Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990-2017

Simon Yadgir¹, Catherine Owens Johnson¹, Victor Aboyans^{2

3}, Oladimeji M Adebayo⁴, Rufus Adesoji Adedoyin⁵, Mohsen Afarideh⁶, Fares Alahdab⁷, Alaa Alashi⁸, Vahid Alipour^{9

10}, Jalal Arabloo⁹, Samad Azari⁹, Celine M Barthelemy¹, Catherine P Benziger¹¹, Adam E Berman¹², Ali Bijani¹³, Juan J Carrero¹⁴, Félix Carvalho^{15

16}, Ahmad Daryani, Andre R Durães^{17

18}, Alireza Esteghamati⁶, Talha A Farid¹⁹, Farshad Farzadfar²⁰, Eduarda Fernandes²¹, Irina Filip^{22

23}, Mohamed M Gad^{8

24}, Samer Hamidi²⁵, Simon I Hay^{1

26

2}, Olayinka Stephen Ilesanmi²⁷, Seyed Sina Naghibi Irvani²⁸, Mikk Jürisson²⁹, Amir Kasaeian^{30

31}, Andre Pascal Kengne^{32

33}, Abdur Rahman Khan¹⁹, Adnan Kisa^{34

35}, Sezer Kisa³⁶, Dhaval Kolte³⁷, Navid Manafi^{38

39}, Amir Manafi⁴⁰, George A Mensah^{33

41}, Erkin M Mirrakhimov^{42

43}, Yousef Mohammad⁴⁴, Ali H Mokdad^{1

45}, Ruxandra Irina Negoi^{46

47}, Huong Lan Thi Nguyen⁴⁸, Trang Huyen Nguyen⁴⁹, Molly R Nixon¹, Catherine M Otto⁵⁰, Shanti Patel⁵¹, Thomas Pilgrim⁵², Amir Radfar^{53

54}, David Laith Rawaf^{55

56}, Salman Rawaf^{57

58}, Wasiq Faraz Rawasia⁵⁹, Aziz Rezapour⁹, Leonardo Roever⁶⁰, Anas M Saad⁶¹, Seyedmohammad Saadatagah⁶², Subramanian Senthilkumaran⁶³, Karen Sliwa³³, Berhe Etsay Tesfay⁶⁴, Bach Xuan Tran⁶⁵, Irfan Ullah^{66

67}, Muthiah Vaduganathan⁶⁸, Tommi Juhani Vasankari⁶⁹, Charles D A Wolfe^{70

71}, Naohiro Yonemoto⁷², Gregory A Roth^{1

45

50}; Global Burden of Disease Study 2017 Nonrheumatic Valve Disease Collaborators

