Prevalence of Structural Heart Diseases Detected by Handheld Echocardiographic Device in School-Age Children in Iran: The SHED LIGHT Study

Glob Heart. 2022 Jun 15;17(1):39. doi: 10.5334/gh.1121. eCollection 2022.

Abstract

Background: Structural heart disease (SHD) has great impacts on healthcare systems, creating further public health concerns. Proper data are scant regarding the magnitude of the affected population by SHD.

Objectives: This study aimed to determine the prevalence of SHD among children and adolescents in an Iranian population.

Methods: In this population-based study, a multistage cluster-random sampling was used to choose schools from the Tehran urban area. All students were examined using a handheld Vscan device by echocardiographer, and the results were concurrently supervised and interpreted by cardiologists. All the major findings were reevaluated in hospital clinics.

Results: Of 15,130 students (6-18 years, 52.2% boys) who were examined, the prevalence of individuals with congenital heart disease (CHD) and cardiomyopathy was 152 (10.046 per 1,000 persons) and 9 (0.595 per 1,000 persons), respectively. The prevalence of definite and borderline rheumatic heart disease (RHD) was 30 (2 per 1,000 persons) and 113 (7.5 per 1,000 persons), correspondingly. Non-rheumatic valvular heart disease (VHD) was also detected in 465 (30.7 per 1,000 persons) students. Of all the pathologies, only 39 (25.6%) cases with CHD and 1 (0.007%) cases with RHD had already been diagnosed. Parental consanguinity was the strongest predictor of CHD and SHD (odds ratio [OR]: 1.907, 95% CI, 1.358 to 2.680; P < 0.001 and OR, 1.855, 95% CI, 1.334 to 2.579; P < 0.001, respectively). The female sex (OR, 1.262, 95% CI, 1.013 to 1.573; P = 0.038) and fathers' low literacy (OR, 1.872, 95% CI, 1.068 to 3.281; P = 0.029) were the strongest predictors of non-rheumatic VHD and RHD, correspondingly.

Conclusions: The implementation of echocardiographic examinations for detecting SHD among young population is feasible which detected SHD prevalence in our population comparable to previous reports. Further studies are required to delineate its economic aspects for community-based screening.

Keywords: Echocardiography; Prevalence; Screening; Structural heart disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Echocardiography / methods
  • Female
  • Heart Defects, Congenital* / diagnostic imaging
  • Heart Defects, Congenital* / epidemiology
  • Humans
  • Iran / epidemiology
  • Male
  • Mass Screening / methods
  • Prevalence
  • Rheumatic Heart Disease* / epidemiology
  • Schools

Grants and funding

The study grant was mainly provided by the National Institute for Medical Research Development (NIMAD) under the identification number of 962126. The other portion of funding was provided by Rajaie Cardiovascular Medical and Research Center, Tehran, Iran. The regional representative of GE Healthcare in our country (Tajhizat Pezeshki Pishrafteh Co, Tehran, Iran) provided Vscan machines during the study period. The SHED LIGHT investigators thank the regional representative of GE Healthcare in Iran (Tajhizat Pezeshki Pishrafteh Co, Tehran, Iran), who helped us during the study, particularly Dr Arash Shafii and Mrs Bahareh Aghababaei Samani. Many thanks are also due to the authorities of Rajaie Cardiovascular Medical and Research Center, who assisted us in the transportation of team members and devices and the study team planning, particularly Dr Saeid Eftekhari, PharmD, Mrs Zahra Hanifi, Mrs Roghieh Sepordeh, Mrs Shokat Mahdavi, Mr Hamidreza Kolouei, and Mr Morteza Tavana. In addition, we greatly thank Drs. Hamideh Khesali, MD, Mehrdad Jafari, MD, Mohammad Reza Eftekhari, MD, Nasrin Ghdakkar, MD, Kamran Mohammadi, MD, Nakisa Khansari, MD, and Samaneh Pourhosseinali, MD, who participated in recruiting some of studied individuals. Moreover, we would like to greatly thank Prof. Reza Malekzadeh who helped us with the conduction of the study and critically reviewed the final manuscript.