Mitral regurgitation epidemiology and demographics: Difference between revisions

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{{Mitral regurgitation}}
{{Mitral regurgitation}}
{{CMG}}; {{AE}} [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.
{{CMG}}; {{AE}} [[Varun Kumar]], M.B.B.S., [[Lakshmi Gopalakrishnan]], M.B.B.S., {{Rim}}


==Overview==
==Overview==
Mitral regurgitation (MR) is one of the most common [[valvular disease]]s in the general population, ranking first among valvular regurgitation abnormailities. The prevalence of MR of a severity equal to or more than mild was reported in The Framingham Heart Study as 19.0% in men and 19.1% in women.  The prevalence of MR increases with age.


==Epidemiology and Demographics==
==Prevalence==
The incidence of mitral regurgitation is approximately 2% in a modern Western population.  In the past, rheumatic heart disease was the leading cause of mitral regurgitation in Western countries, but now [[mitral valve prolapse]] is the leading cause and accounts for 45% of cases in Western countries.<ref name='MedicineNetMVP-Kulick'>{{cite web|url=http://www.medicinenet.com/mitral_valve_prolapse/article.htm|title=Mitral Valve Prolapse (MVP) |accessdate=2010-01-18 |last=Kulick |first=Daniel|work=MedicineNet.com |publisher=MedicineNet, Inc }}</ref>  In Asia, North Africa, and the Middle East, and among some immagrant populations in the US, rheumatic heart disease remains the leading cause of mitral regurgitation.  [[Coronary artery disease]] resulting ischemia injury is responsible for 3% to 25% of MR cases.


==Prevalence==
* The Framingham Heart Study, a prospective epidemiologic study, evaluated the [[prevalence]] and severity of MR and other valvular diseases by color [[Doppler]] examinations in 1,696 men and 1,893 women.  
The Framingham Heart Study, a prospective epidemiologic study, evaluated the [[prevalence]] and severity of MR and other valvular diseases by color [[Doppler]] examinations in 1,696 men and 1,893 women. The study revealed that MR is one of the two most common valvular abnormalities in the general population. The prevalence of MR (with a severity ranging from trace to moderate regurgitation) was 87.7% in men and 91.5% in women. When trace regurgitation is excluded, the prevalence of mild and moderate MR was 19.0% in men and 19.1% in women, which makes it the most common type of valvular regurgitation in the general population. The elevated prevalence of trace regurgitation can be a normal finding related to an artifact or an anatomic characteristic of the closure of the [[mitral valve]].
* The study revealed that MR is the most common valvular regurgitation in the general population, followed by [[tricuspid regurgitation]] and then [[aortic regurgitation]].
* The prevalence of MR (with a severity ranging from trace to ≥ moderate regurgitation) was 87.7% in men and 91.5% in women.  
* When trace regurgitation is excluded, the prevalence of MR of a severity ≥ mild was 19.0% in men and 19.1% in women.  
* The elevated prevalence of trace regurgitation can be a normal finding related to an artifact or an anatomic characteristic of the closure of the [[mitral valve]].<ref name="pmid10190406">{{cite journal| author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL et al.| title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) | journal=Am J Cardiol | year= 1999 | volume= 83 | issue= 6 | pages= 897-902 | pmid=10190406 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10190406  }} </ref><ref name="pmid101904062">{{cite journal| author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL et al.| title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) | journal=Am J Cardiol | year= 1999 | volume= 83 | issue= 6 | pages= 897-902 | pmid=10190406 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10190406  }}</ref>


==Age==
==Age==
The prevalence of mitral regurgitation increases with age. Mitral regurgitation is one of the most common valvular heart disease in the elderly. Shown below are tables depicting the prevalence of MR by age and severity in men and women according the results of the Framingham Heart Study.
 
* The prevalence of MR increases with age. MR is one of the most common valvular heart disease in the elderly.  
* Shown below are tables depicting the prevalence of MR by age and severity in men and women according the results of the Framingham Heart Study.<ref name="pmid10190406">{{cite journal| author=Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL et al.| title=Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study) | journal=Am J Cardiol | year= 1999 | volume= 83 | issue= 6 | pages= 897-902 | pmid=10190406 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10190406  }} </ref>


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==Gender==
==Gender==
Overall, mitral regurgitation affects both males and females equally.<ref>[http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/mitral-valve-disease/ The Cleveland Clinic Center for Continuing Education > Mitral Valve Disease: Stenosis and Regurgitation] Authors:  Ronan J. Curtin and Brian P. Griffin. Retrieved September 2010</ref> However, there are some minor imbalances when age is considered.  In patients younger than 20 years, there is a male preponderance, and the severity of involvement is greater in males over the age of 50.  [[ MVP]] is a common cause.  However, most patients with MVP do not develop severe mitral regurgitation.  Older age, male gender, and auscultatory evidence of severe MR are prognostic clues that identify patients with mitral valve prolapse who are at a relatively high risk of complications), myxomatous degeneration.
 
* Overall, mitral regurgitation affects both males and females equally.  However, there are some minor differences when age is considered.


==References==
==References==

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S., Lakshmi Gopalakrishnan, M.B.B.S., Rim Halaby, M.D. [2]

Overview

Mitral regurgitation (MR) is one of the most common valvular diseases in the general population, ranking first among valvular regurgitation abnormailities. The prevalence of MR of a severity equal to or more than mild was reported in The Framingham Heart Study as 19.0% in men and 19.1% in women. The prevalence of MR increases with age.

Prevalence

  • The Framingham Heart Study, a prospective epidemiologic study, evaluated the prevalence and severity of MR and other valvular diseases by color Doppler examinations in 1,696 men and 1,893 women.
  • The study revealed that MR is the most common valvular regurgitation in the general population, followed by tricuspid regurgitation and then aortic regurgitation.
  • The prevalence of MR (with a severity ranging from trace to ≥ moderate regurgitation) was 87.7% in men and 91.5% in women.
  • When trace regurgitation is excluded, the prevalence of MR of a severity ≥ mild was 19.0% in men and 19.1% in women.
  • The elevated prevalence of trace regurgitation can be a normal finding related to an artifact or an anatomic characteristic of the closure of the mitral valve.[1][2]

Age

  • The prevalence of MR increases with age. MR is one of the most common valvular heart disease in the elderly.
  • Shown below are tables depicting the prevalence of MR by age and severity in men and women according the results of the Framingham Heart Study.[1]
Severity of MR Prevalence of MR by age in men
26-29 40-49 50-59 60-69 70-83
No MR (%) 14.4 13.3 11.3 12.7 9.0
Trace (%) 76.7 72.9 74.6 60.3 51.7
Mild (%) 8.9 13.5 12.5 24.6 28.1
Moderate or severe (%) 0 0.3 1.6 2.4 11.2


Severity of MR Prevalence of MR by age in women
26-29 40-49 50-59 60-69 70-83
No MR (%) 14.0 8.6 9.0 7.2 5.6
Trace (%) 76.3 75 74 66.5 70.8
Mild (%) 9.7 15.5 16 24 23.6
Moderate or severe (%) 0 0.9 1 2.3 0

Gender

  • Overall, mitral regurgitation affects both males and females equally. However, there are some minor differences when age is considered.

References

  1. ↑ 1.0 1.1 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)". Am J Cardiol. 83 (6): 897–902. PMID 10190406.
  2. ↑ 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)". Am J Cardiol. 83 (6): 897–902. PMID 10190406.

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