Improvement of Rheumatic Valvular Heart Disease in Patients Undergoing Prolonged Antibiotic Prophylaxis
Secondary prophylaxis of rheumatic heart diseases is efficient in reducing disease recurrence, heart damage, and cardiac impairment. We aimed to monitor the clinical evolution of a large Brazilian cohort of rheumatic patients under prolonged secondary prophylaxis. From 1986 to 2018, a cohort of 593...
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doaj-2a33061247dc46b9a15bf7716a60fedc2021-06-23T04:41:26ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-06-01810.3389/fcvm.2021.676098676098Improvement of Rheumatic Valvular Heart Disease in Patients Undergoing Prolonged Antibiotic ProphylaxisRenato Pedro de Almeida Torres0Rômulo Francisco de Almeida Torres1Gabrielle de Crombrugghe2Scarllet Palacin Moraes da Silva3Sarah Leticia Veroneze Cordeiro4Karine Alessandra Bosi5Pierre R. Smeesters6Pierre R. Smeesters7Pierre R. Smeesters8Pierre R. Smeesters9Rosângela Stadnick Lauth de Almeida Torres10Rosângela Stadnick Lauth de Almeida Torres11Department of Pediatric Cardiology, Hospital Pequeno Principe, Curitiba, BrazilDepartment of Hemodynamics and Interventional Cardiology, Hospital Marcelino Champagnat, Curitiba, BrazilDivision of Pediatric Infectious Diseases and Infection Prevention and Control, Hospital Universitaire des Enfants Reine Fabiola, Brussels, BelgiumDepartment of Medicine, Universidade Positivo, Curitiba, BrazilUniversidade Positivo, Curitiba, BrazilUniversidade Positivo, Curitiba, BrazilDivision of Pediatric Infectious Diseases and Infection Prevention and Control, Hospital Universitaire des Enfants Reine Fabiola, Brussels, BelgiumMurdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, VIC, AustraliaDepartment of Paediatrics, University of Melbourne, Melbourne, VIC, AustraliaMolecular Bacteriology Laboratory, Faculty of Medicine, Free University of Brussels, Brussels, BelgiumDepartment of Medicine, Universidade Positivo, Curitiba, BrazilEpidemiology Laboratory and Disease Control Division, Laboratório Central do Estado do Paraná, Curitiba, BrazilSecondary prophylaxis of rheumatic heart diseases is efficient in reducing disease recurrence, heart damage, and cardiac impairment. We aimed to monitor the clinical evolution of a large Brazilian cohort of rheumatic patients under prolonged secondary prophylaxis. From 1986 to 2018, a cohort of 593 patients with rheumatic fever was followed every 6 months by the Reference Center for the Control and Prevention of Rheumatic Fever and Rheumatic Cardiopathy (CPCFR), Paraná, Brazil. In this cohort, 243 (41%) patients did not present cardiac damage (group I), while 350 (59%) were diagnosed with rheumatic heart disease (RHD) (group II) using the latest case definition. Among group II, 233 and 15 patients had impairment of the mitral and aortic valves, respectively, while 102 patients had impairment of both valves. Lesions on the mitral and aortic valves presented a regression in 69.9 and 48.7% of the patients, respectively. Active patient recruitment in the reference center and early detection of oropharyngeal GAS were important factors for optimal adherence to the prophylactic treatment. Patients with disease progression were associated with noncompliance to secondary prophylaxis. No patients undergoing regular prophylaxis presented progression of the rheumatic cardiac disease. Eighteen valvular surgeries were performed, and four (0.7%) patients died. This study confirmed that tailored and active efforts invested in rheumatic heart disease secondary prevention allowed for significant clinical improvement.https://www.frontiersin.org/articles/10.3389/fcvm.2021.676098/fullsecondary prophylaxisrheumatic heart diseasebenzathine penicillin GGroup A β-hemolytic Streptococcuscarditisrecurrence |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Renato Pedro de Almeida Torres Rômulo Francisco de Almeida Torres Gabrielle de Crombrugghe Scarllet Palacin Moraes da Silva Sarah Leticia Veroneze Cordeiro Karine Alessandra Bosi Pierre R. Smeesters Pierre R. Smeesters Pierre R. Smeesters Pierre R. Smeesters Rosângela Stadnick Lauth de Almeida Torres Rosângela Stadnick Lauth de Almeida Torres |