Affiliations

¹ Institute for Health Metrics and Evaluation (S.Y., C.O.J., C.M.B., S.I.H., A.H.M., M.R.N., G.A.R.), University of Washington, Seattle.
² Department of Cardiology, Dupuytren University Hospital, Limoges, France (V. Aboyans).
³ Institute of Epidemiology, University of Limoges, France (V. Aboyans).
⁴ College of Medicine, University College Hospital, College of Medicine, University College Hospital, Ibadan, Oyo, Nigeria (O.M.A.).
⁵ Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria (R.A.A.).
⁶ Endocrinology and Metabolism Research Center (M.A., A.E.), Tehran University of Medical Sciences, Iran.
⁷ Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN (F.A.).
⁸ Department of Cardiovascular Medicine (A.A., M.M.G.), Cleveland Clinic, OH.
⁹ Health Management and Economics Research Center (V. Alipour, J.A., S.A., A. Rezapour), Iran University of Medical Sciences, Tehran.
¹⁰ Health Economics Department (V. Alipour), Iran University of Medical Sciences, Tehran.
¹¹ Heart and Vascular Center, Essentia Health, Duluth, MN (C.P.B.).
¹² Department of Medicine, Medical College of Georgia at Augusta University (A.E.B.).
¹³ Social Determinants of Health Research Center, Babol University of Medical Sciences, Mazandaran, Iran (A.B.).
¹⁴ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (J.J.C.).
¹⁵ Applied Molecular Biosciences Unit (F.C.), University of Porto, Portugal.
¹⁶ Institute of Public Health (F.C.), University of Porto, Portugal.
¹⁷ Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran (A.D.).
¹⁸ School of Medicine, Federal University of Bahia, Salvador, Brazil (A.R.D.).
¹⁹ Division of Cardiovascular Medicine, University of Louisville, KY (T.A.F., A.R.K.).
²⁰ Non-communicable Diseases Research Center (F.F.), Tehran University of Medical Sciences, Iran.
²¹ REQUIMTE/LAQV (E.F.), University of Porto, Portugal.
²² Psychiatry Department, Kaiser Permanente, Fontana, CA (I.F.).
²³ Department of Health Sciences, A.T. Still University, Mesa, AZ (I.F.).
²⁴ Gillings School of Global Public Health, University of North Carolina Chapel Hill (M.M.G.).
²⁵ School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates (S.H.).
²⁶ School of Medicine (S.I.H.), University of Washington, Seattle.
²⁷ Department of Community Medicine, University of Ibadan, Nigeria (O.S.I.).
²⁸ Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran (S.S.N.I.).
²⁹ Institute of Family Medicine and Public Health, University of Tartu, Tartumaa, Estonia (M.J.).
³⁰ Hematology-Oncology and Stem Cell Transplantation Research Center (A. Kasaeian), Tehran University of Medical Sciences, Iran.
³¹ Hematologic Malignancies Research Center (A. Kasaeian), Tehran University of Medical Sciences, Iran.
³² Non-communicable Diseases Research Unit, Medical Research Council South Africa, Cape Town (A.P.K.).
³³ Department of Medicine, University of Cape Town, South Africa (A.P.K., G.A.M., K.S.).
³⁴ Department of Health Management and Health Economics, Kristiania University College, Oslo, Norway (A. Kisa).
³⁵ Department of Health Services Policy and Management, University of South Carolina, Columbia (A. Kisa).
³⁶ Department of Nursing and Health Promotion, Oslo Metropolitan University, Norway (S.K.).
³⁷ Department of Medicine, Brown University, Providence, RI (D.K.).
³⁸ Ophthalmology Department (N.M.), Iran University of Medical Sciences, Tehran.
³⁹ Ophthalmology Department, University of Manitoba, Winnipeg, Canada (N.M.).
⁴⁰ Department of Surgery, University of Virginia, Charlottesville (A.M.).
⁴¹ Center for Translation Research and Implementation Science, National Institutes of Health, Bethesda, MD (G.A.M.).
⁴² Faculty of General Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan (E.M.M.).
⁴³ Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan (E.M.M.).
⁴⁴ Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia (Y.M.).
⁴⁵ Department of Health Metrics Sciences (A.H.M., G.A.R.), University of Washington, Seattle.
⁴⁶ Anatomy and Embryology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (R.I.N.).
⁴⁷ Department of Cardiology, Cardio-Aid, Bucharest, Romania (R.I.N.).
⁴⁸ Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam (H.L.T.N.).
⁴⁹ Center of Excellence in Behavioral Health, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam (T.H.N.).
⁵⁰ Division of Cardiology (C.M.O., G.A.R.), University of Washington, Seattle.
⁵¹ Department of Medicine, Maimonides Medical Center, Brooklyn, NY (S.P.).
⁵² Department of Cardiology, University of Bern, Switzerland (T.P.).
⁵³ College of Graduate Health Sciences, A.T. Still University, Mesa, AZ (A. Radfar).
⁵⁴ Medichem, Barcelona, Spain (A. Radfar).
⁵⁵ WHO Collaborating Centre for Public Health Education and Training (D.L.R.), Imperial College London, United Kingdom.
⁵⁶ University College London Hospitals, United Kingdom (D.L.R.).
⁵⁷ Department of Primary Care and Public Health (S.R.), Imperial College London, United Kingdom.
⁵⁸ Public Health England, London, United Kingdom (S.R.).
⁵⁹ Cardiovascular Medicine, West Virginia University, Morgantown (W.F.R.).
⁶⁰ Department of Clinical Research, Federal University of Uberl ândia, Brazil (L.R.).
⁶¹ Faculty of Medicine, Ain Shams University, Cairo, Egypt (A.M.S.).
⁶² Department of Cardiology (S. Saadatagah), Tehran University of Medical Sciences, Iran.
⁶³ Emergency Department, Manian Medical Centre, ERODE, Tamil Nadu, India (S. Senthilkumaran).
⁶⁴ Department of Public Health, Adigrat University, Tigray, Ethiopia (B.E.T.).
⁶⁵ Department of Health Economics, Hanoi Medical University, Vietnam (B.X.T.).
⁶⁶ Gomal Center of Biochemistry and Biotechnology, Gomal University, Faisalabad, Pakistan (I.U.).
⁶⁷ TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan (I.U.).
⁶⁸ Heart and Vascular Center, Harvard University, Boston, MA (M.V.).
⁶⁹ UKK Institute, Tampere, Finland (T.J.V.).
⁷⁰ School of Population Health & Environmental Sciences, King's College London, United Kingdom (C.D.A.W.).
⁷¹ Biomedical Research Council, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (C.D.A.W.).
⁷² Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan (N.Y.).

