Rheumatic Heart Disease Screening by Echocardiography

Rheumatic Heart Disease Screening by Echocardiography. The Inadequacy of World Health Organization Criteria for Optimizing the Diagnosis of Subclinical Disease
Eloi Marijon MD*, David S. Celermajer PhD, FRACP, Muriel Tafflet PhD, Saïd El-Haou PhD, Dinesh N. Jani MD, Beatriz Ferreira MD, PhD, Ana-Olga Mocumbi MD, PhD, Christophe Paquet MD, MPH, Daniel Sidi MD, PhD, and Xavier Jouven MD, PhD
From Université Paris Descartes, AP-HP, Hôpital Européen Georges Pompidou, Paris, France (E.M., X.J.); Paris Cardiovascular Research Center, INSERM 970, Université Paris Descartes, AP-HP, Hôpital Européen Georges Pompidou, Paris, France (E.M., M.T., X.J.); Department of Medicine, Sydney University, Sydney, Australia (D.S.C.); INSERM UMRS-956, Université Pierre et Marie Curie, Paris, France (S.E.H.); Instituto do Coração, Maputo, Mozambique (D.N.J., B.F., A.O.M., D.S.); Institut de Veille Sanitaire, Saint Maurice, France (C.P.); and Université Paris Descartes, AP-HP, Hôpital Necker-Enfants Malades, Paris, France (D.S.).


* To whom correspondence should be addressed. E-mail: eloi_marijon@yahoo.fr.


Background—Early case detection is vital in rheumatic heart disease (RHD) in children to minimize the risk of advanced valvular heart disease by preventive measures. The currently utilized World Health Organization (WHO) criteria for echocardiographic diagnosis of subclinical RHD emphasize the presence of pathological valve regurgitation but do not include valves with morphological features of RHD without pathological regurgitation. We hypothesized that adding morphological features to diagnostic criteria might have significant consequences in terms of case detection rates./.../