Epidemiological and Demographic Analysis of Rheumatic Heart Diseases in Northeastern Iran: A Cross-Sectional Study

Article Info Background: Rheumatic mitral stenosis (MS) remains a significant health concern in developing regions. This study aimed to determine the prevalence and characteristics of rheumatic MS in Northeastern Iran. Material and Methods: In this cross-sectional study (2016-2020), we analyzed data from 1,035 rheumatic MS patients at two tertiary cardiology centers in Mashhad. Demographic, clinical, and echocardiographic parameters were extracted from the registered echocardiographic database at Mashhad University of Medical Sciences. Statistical analysis was undertaken using SPSSv22 with appropriate tests (Chi-square, ANOVA, Kruskal-Wallis; p<0.05). Results: The study population (mean age 50.0±13.3 years) revealed 79.3% female predominance. Prevalence was 0.3 per 1,000 population. Concomitant valvular involvement was common: aortic regurgitation (60.4%), mitral regurgitation (43.8%), tricuspid regurgitation (38%), and aortic stenosis (25%). Males exhibited more severe MS (p<0.05) with greater pulmonary artery pressures and greater need for percutaneous transvenous mitral commissurotomy (PTMC). Conclusion: While rheumatic MS prevalence in Northeastern Iran aligns with global declining trends, the significant female predominance contrasts with greater disease severity in males. These findings highlight the need for: 1) comprehensive echocardiographic evaluation, 2) gender-specific management approaches, and 3) strengthened prevention programs. The persistence of clinically significant MS burden underlines the importance of ameliorating primary and secondary prevention strategies in the region.