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Cardiac conditions
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
In pregnancy, RHD can lead to heart failure (see Box 2.11) and pulmonary oedema (see Chapter 5), with or without arrhythmias. Management during pregnancy is aimed at identification, assessment and preventing/treating heart failure and pulmonary oedema. Volume status should be carefully monitored, and activity may need to be reduced. Bacterial endocarditis is a possible complication, so prophylactic antibiotics may be necessary. As it may recur in pregnancy, rheumatic fever prophylaxis may also be considered for women with RHD.
Relationship between body mass index and the degree of mitral valve stenosis: Supporting evidence for the obesity paradox phenomenon
Published in Ade Gafar Abdullah, Isma Widiaty, Cep Ubad Abdullah, Medical Technology and Environmental Health, 2020
A.N. Lestari, I.R. Alie, M.R. Akbar
Rheumatic heart disease (RHD) is a burden for low- or middle-income countries, and for immigrants and the elderly in high-income countries (Rothenbühler et al. 2014). In Indonesia, the incidence of RHD is estimated to reach 1.18 million cases (Watkins et al. 2017). The feature of RHD pathogenesis is inflammation. Various studies relate the inflammation state with cytokine involvement produced from adipose tissue. High body mass index (BMI) can be an indicator for the level of visceral adipose tissue (Harrington et al. 2013). In contrast, there has been an ongoing controversion about the role of adipokines, a factor from adipose tissue, toward inflammation.
Swarm Intelligence and Evolutionary Algorithms for Heart Disease Diagnosis
Published in Sandeep Kumar, Anand Nayyar, Anand Paul, Swarm Intelligence and Evolutionary Algorithms in Healthcare and Drug Development, 2019
Rheumatic heart disease (RHD): This disease is caused due to rheumatic fever. Prolonged rheumatic fever damages the heart valves and heart muscles. The streptococcal bacteria are the primary pathogen that causes this disease.
The microbiome and rheumatic heart disease: current knowledge and future perspectives
Published in Acta Cardiologica, 2023
Gunavathy Nagarajan, Ramajayam Govindan, Maheshkumar Poomarimuthu, Rathinavel Andiappan, Sivakumar Elango, Stalinraja Maruthamuthu, Jayalakshmi Mariakuttikan, Sony Kadiam
Rheumatic heart disease (RHD) is an autoimmune disease caused by group A Streptococcus (GAS) infection followed by acute rheumatic fever (ARF) resulting in the damage of heart valves [1]. RHD is the most commonly acquired heart disease in children and young adults with a global burden of over 40 million cases accounting for 306,000 deaths annually and around 10.5 million disability-adjusted life-years (DALYs) each year [2,3]. ARF is an illness that stems from poverty, overcrowding and poor living conditions which may occur at any age. Most cases occur in children between the ages of 5 and 15 years, while the prevalence of RHD peaks in early adulthood. High-risk populations acquire frequent GAS infections that cause recurrent or prolonged episodes of ARF, thus increasing the risk of RHD development [4].
Association of HLA-DRB1 Alleles with Rheumatic Fever and Rheumatic Heart Disease: A Meta-analysis
Published in Immunological Investigations, 2022
Maheshkumar Poomarimuthu, Thirunavukkarasu Ramasamy, Ramajayam Govindan, Rathinavel Andiappan, Gunavathy Nagarajan, Sony Kadiam, Jayalakshmi Mariakuttikan
Rheumatic fever (RF) and its sequel rheumatic heart disease (RHD) is an autoimmune disease caused by an abnormal host immune response to group A streptococcus (GAS) infection (Cunningham 2014). The Global Burden of Disease (GBD) study estimated that globally there are over 33 million prevalent cases of RHD, resulting in 275 000 deaths and 10.5 million disability-adjusted life-years (DALYs) each year (Macleod et al. 2019; Watkins et al. 2017). Molecular mimicry and cross reactivity between GAS antigens and human cardiac proteins are cornerstone of the disease pathogenesis (Cunningham 2014; Guilherme et al. 2006). GAS infection distinctively activates various immune pathways in susceptible hosts that result in postinfectious sequel which affects various organs. The human leukocyte antigen (HLA) class II molecules expressed on the surface of antigen-presenting cells (APCs) present GAS antigenic peptides to T-cell receptor (TCR) and activate adaptive immune response. Simultaneously the activated CD4+ T cells stimulate cytokine expression and facilitate B lymphocytes for antibody secretion, which plays crucial role in the initiation of RF and its progression to RHD. The impact of host genetics in the regulation of immune reactions during post-GAS sequel influences the development of RF and RHD (Carapetis et al. 2016; Cunningham 2014; Guilherme et al. 2006; Martin et al. 2015).
Use of broad consent and related procedures in genomics research: Perspectives from research participants in the Genetics of Rheumatic Heart Disease (RHDGen) study in a University Teaching Hospital in Zambia
Published in Global Bioethics, 2020
Oliver Mweemba, John Musuku, Bongani M. Mayosi, Michael Parker, Rwamahe Rutakumwa, Janet Seeley, Paulina Tindana, Jantina De Vries
RHD is caused by an aberrant immune response to Streptococcus pyogenes throat infection, and affects mostly children and young adults (Karthikeyan et al., 2012). The condition is strongly poverty-related (Carapetis & Zuhlke, 2011) – whilst virtually eradicated in wealthy countries and communities, it continues to be a devastating illness in poor communities in Africa, often resulting in premature death (Zühlke et al., 2016). It is estimated that RHD could account for up to 1.4 million deaths per year and is one of the leading non-communicable diseases among children and young adults in low- and middle-income countries (Carapetis, Steer, Mulholland, & Weber, 2005; Watkins et al., 2017). Whilst surgical operations are available to replace damaged heart valves, in Africa such operations are currently only routinely available to public sector patients in a few countries such as Namibia, Senegal, and South Africa. Zambian patients do not normally have access to such operations. Genetic risk factors play a considerable role in the aetiology of RHD (Engel, Stander, Vogel, Adeyemo, & Mayosi, 2011), providing a strong rationale for conducting large-scale population based genomic studies on this condition.