PMID: 32223336
DOI: 10.1161/CIRCULATIONAHA.119.043391

Multicenter Study

Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990-2017

Simon Yadgir et al. Circulation. 2020.

. 2020 May 26;141(21):1670-1680.

doi: 10.1161/CIRCULATIONAHA.119.043391. Epub 2020 Mar 29.

Authors

Affiliations

¹ Institute for Health Metrics and Evaluation (S.Y., C.O.J., C.M.B., S.I.H., A.H.M., M.R.N., G.A.R.), University of Washington, Seattle.
² Department of Cardiology, Dupuytren University Hospital, Limoges, France (V. Aboyans).
³ Institute of Epidemiology, University of Limoges, France (V. Aboyans).
⁴ College of Medicine, University College Hospital, College of Medicine, University College Hospital, Ibadan, Oyo, Nigeria (O.M.A.).
⁵ Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria (R.A.A.).
⁶ Endocrinology and Metabolism Research Center (M.A., A.E.), Tehran University of Medical Sciences, Iran.
⁷ Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN (F.A.).
⁸ Department of Cardiovascular Medicine (A.A., M.M.G.), Cleveland Clinic, OH.
⁹ Health Management and Economics Research Center (V. Alipour, J.A., S.A., A. Rezapour), Iran University of Medical Sciences, Tehran.
¹⁰ Health Economics Department (V. Alipour), Iran University of Medical Sciences, Tehran.
¹¹ Heart and Vascular Center, Essentia Health, Duluth, MN (C.P.B.).
¹² Department of Medicine, Medical College of Georgia at Augusta University (A.E.B.).
¹³ Social Determinants of Health Research Center, Babol University of Medical Sciences, Mazandaran, Iran (A.B.).
¹⁴ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (J.J.C.).
¹⁵ Applied Molecular Biosciences Unit (F.C.), University of Porto, Portugal.
¹⁶ Institute of Public Health (F.C.), University of Porto, Portugal.
¹⁷ Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran (A.D.).
¹⁸ School of Medicine, Federal University of Bahia, Salvador, Brazil (A.R.D.).
¹⁹ Division of Cardiovascular Medicine, University of Louisville, KY (T.A.F., A.R.K.).
²⁰ Non-communicable Diseases Research Center (F.F.), Tehran University of Medical Sciences, Iran.
²¹ REQUIMTE/LAQV (E.F.), University of Porto, Portugal.
²² Psychiatry Department, Kaiser Permanente, Fontana, CA (I.F.).
²³ Department of Health Sciences, A.T. Still University, Mesa, AZ (I.F.).
²⁴ Gillings School of Global Public Health, University of North Carolina Chapel Hill (M.M.G.).
²⁵ School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates (S.H.).
²⁶ School of Medicine (S.I.H.), University of Washington, Seattle.
²⁷ Department of Community Medicine, University of Ibadan, Nigeria (O.S.I.).
²⁸ Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran (S.S.N.I.).
²⁹ Institute of Family Medicine and Public Health, University of Tartu, Tartumaa, Estonia (M.J.).
³⁰ Hematology-Oncology and Stem Cell Transplantation Research Center (A. Kasaeian), Tehran University of Medical Sciences, Iran.
³¹ Hematologic Malignancies Research Center (A. Kasaeian), Tehran University of Medical Sciences, Iran.
³² Non-communicable Diseases Research Unit, Medical Research Council South Africa, Cape Town (A.P.K.).
³³ Department of Medicine, University of Cape Town, South Africa (A.P.K., G.A.M., K.S.).
