Prevalence of valvar regurgitation in Nigerian children with structurally normal hearts using colour doppler echocardiography

Main Article Content

Chika O Duru*
Josephat M Chinawa
Igoche D Peter
Ibrahim Aliyu
Fidelia Bode-Thomas

Abstract



Background: Doppler echocardiography is a reliable and non-invasive method of detecting valvar regurgitation. The aim of this study was to determine the prevalence of valvar regurgitation in children with structurally normal hearts and explore its relationship with age, gender and anthropometry.


Methods: This was a descriptive cross-sectional study conducted in four tertiary hospitals in Nigeria. Two hundred and thirty-three children (124 males and 109 females), from birth to 18 years were recruited prospectively. Using transthoracic echocardiography, the presence of valvar regurgitation was assessed across the four cardiac valves using Color Doppler interrogation after structural abnormalities were ruled out. Data was analyzed using the Statistical Package for Social Sciences (SPSS) software, version 22.


Results: Valvar regurgitation was found in 158/233 children giving a prevalence of 67.8%. They consisted of 87 males and 71 females with a male: female ratio of 1.2:1. Of these, 82 (35.2%) had a single valvar regurgitation, 72 (30.9%) had regurgitation at two valves while 4 (1.7%) had regurgitation at three valves. Pulmonary regurgitation was the most common in 52.8% of cases while aortic regurgitation was seen in only two children (0.9%). There was a non-significant negative correlation of age and body surface area with presence of tricuspid regurgitation (ρ -0.79, p=0.22 and ρ -0.12, p=0.08) and mitral regurgitation (ρ -0.04, p=0.56 and ρ -0.02, p=0.83) but positive correlation with pulmonary regurgitation (ρ 0.11, p= 0.11 and ρ 0.12, p= 0.08). The presence of valvar regurgitation was not associated with gender (p=.>0.05).


Conclusion: The prevalence of valvar regurgitation in apparently healthy Nigerian children is 67.8%. The presence of valvar regurgitation especially of the right sided valves could be a physiologic finding in apparently healthy children with structurally normal hearts. Regurgitation of the left sided valves is rare.



Downloads

Download data is not yet available.

Article Details

Duru, C. O., Chinawa, J. M., Peter, I. D., Aliyu, I., & Bode-Thomas, F. (2020). Prevalence of valvar regurgitation in Nigerian children with structurally normal hearts using colour doppler echocardiography. Journal of Cardiovascular Medicine and Cardiology, 7(3), 262–267. https://doi.org/10.17352/2455-2976.000149
Research Article(s)

Copyright (c) 2020 Duru CO, et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Licensing and protecting the author rights is the central aim and core of the publishing business. Peertechz dedicates itself in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. Peertechz licensing terms are formulated to facilitate reuse of the manuscripts published in journals to take maximum advantage of Open Access publication and for the purpose of disseminating knowledge.

We support 'libre' open access, which defines Open Access in true terms as free of charge online access along with usage rights. The usage rights are granted through the use of specific Creative Commons license.

Peertechz accomplice with- [CC BY 4.0]

Explanation

'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.

Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.

With this license, the authors are allowed that after publishing with Peertechz, they can share their research by posting a free draft copy of their article to any repository or website.
'CC BY' license observance:

License Name

Permission to read and download

Permission to display in a repository

Permission to translate

Commercial uses of manuscript

CC BY 4.0

Yes

Yes

Yes

Yes

The authors please note that Creative Commons license is focused on making creative works available for discovery and reuse. Creative Commons licenses provide an alternative to standard copyrights, allowing authors to specify ways that their works can be used without having to grant permission for each individual request. Others who want to reserve all of their rights under copyright law should not use CC licenses.

Richards KL, Cannon SR, Crawford MH, Sorensen SG (1983) Noninvasive diagnosis of aortic regurgitation and mitral valve disease with pulsed Doppler spectral analysis. Am J Cardiol 51: 1122-11277. Link: https://bit.ly/3259ujq

Rahko PS (1989) Prevalence of Regurgitant Murmurs in Patients with Valvular Regurgitation detected by Doppler Echocardiography. Ann Intern Med 111: 466-472. Link: https://bit.ly/2EbHBhS

Brand A, Dollberg S, Keren A (1992) The prevalence of valvular regurgitation in children with structurally normal hearts: a color Doppler echocardiographic study. Am Heart J 123: 177-80. Link: https://bit.ly/3l90bYO

Zoghbi WA, Adams D, Bonow RO, Enriquez-Sarano M, Foster E, et al. (2017) Recommendations for the non-invasive evaluation of native valvular regurgitation. A report from the American Society of Echocardiography. Developed in collaboration with the Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr 30: 303-371. Link: https://bit.ly/3l3jAKs

Schmidt A, Almeida OC, Pazin A, Marin-Neto JA, Maciel BC (2000) Valvular Regurgitation by Color Doppler Echocardiography. Arq Bras Cardiol 74: 273-281. Link: https://bit.ly/31ejibG

