Atrioventricular valve regurgitation: still a long road ahead

In this issue of Heart , Cahill et al report an analysis of the OxValve cohort assessing the prevalence, presentation and outcome of atrioventricular valve regurgitations.1 The strength of the OxValve cohort is that it was prospectively designed to specifically study heart valve disease using systematic echocardiographic examination in an unselected population aged 65 years or more in a community setting. Echocardiography is the only means to reliably assess the prevalence of heart valve disease since auscultation correctly identifies only around 10% of patients with heart valve disease.2 Unbiased assessment of the prevalence and characteristics of patients with heart valve disease needs to be performed in a community setting, as illustrated by differences between the OxValve and the hospital database cohorts. Moreover, contemporary guideline-based criteria were used in the OxValve cohort for the quantification of the severity of regurgitations and the identification of their mechanisms. Such detailed analyses were not performed in the rare previous population-based studies on the epidemiology of heart valve disease. The collection of detailed and standardised echocardiographic data in a large population-based study is therefore highly relevant in the field of heart valve disease. The unadjusted prevalence of moderate or severe mitral or tricuspid regurgitation was estimated at 2.0% in subjects aged 65–75 years and 7.7% in those aged ≥75 years. This considerable increase in the prevalence …