Reason for change in diagnosis in patients with definite RHD at baseline or follow-up
| Baseline | Follow-up | Reason for change in diagnosis | ||
|---|---|---|---|---|
| Diagnosis | Detailed findings | Diagnosis | Detailed findings | |
| (A) Improvement | ||||
| Definite RHD A | Pathological MR—moderate AMVL thickening Excessive leaflet tip motion of MV | Borderline RHD B* | Pathological MR—mild AMVL thickening | Resolution of excessive tip motion |
| Definite RHD D | Pathological MR—moderate Pathological AR | Borderline RHD B | Pathological MR—mild | No AR |
| Definite RHD C | Pathological AR—mild AV thickening Coaptation defect of AV | Normal with NSVA | AR—not pathological (not high velocity or pan-diastolic) | AR not pathological Resolution of morphological features |
| Definite RHD A | Pathological MR—mild AMVL thickening Restricted leaflet motion of MV | Borderline RHD A | MR—not pathological (not pan-systolic) AMVL thickening Restricted leaflet motion of MV | MR not pathological |
| Definite RHD A | Pathological MR—mild Pathological AR AMVL thickening Restricted leaflet motion of MV | Normal | None | Resolution of all findings |
| Definite RHD A | Pathological MR—mild AMVL thickening Restricted leaflet motion of MV | Borderline RHD A | MR—not pathological (not pan-systolic) AMVL thickening Restricted leaflet motion of MV | MR not pathological |
| (B) Progression | ||||
| Borderline RHD B | Pathological MR—moderate AMVL thickening | Definite RHD A | Pathological MR—severe AMVL thickening Excessive leaflet tip motion of MV | Developed one additional morphological feature |
| Borderline RHD C | Pathological AR—severe | Definite RHD C | Pathological AR—severe Coaptation defect of AV Prolapse of AV | Developed two morphological features |
| Borderline RHD B | Pathological MR—mild | Definite RHD A | Pathological MR—moderate Pathological AR AMVL thickening Restricted leaflet motion of MV | Developed two morphological features Also developed pathological AR |
| Borderline RHD B | Pathological MR—mild | Definite RHD A | Pathological MR—moderate Pathological AR AMVL thickening Restricted leaflet motion of MV | Developed two morphological features Also developed pathological AR |
*Participant was 22 years age at follow-up and using WHF criteria for individuals aged >20 years would be classified as ‘normal’.
AMVL, anterior mitral valve leaflet; AR, aortic regurgitation; AV, aortic valve; MR, mitral regurgitation; MV, mitral valve; NSVA, non-specific valvular abnormality; RHD, rheumatic heart disease; WHF, World Heart Federation.