³⁴ Department of Health Management and Health Economics, Kristiania University College, Oslo, Norway (A. Kisa).
³⁵ Department of Health Services Policy and Management, University of South Carolina, Columbia (A. Kisa).
³⁶ Department of Nursing and Health Promotion, Oslo Metropolitan University, Norway (S.K.).
³⁷ Department of Medicine, Brown University, Providence, RI (D.K.).
³⁸ Ophthalmology Department (N.M.), Iran University of Medical Sciences, Tehran.
³⁹ Ophthalmology Department, University of Manitoba, Winnipeg, Canada (N.M.).
⁴⁰ Department of Surgery, University of Virginia, Charlottesville (A.M.).
⁴¹ Center for Translation Research and Implementation Science, National Institutes of Health, Bethesda, MD (G.A.M.).
⁴² Faculty of General Medicine, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan (E.M.M.).
⁴³ Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan (E.M.M.).
⁴⁴ Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia (Y.M.).
⁴⁵ Department of Health Metrics Sciences (A.H.M., G.A.R.), University of Washington, Seattle.
⁴⁶ Anatomy and Embryology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (R.I.N.).
⁴⁷ Department of Cardiology, Cardio-Aid, Bucharest, Romania (R.I.N.).
⁴⁸ Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam (H.L.T.N.).
⁴⁹ Center of Excellence in Behavioral Health, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam (T.H.N.).
⁵⁰ Division of Cardiology (C.M.O., G.A.R.), University of Washington, Seattle.
⁵¹ Department of Medicine, Maimonides Medical Center, Brooklyn, NY (S.P.).
⁵² Department of Cardiology, University of Bern, Switzerland (T.P.).
⁵³ College of Graduate Health Sciences, A.T. Still University, Mesa, AZ (A. Radfar).
⁵⁴ Medichem, Barcelona, Spain (A. Radfar).
⁵⁵ WHO Collaborating Centre for Public Health Education and Training (D.L.R.), Imperial College London, United Kingdom.
⁵⁶ University College London Hospitals, United Kingdom (D.L.R.).
⁵⁷ Department of Primary Care and Public Health (S.R.), Imperial College London, United Kingdom.
⁵⁸ Public Health England, London, United Kingdom (S.R.).
⁵⁹ Cardiovascular Medicine, West Virginia University, Morgantown (W.F.R.).
⁶⁰ Department of Clinical Research, Federal University of Uberl ândia, Brazil (L.R.).
⁶¹ Faculty of Medicine, Ain Shams University, Cairo, Egypt (A.M.S.).
⁶² Department of Cardiology (S. Saadatagah), Tehran University of Medical Sciences, Iran.
⁶³ Emergency Department, Manian Medical Centre, ERODE, Tamil Nadu, India (S. Senthilkumaran).
⁶⁴ Department of Public Health, Adigrat University, Tigray, Ethiopia (B.E.T.).
⁶⁵ Department of Health Economics, Hanoi Medical University, Vietnam (B.X.T.).
⁶⁶ Gomal Center of Biochemistry and Biotechnology, Gomal University, Faisalabad, Pakistan (I.U.).
⁶⁷ TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan (I.U.).
⁶⁸ Heart and Vascular Center, Harvard University, Boston, MA (M.V.).
⁶⁹ UKK Institute, Tampere, Finland (T.J.V.).
⁷⁰ School of Population Health & Environmental Sciences, King's College London, United Kingdom (C.D.A.W.).
⁷¹ Biomedical Research Council, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (C.D.A.W.).
⁷² Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan (N.Y.).

