Abstract
BACKGROUND AND AIMS: Valvular heart diseases (VHDs) significantly contribute to global cardiovascular mortality and morbidity, with a shift in epidemiology from rheumatic heart disease (RHD) in developing nations to degenerative valvular diseases in aging populations of industrialized countries. We aim to evaluate the prevalence and pathological patterns of VHDs in individuals over 40 in Yazd, Iran, using high-quality echocardiographic evaluations to inform public health strategies and optimize resource allocation for VHD prevention and management. METHODS: This cross-sectional study involved 600 randomly selected individuals aged 40 and older from the Yazd Health Study (YaHS), conducted at Afshar Hospital in Yazd, Iran, from September 2023 to May 2024. Participants underwent echocardiography to assess valvular health, with demographic and comorbidity data collected from medical records. Echocardiographic evaluations were performed using a VIVID 4 ultrasound device, following guidelines from the American Society of Echocardiography. RESULTS: Among the 600 participants, 35 (5.8%) were diagnosed with VHD, with mitral valve prolapse (MVP) being the most common (28.6%), followed by tricuspid regurgitation (TR) (20%), mitral regurgitation (MR) (11.4%), aortic regurgitation (AR) (11.4%), and MS (8.6%). Hypertension (HTN) was significantly more prevalent in VHD patients (71.4%) compared to those without VHD (35.2%), and reduced ejection fraction (EF < 45%) was also more common in the VHD group. Degenerative changes were the leading cause of VHD, making up 57.1% of cases, while HTN and reduced EF were identified as significant independent risk factors for VHD. CONCLUSION: This study reveals a significant prevalence of VHD in the YaHS, with HTN and reduced EF identified as key risk factors. MVP was the most common type of VHD, followed by TR, MR, and AR. The findings emphasize the need for early management of HTN and heart failure (HF) to reduce the impact of VHD.