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Changes in valvular regurgitation in mid-term follow-up of children with first attack acute rheumatic fever: first evaluation after the updated Jones criteria

Published online by Cambridge University Press:  10 January 2020

Muhlike Güler Open the ORCID record for Muhlike Güler [Opens in a new window] ,
Fuat Laloğlu  and
Naci Ceviz
Muhlike Güler*
Affiliation:
Department of Pediatric Cardiology, Ataturk University Medical Faculty, Erzurum, Turkey
Fuat Laloğlu
Affiliation:
Department of Pediatric Cardiology, Ataturk University Medical Faculty, Erzurum, Turkey
Naci Ceviz
Affiliation:
Department of Pediatric Cardiology, Ataturk University Medical Faculty, Erzurum, Turkey
*
Author for correspondence: M. Güler, Department of Pediatric Cardiology, Ataturk University Medical Faculty, Erzurum, Turkey. Phone: 0442 0344 78 85; Fax: 0442 344 78 67; E-mail: muhlikeguler@gmail.com
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Abstract

Aim:

In present study, we aimed to evaluate the changes in valvular regurgitations in mid-term follow-up of children with first attack acute rheumatic fever diagnosed after updated Jones criteria.

Materials and methods:

The medical records of the children diagnosed with acute rheumatic fever between June 2015 and November 2018 were evaluated retrospectively. When compared to the findings during diagnosis, the changes in the degree of valvular regurgitation in the last visit were coded as same, regressed, or disappeared.

Results:

A total of 50 children were diagnosed with the first attack of acute rheumatic fever between the noted dates. Nine patients (18%) could be diagnosed depending on the new criteria. Eight patients did not have carditis, and 35 patients (49 valves) could be followed for a median follow-up period of 11.7 ± 3.3 months. In our study, the valvar lesions continued in 82% of patients with clinical carditis at the end of the first year and the degree of valvular regurgitation decreased in 39% of them. Despite this, in a significantly higher (p = 0.031) ratio of patients with silent carditis (41%), valvar lesions disappeared in the same follow-up period. In 18.4% of the involved valves, regurgitation regressed to physiological level.

Conclusion:

Updated Jones criteria make it possible to diagnose a significant number of patients, and the ratio of complete recovery among patients with silent carditis is significantly higher. Also, it can be speculated that the normal children in whom a physiological mitral regurgitation is detected should be followed in terms of rheumatic heart disease.

Keywords

Acute rheumatic feverchildrenupdated Jones criteria
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 3 , March 2020 , pp. 369 - 371
Copyright
© Cambridge University Press 2020

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