Study On The Prevalence And Risk Factors Of Aortic And Mitral Valve Disease Among Chinese Aged 35 Years And Over

BackgroudThe etiology of heart valve disease(HVD)includes inflammation,ischemic necrosis,degenerative changes,myxoid degeneration,congenital malformations,rheumatic diseases and other causes which lead to heart valve and its subsidiary structure abnormalities.With the aging of the population and widespread use of echocardiography,the prevalence of chronic heart disease increases.As an important part of the study project "Survey on Prevalence of Major Cardiovascular Diseases&Key Technology Research in China",color doppler echocardiography was used to diagnose HVD in adults aged 35 years and over in rural and urban areas of eastern,central and western China.Part of the data was analyzed in this study.ObjectiveTo explore the prevalence and related factors of mitral regurgitation(MR),mitral stenosis(MS),aortic regurgitation(AR),and aortic stenosis(AS)among Chinese adults aged 35 years and over.MethodThe residents aged 35 years and over were sampled with a stratified multistage sampling method.Firstly,262 districts or counties were sampled from 31 provinces to investigate the prevalence of hypertension.Then the 262 sampled districts or counties were divided into eastern,central and western regions according to the national economy and 33 districts or counties were re-sampled from these 262 districts or counties.After that villages and communities were sampled from the districts or counties which were chose.At last the residents aged ≥35 years were sampled from villages and communities and invited to participate in the study.The contents of the survey include the questionnaire,physical examination,laboratory examination and other auxiliary examinations.The information of age,gender,smoking,alcohol and personal meidcal history was collected through prodesigned questionnaires,the information on height and weight was collected through physical examination and the heart structure and function information was collected through echocardiography.Fasting blood samples were collected and serum glucose and lipids were determined.The risk factors of mitral and aortic valvular disease were analyzed by Logistic regression model.The possible risk factors were analyzed by univariate Logistic regression analysis.Then the stepwise Logistic regression model was used to analyze the risk factors which had statistical significance in univariate analysis.ResultThe data of 28 909 subjects were analyzed and the mean age was 57.4±13.4 years.MR was present in 18.3%of the subjects,both was 18.3%in men and women;MS was present in 0.3%of the subjects,0.1%in men and 0.4%in women;AR was present in 16.4%of the subjects,17.9%in men and 15.2%in women;AS was present in 1.4%of the subjects,1.5%in men and 1.3%in women.The prevalence of MR、MS、AR、AS all increased with age.The results of the multivariate stepwise Logistic regression showed that among all the factors analyzed age,systolic blood pressure,urban,BMI is 24-28kg/m2,BMI ≥28kg/m,eastern region,central region,heart disease history,left front diameter,left ventricular end diastolic diameter,left ventricular ejection fraction,left ventricular end-diastolic wall thickness were significantly correlated with MR;Female,age,urban,central region,eastern region,left atrial diameter,Left ventricular end systolic diameter,were significantly correlated with MS;Female,age,urban,central region,eastern region,systolic blood pressure,left atrial diameter,ventricular end diastolic thickness,left ventricular end diastolic diameter,left ventricular ejection fraction,left ventricular end-diastolic wall thickness were significantly correlated with AR;Age,urban,central region,eastern region,left atrial diameter,ventricular end diastolic thickness,left ventricular end diastolic diameter,left ventricular end systolic diameter,left ventricular ejection fraction were significantly correlated with AS.ConclusionThe prevalence of MR and AR in the Chinese aged ≥ 35 years.MR was higher in females,AR was higher in males.Although various types of HVD had different risk factors,they share some common risk factors,such as age,urban and rural areas,eastern and central and western regions.More attention should be paid to aortic and mitral valve disease in order to detect the mitral and aortic valve disease earlier and improve the quality life and improve the prognosis of patients.