paul-Christian
Heintzen, Matthias
Rassaf, Tienush
Er, Fikret
Vorphal, Marc
Sigusch, Holger
Spargias, Konstantinos
Mizariene, Vaida
Kamperidis, Vasileios
Sachpekidis, Vasileios
Bellos, Vasileios
Kanakakis, Ioannis
Papafaklis, Michail
Makris, Athanasios
Poulimenos, Leonidas
Katsaros, Andreas
Lampropoulos, Konstantinos
Bartha, Elektra
Cassar, Daniela
Zsary, Andras
Jebelovszki, Eva
Borsanyi, Tunde
Cziraki, Attila
Lupkovics, Geza
Jarai, Zoltan
Ibrahimi, Pranvera
Arapova, Rano
Laahunova, Elmira
Rancane, Gita
Delgado, Victoria
Radauskaite, Greta
Raugaliene, Raugaliene
Xuereb, Robert George
Djaberi, Roxana
Komar, Monika
Szymanski, Piotr
Zaborska, Beata
Mizia-Stec, Katarzyna
Regulski, Mateusz
Bogacki, Piotr
Tomkiewicz-Pajak, Lidia
Sedziwy, Ewa
Komor, Klaudiusz
Myszor, Jaroslaw
Joao, Isabel
Martins, Rui
Cabral, Sofia
Gago, Paula
Cardoso, Goncalo
Almeida, Ines
Antunes, Nuno
Ribeiras, Regina
Carvalho, Sofia
Galrinho, Ana
Sousa, Carla
Grigorica, Lucica
Mitre, Adriana
Ionac, Adina
Tint, Diana
Petris, Antoniu Octavian
Popescu, Andreea
Onut, Roxana
Beleslin, Branko
Pop, Calin
Usurelu, Catalin
Beyer, Ruxandra
Militaru, Constantin
Eminovici, Gabriela
Arsenescu-Georgescu, Catalina
Irtyuga, Olga
Semenova, Elena
Boldyrev, Sergey
Kozmin, Dmitry
Simkova, Iveta
Gross, Yuriy
Zotov, Alexander
Kuznetsov, Dmitry
Nemchenko, Evgeniy
Kulumbegov, Oleg
Jakubov, Ramis
Stefanov, Sergei
Schneider, Yuri
Tsechanovich, Valeriy
Voronva, Tatyana
Evangelista, Arturo
Fomenko, Mikhail
Gamzaev, Alisher
Mayorova, Olga
Skripkina, Elena
Safina, Vasilya
Slastin, Yaroslav
Koroleva, Tatyana
Polyaeva, Larisa
Tarasenko, Ivan
Alekseeva, Svetlana
Dogan, Sait Mesut
Magamet, Victorya
Medvedev, Igor
Khilova, Liliya
Verevetinov, Artem
Stojsic-Milosavljevic, Anastazija
Nikolic, Natasa Markovic
Ostric, Dimitra Kalimanovska
Ruzicic, Dusan
Pavlovic, Savo
Milosavljevic, Jelica
Rahman-Haley, Shelley
Jovovic, Ljiljana
Margoczy, Roman
Valocik, Gabriel
Studencan, Martin
Iglesias, Francisco Calvo
Mendez, Irene
Gomez, Ariana Gonzalez
Sanchez Fernandez, Pedro L
Valenzuela, Gonzalo de la Morena
Cladellas, Merce
Iung, Bernard
Villegas, David Villagomez
Moral, Sergio
Gallego, Irene Menduina
Paya, Rafael
Caballero, Luis
Paton, Ramon Rubio
Iglesia-Carreno, Cristina
Esteban, Esther
Mitroi, Cristina
Alberca, Maria Teresa
Bax, Jeroen
Valle, Alfonso
Molina-Mora, Maria Jose
Castro, Noelia
Sayar, Nurten
Demirtas, Abdullah Orhan
Yesilay, Asuman
Demir, Serafettin
Bozkurt, Abdi
Kanar, Batur
Gudul, Naile Eris
Price, Susanna
Yildirim, Tarik
Taylan, Gokay
Mert, Kadir Ugur
Yilmaztepe, Mustafa Adem
Mert, Gurbet Ozge
Cosansu, Kahraman
Sayin, Muhammet Rasit
Karabag, Turgut
Druais, Hervé
Laroche, Cécile
Debonis, Michele
Ince, Hüseyin
Bardet, Hélène
Plurien, François
Gervais, Renaud
Sime, Iveta
Cabral, Sofia
Prendergast, Bernard
Rosenhek, Raphael
Wendler, Olaf
Ruschitzka, Frank
Haude, Michael
Popescu, Bogdan A
Windecker, Stephan
Hindricks, Gerhard
Vahanian, Alec
Maggioni, Aldo
Mekhaldi, Souad
Lemaitre, Katell
Authier, Sebastien
Goda, Artan
Samadov, Fuad
Pasquet, Agnés
Linhartova, Katerina
Ihlemann, Nikolaj
Abdelhamid, Magdy
Saraste, Antti
Apor, Astrid
Bajraktari, Gani
Mirrakhimov, Erkin
Demarco, Daniela Cassar
Ribeiras, Regina
Bogachev-Prokophiev, Alexander
Shirka, Ervina
Dado, Elona
Zera, Eliverta
Bica, Loreta
Heger, Maria
Basic, Daniel
Rustamova, Yasmin
Jahangirov, Tofig
Ahmedov, Tahir
Huseynov, Saleh
Pierard, Luc
LANCELLOTTI, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Cosyns, Bernard
Van Camp, Gery
Van de Veire, Nico
Sindelarova, Stepanka
Linhartova, Katerina
Branny, Marian
Parenicova, Ilona
Vondrackova, Dagmar Jungwirtova
Homza, Miroslav
Ostransky, Jiri
Hasan-Ali, Hosam
Abdelhady, Yasser
Hassan, Mohamed
Soliman, Hytham
Mostafa, Ahmad Elsayed
Moaaz, Moemen
Kazamel, Ghada
Sadek, Yasser
Eltobgi, Sherif
Kamal, Diaa
Kylmala, Minna
Turpeinen, Anu
Monin, Jean-Luc
Jobic, Yannick
Attias, David
Magne, Julien
Marechaux, Sylvestre
Donal, Erwan
Biere, Loic
Bernard, Anne
Daudin, Magalie
Khounlaboud, Moukda
Habib, Gilbert
Audonnet, Martin
Thuny, Franck
Berenfeld, Alain
More authors (246 more) Less
Language :
English
Title :
Contemporary Presentation and Management of Valvular Heart Disease: The EURObservational Research Programme Valvular Heart Disease II Survey.
Publication date :
October 2019
Journal title :
Circulation
ISSN :
0009-7322
eISSN :
1524-4539
Publisher :
Lippincott Williams & Wilkins, Us md
Volume :
140
Issue :
14
Pages :
1156-1169
Peer reviewed :
Peer Reviewed verified by ORBi
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