Rheumatic heart failure: A review of clinical status and meta-analysis of echocardiography diagnosis and efficacy of shorter duration of antibiotic

Rheumatic heart failure (RHF) is a potentially preventable cardiac complication of rheumatic fever (RF) characterized by scarring or stretching in one or more cardiac valves leading to low cardiac output. Over the past five decades, the epidemiology of RHF has shifted markedly, reducing in high-income countries while increasing in low/middle-income countries. However, the shift has lacked a matching proportional expansion in research and public health practices. Prophylactic and curative therapies combined with targeted public health control programs have been associated with the reducing prevalence in high-income countries but such strategies either have not been adequately implemented or have not translated into reduced burden in low-income countries. Further, the lack of recent research has undermined access to evidence-based data to support the development of treatment guidelines appropriate for low/middle-income countries. In the present paper, we review published data to provide a comprehensive update on epidemiology, pathophysiology, diagnosis, and management strategies for RHF.