PMID: 32223336
DOI: 10.1161/CIRCULATIONAHA.119.043391

Erratum in

Correction to: Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990-2017.
[No authors listed] [No authors listed] Circulation. 2020 May 26;141(21):e836. doi: 10.1161/CIR.0000000000000848. Epub 2020 May 26. Circulation. 2020. PMID: 32453659 No abstract available.

Abstract

Background: Nonrheumatic valvular diseases are common; however, no studies have estimated their global or national burden. As part of the Global Burden of Disease Study 2017, mortality, prevalence, and disability-adjusted life-years (DALYs) for calcific aortic valve disease (CAVD), degenerative mitral valve disease, and other nonrheumatic valvular diseases were estimated for 195 countries and territories from 1990 to 2017.

Methods: Vital registration data, epidemiologic survey data, and administrative hospital data were used to estimate disease burden using the Global Burden of Disease Study modeling framework, which ensures comparability across locations. Geospatial statistical methods were used to estimate disease for all countries, because data on nonrheumatic valvular diseases are extremely limited for some regions of the world, such as Sub-Saharan Africa and South Asia. Results accounted for estimated level of disease severity as well as the estimated availability of valve repair or replacement procedures. DALYs and other measures of health-related burden were generated for both sexes and each 5-year age group, location, and year from 1990 to 2017.

Results: Globally, CAVD and degenerative mitral valve disease caused 102 700 (95% uncertainty interval [UI], 82 700-107 900) and 35 700 (95% UI, 30 500-42 500) deaths, and 12.6 million (95% UI, 11.4 million-13.8 million) and 18.1 million (95% UI, 17.6 million-18.6 million) prevalent cases existed in 2017, respectively. A total of 2.5 million (95% UI, 2.3 million-2.8 million) DALYs were estimated as caused by nonrheumatic valvular diseases globally, representing 0.10% (95% UI, 0.09%-0.11%) of total lost health from all diseases in 2017. The number of DALYs increased for CAVD and degenerative mitral valve disease between 1990 and 2017 by 101% (95% UI, 79%-117%) and 35% (95% UI, 23%-47%), respectively. There is significant geographic variation in the prevalence, mortality rate, and overall burden of these diseases, with highest age-standardized DALY rates of CAVD estimated for high-income countries.

Conclusions: These global and national estimates demonstrate that CAVD and degenerative mitral valve disease are important causes of disease burden among older adults. Efforts to clarify modifiable risk factors and improve access to valve interventions are necessary if progress is to be made toward reducing, and eventually eliminating, the burden of these highly treatable diseases.

Keywords: aortic valve; global burden of disease; heart valve diseases; mitral valve.

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Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990-2017

Affiliations

Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990-2017

Authors

Affiliations

Erratum in

Abstract

Publication types

MeSH terms

Supplementary concepts

LinkOut - more resources

Full Text Sources

Medical

Research Materials