Virtual Conference
Heart 2022 Conference

Sahadeb Prasad Dhungana

Nobel Medical College Teaching Hospital, Nepal

Title: Prevalence and predictors of outcome in patients with predominant rheumatic mitral stenosis in eastern Nepal


Background: Rheumatic heart disease (RHD) is an important public health problem in developing nations. This study aims to investigate the prevalence and predictors of outcomes of patients with rheumatic mitral stenosis (MS).

Methods: A prospective observational study was conducted in a tertiary care hospital. A total of 850 participants of RHD were screened for MS by a convenient sampling method from January 2019 to December 2021. Demographic data, echocardiography parameters, and outcomes were noted. Patients were followed up at six months intervals for a median of 720 days. Outcome variables included mortality, hospitalization, new-onset atrial fibrillation (AF), stroke, bleeding risk, and interventions.

Results: A total of 696 (81.88%) patients with predominant MS were enrolled including 203 (29.2 %) males and 493 (70.8 %) females. The mean age was 45.19 ± 14.73 years. Two hundred and ninety-nine (43 %) patients had AF and 46 (6.6%) patients had thrombus in the left atrium (LA). Median survival was 1026.04 days (95%CI: 1009.72-1042.36) with higher survival in patients with sinus rhythm 1049.38 days (95%CI: 1032.82-1065.94) vs AF 994.36 days (95%CI: 963.58-1025.147) (P- 0.001). Outcome measures included hospitalization 156 (22.4%), new-onset AF 152 (21.83%), mitral valvotomy or surgeries 116 (16.66%), mortality 41 (5.9%), bleeding 36 (5.17%) and stroke 26 (4%).  

Conclusions: Median survival was higher in patients with MS in sinus rhythm. Old age, higher NYHA class, low eGFR, dilated LA, presence of LA clot, warfarin use, pulmonary hypertension, and history of hospitalization were as


Cardiology Unit, Department of Internal Medicine, Nobel Medical College Teaching Hospital, Biratnagar, Nepal