Yoshida K, Yoshikawa J, Shakudo M, Akasaka T, Jyo Y, et al. (1988) Color Doppler Evaluation of Valvular Regurgitation in Normal Subjects. Circulation 78: 840-847. Link: https://bit.ly/3hkyJEQ

Sahn DJ, Maciel BC (1988) Physiological valvular regurgitation. Doppler echocardiography and the potential for iatrogenic heart disease. Circulation 78: 1075 – 1077. Link: https://bit.ly/3aIEREw

Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, et al. (1999) Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham heart study). J Am Coll Cardiol 83: 897-902. Link: https://bit.ly/2FJhTSm

Thompson JDR, Allen J, Cribbs JL (2000) Left sided valvar regurgitation in normal children and adolescents. Heart 83: 185-187. Link: https://bit.ly/2FKwxbZ

Ayabakan C, Özkutlu S, Kýlýç A (2003) The Doppler echocardiographic assessment of valvular regurgitation in normal children. Turk J Pediatr 45: 102-107. Link: https://bit.ly/2ErWGLO

Lee ST, Lin MT (2010) Color Doppler Echocardiographic assessment of valvar regurgitation in normal infants. J Formos Med Assoc 109: 56-61. Link: https://bit.ly/2YowLMu

Van Dijk APJ, Van Oort AM, Daniels O (1994) Right –sided valvular regurgitation in normal children determined by combined colour-coded and continuous wave Doppler echocardiography. Acts Paediatr 83: 200-203. Link: https://bit.ly/3aH0Vzt

Choong CY, Abascal VM, Weyman J, Levine RA, Gentile F, et al. (1989) prevalence of valvular regurgitation by Doppler echocardiography in patients with structurally normal hearts by two-dimensional echocardiography. Am Heart J 117: 636-642. Link: https://bit.ly/3aGHCpW

Mostellar RD (1987) Simplified calculation of body surface area. N Engl J Med 317: 1098. Link: https://bit.ly/3l6Dynt

Lai WW, Geva T, Shirali GS, Frommelt PC, Humes RA, et al. (2006) Guidelines and standards for performance of a pediatric echocardiogram: A Report for the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 19: 1413-1430. Link: https://bit.ly/2Ej96FY

Da Silva Mattos S, Severi R, Cavalcanti CV, Da Fonte Freire M, et al. (1992) Valvar regurgitation in normal children, Is it clinically significant? Cardiology in the Young 2: 291-297. Link: https://bit.ly/2E3ju53

Okura H, Takada Y, Yamabe A, Ozaki T, Yamagishi H, et al. (2011) Prevalence and Correlates of Physiological Valvular Regurgitation in Healthy Subjects. A Color Doppler Echocardiographic Study in the Current Era. Circ J 75: 2699-2704. Link: https://bit.ly/2YkC27K

Lebowitz NE, Bella JN, Roman MJ, Liu JE, Fishman DP, et al. (2000) Prevalence and correlates of aortic regurgitation in American Indians: the Strong Heart Study. J Am Coll Cardiol 36: 461–467. Link: https://bit.ly/2Q8TDee

Avierinos JF, Inamo J, Grigioni F, Gersh B, Shub C, et al. (2008) Sex differences in morphology and outcomes of mitral valve prolapse. Ann Intern Med 149: 787-795. Link: https://bit.ly/2Q9wyIo

Nitsche C, Koschutnik M, Kammerlander A, Hengstenberg C, Mascherbauer J (2020) Gender-specific differences in valvular heart disease. Wien Klin Wochenschr 132: 61-68. Link: https://bit.ly/2FCLsos

Tornos P, Sambola A, Permanyer-Miralda G, Evangelista A, Gomez Z, et al. (2006) Long-term outcome of surgically treated aortic regurgitation: influence of guideline adherence toward early surgery. J Am Coll Cardiol 47: 1012-1017. Link: https://bit.ly/34kSGHW

Marsan NA (2019) Gender difference in mitral valve disease: Where is the bias? Eur J Prev Cardiol 26: 1430-1432. Link: https://bit.ly/3aHP18x

Shi Y, Wan Y, Wang Y, Wang K, Wang Q (2017) Mechanism underlying gender difference in heart disease risks and corresponding preventive measures. Eur J Prev Cardiol 24: 1807-1808. Link: https://bit.ly/2EpcajK

Jones EC, Devereux RB, Roman MJ, Liu JE, Fishman D, et al. (2001) Prevalence and correlates of mitral regurgitation in a population-based sample (the Strong Heart Study). Am J Cardiol 87: 298-304. Link: https://bit.ly/3l6E3hl

Arsalan M, Walther T, Smith RL, Grayburn PA (2017) Tricuspid regurgitation diagnosis and treatment. Eur Heart J 38: 634-638. Link: https://bit.ly/32eLM4j

Cebeci BS, Kardesoglu E, Celik T, Demiralp E (2004) Echocardiographical Characteristics of Healthy Young Subjects with Physiological Mitral Regurgitation. Journal of International Medical Research 32: 240-244. Link: https://bit.ly/3l6PyWn