Valvular heart disease in Japan: Characteristics and treatment of patients in acute care hospitals in 2019

• Published in: Journal of cardiology Vol. 82; no. 1; pp. 29 - 34
• Main Authors: Izumi, Chisato, Matsuyama, Rei, Asaoka, Miyoshi, Iwasaki, Kosuke, Takeshima, Tomomi, Murphy, Shannon, Teng, Lida, Igarashi, Ataru
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-07-2023
• Subjects: Aged; Aged, 80 and over; Aortic Valve Stenosis - epidemiology; Epidemiology; Heart valve; Heart Valve Diseases - diagnosis; Heart Valve Diseases - epidemiology; Heart Valve Diseases - therapy; Hospitals; Humans; Japan - epidemiology; Mitral Valve Insufficiency - diagnosis; Mitral Valve Insufficiency - epidemiology; Mitral Valve Insufficiency - therapy; Retrospective Studies; Valve disease; Valve replacement; Japan; Valve disease; Valve replacement; Heart valve; Epidemiology
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2023.03.007

Valvular heart disease (VHD) is one of the commonest causes of cardiovascular morbidity and mortality worldwide, with acquired VHD especially prevalent in countries with aging populations. The scope and pattern of disease are not well understood, as some patients are asymptomatic and available options for invasive treatment vary by affected valve. We sought to understand the burden of VHD in Japan including the distribution of patients by valve disease type and age, using administrative claims data from acute care hospitals.
This was a retrospective descriptive study of patients with VHD diagnosis and at least one record of echocardiography in 2019 documented in the Medical Data Vision database. Affected valve(s) and type of valve disease were characterized using ICD-10 codes; patients undergoing invasive treatment for VHD at the same facility and during the same year as their diagnosis were assessed using procedure codes.
Of 203,398 patients with VHD diagnosis and a record of echocardiography in 2019, 49.0 % had a mitral valve disorder, 44.9 % aortic valve, 22.9 % tricuspid valve, and 2.2 % pulmonic valve (14.9 % of patients had more than one disordered valve). A total of 7201 patients (<4 % of the total diagnosed population) received invasive treatment for VHD in 2019 at the diagnosing hospital. Patients with aortic stenosis (AS) had the highest mean age, at 79 years. Although mitral regurgitation was the most common VHD among diagnosed patients, AS predominated in the cohort of treated patients. A substantial portion of patients undergoing treatment for AS were age 85 years or older (27.2 %).
The cohort of treated patients in 2019 was a small fraction of the total population with a VHD diagnosis in that year. Wide availability of transcatheter treatment for AS in Japan may be allowing more elderly patients to receive intervention than in other types of VHD.
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•Mitral regurgitation was the most common valvular heart disease diagnosed in 2019.•The cohort of treated patients at the diagnosing hospital was small.•Aortic stenosis (AS) predominated in the cohort of treated patients.•The proportion of elderly was notably higher for patients with treatment for AS.