spellingShingle |
Renato Pedro de Almeida Torres Rômulo Francisco de Almeida Torres Gabrielle de Crombrugghe Scarllet Palacin Moraes da Silva Sarah Leticia Veroneze Cordeiro Karine Alessandra Bosi Pierre R. Smeesters Pierre R. Smeesters Pierre R. Smeesters Pierre R. Smeesters Rosângela Stadnick Lauth de Almeida Torres Rosângela Stadnick Lauth de Almeida Torres Improvement of Rheumatic Valvular Heart Disease in Patients Undergoing Prolonged Antibiotic Prophylaxis Frontiers in Cardiovascular Medicine secondary prophylaxis rheumatic heart disease benzathine penicillin G Group A β-hemolytic Streptococcus carditis recurrence |
author_facet |
Renato Pedro de Almeida Torres Rômulo Francisco de Almeida Torres Gabrielle de Crombrugghe Scarllet Palacin Moraes da Silva Sarah Leticia Veroneze Cordeiro Karine Alessandra Bosi Pierre R. Smeesters Pierre R. Smeesters Pierre R. Smeesters Pierre R. Smeesters Rosângela Stadnick Lauth de Almeida Torres Rosângela Stadnick Lauth de Almeida Torres |
author_sort |
Renato Pedro de Almeida Torres |
title |
Improvement of Rheumatic Valvular Heart Disease in Patients Undergoing Prolonged Antibiotic Prophylaxis |
title_short |
Improvement of Rheumatic Valvular Heart Disease in Patients Undergoing Prolonged Antibiotic Prophylaxis |
title_full |
Improvement of Rheumatic Valvular Heart Disease in Patients Undergoing Prolonged Antibiotic Prophylaxis |
title_fullStr |
Improvement of Rheumatic Valvular Heart Disease in Patients Undergoing Prolonged Antibiotic Prophylaxis |
title_full_unstemmed |
Improvement of Rheumatic Valvular Heart Disease in Patients Undergoing Prolonged Antibiotic Prophylaxis |
title_sort |
improvement of rheumatic valvular heart disease in patients undergoing prolonged antibiotic prophylaxis |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Cardiovascular Medicine |
issn |
2297-055X |
publishDate |
2021-06-01 |
description |
Secondary prophylaxis of rheumatic heart diseases is efficient in reducing disease recurrence, heart damage, and cardiac impairment. We aimed to monitor the clinical evolution of a large Brazilian cohort of rheumatic patients under prolonged secondary prophylaxis. From 1986 to 2018, a cohort of 593 patients with rheumatic fever was followed every 6 months by the Reference Center for the Control and Prevention of Rheumatic Fever and Rheumatic Cardiopathy (CPCFR), Paraná, Brazil. In this cohort, 243 (41%) patients did not present cardiac damage (group I), while 350 (59%) were diagnosed with rheumatic heart disease (RHD) (group II) using the latest case definition. Among group II, 233 and 15 patients had impairment of the mitral and aortic valves, respectively, while 102 patients had impairment of both valves. Lesions on the mitral and aortic valves presented a regression in 69.9 and 48.7% of the patients, respectively. Active patient recruitment in the reference center and early detection of oropharyngeal GAS were important factors for optimal adherence to the prophylactic treatment. Patients with disease progression were associated with noncompliance to secondary prophylaxis. No patients undergoing regular prophylaxis presented progression of the rheumatic cardiac disease. Eighteen valvular surgeries were performed, and four (0.7%) patients died. This study confirmed that tailored and active efforts invested in rheumatic heart disease secondary prevention allowed for significant clinical improvement. |
topic |
secondary prophylaxis rheumatic heart disease benzathine penicillin G Group A β-hemolytic Streptococcus carditis recurrence |
url |
https://www.frontiersin.org/articles/10.3389/fcvm.2021.676098/full |
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