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Echocardiographic Screening for Rheumatic Heart Disease in High and Low Risk Australian Children

Roberts, Kathryn, Maguire, Graeme, Brown, Alex, Atkinson, David, Remenyi, Bo, Wheaton, Gavin, Kelly, Andrew, Kumar, Raman K., Su, Jiunn-Yih and Carapetis, Jonathan R. (2014). Echocardiographic Screening for Rheumatic Heart Disease in High and Low Risk Australian Children. Circulation,129(19):1953-1961.

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 5
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IRMA ID 75039815xPUB277
Title Echocardiographic Screening for Rheumatic Heart Disease in High and Low Risk Australian Children
Author Roberts, Kathryn
Maguire, Graeme
Brown, Alex
Atkinson, David
Remenyi, Bo
Wheaton, Gavin
Kelly, Andrew
Kumar, Raman K.
Su, Jiunn-Yih
Carapetis, Jonathan R.
Journal Name Circulation
Publication Date 2014
Volume Number 129
Issue Number 19
ISSN 1524-4539   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84901501833
Start Page 1953
End Page 1961
Total Pages 9
Place of Publication United States of America
Publisher American Heart Association, Inc.
HERDC Category C1 - Journal Article (DIISR)
—Echocardiographic screening for rheumatic heart disease (RHD) is becoming more widespread, but screening studies to date have used different echocardiographic definitions. The World Heart Federation has recently published new criteria for the echocardiographic diagnosis of RHD. We aimed to establish the prevalence of RHD in high-risk Indigenous Australian children using these criteria and to compare the findings with a group of Australian children at low risk for RHD.
Methods and Results
—Portable echocardiography was performed on high-risk Indigenous children aged 5 to15 years living in remote communities of northern Australia. A comparison group of low-risk, non-Indigenous children living in urban centers was also screened. Echocardiograms were reported in a standardized, blinded fashion. Of 3946 high-risk children, 34 met World Heart Federation criteria for definite RHD (prevalence, 8.6 per 1000 [95% confidence interval, 6.0–12.0]) and 66 for borderline RHD (prevalence, 16.7 per 1000 [95% confidence interval, 13.0–21.2]). Of 1053 low-risk children, none met the criteria for definite RHD, and 5 met the criteria for borderline RHD. High-risk children were more likely to have definite or borderline RHD than low-risk children (adjusted odds ratio, 5.7 [95% confidence interval, 2.3–14.1]; P<0.001).
Conclusions—The prevalence of definite RHD in high-risk Indigenous Australian children approximates what we expected in our population, and no definite RHD was identified in the low-risk group. This study suggests that definite RHD, as defined by the World Heart Federation criteria, is likely to represent true disease. Borderline RHD was identified in children at both low and high risk, highlighting the need for longitudinal studies to evaluate the clinical significance of this finding.

Keywords Echocardiography
Rheumatic heart disease
Mas screening
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