{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T21:18:43Z","timestamp":1781731123355,"version":"3.54.5"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2011,10,21]],"date-time":"2011-10-21T00:00:00Z","timestamp":1319155200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951111001405_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>To present the long-term follow-up of children hospitalised for severe rheumatic carditis who were treated with corticosteroids.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951111001405_abs2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>This is a retrospective analysis of the outcome of 242 patients with severe rheumatic carditis after discharge from two public hospitals in Niteroi, Brazil. We followed up 118 patients for 4 years or more, with an average of 7.7 years. They were treated with antibiotics to accomplish bacterial eradication and either intravenous methylprednisolone \u2013 40 cases \u2013 or oral prednisone \u2013 78 patients \u2013 to treat carditis. They were followed up in outpatient clinic.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951111001405_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Cardiac failure was categorised as classes III and IV according to the New York Heart Association classification. In the intravenous corticosteroid group, 21 cases (52.5%) had isolated mitral valve regurgitation, 12 (30%) had mitral plus aortic involvement, and seven (17.5%) had aortic lesion only. In the oral prednisone group, 45 (58%) had mitral valve regurgitation only, 27 (34%) had mitral plus aortic involvement, and six (8%) had aortic lesion only. A total of 28 children were in their first disease attack, of whom 19 (68%) had a rupture of chordae tendineae. A total of 58 patients (49%) sustained recurrence of carditis because of neglected secondary prophylaxis. In all, 19 cases (16%) underwent cardiac surgery \u2013 valve replacement or valvuloplasty. In 33% of the cases, the outcome was favourable \u2013 asymptomatic at follow-up. The overall mortality rate was 6.8%.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951111001405_abs4\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>Many critically ill patients who complied with secondary prophylaxis were left with minor injuries, whereas those who neglected it or abandoned it had serious sequelae. The rate of abandonment and loss to follow-up was very high. Many cases (49%) were re-hospitalised because of carditis recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951111001405","type":"journal-article","created":{"date-parts":[[2011,10,21]],"date-time":"2011-10-21T12:40:19Z","timestamp":1319200819000},"page":"263-269","source":"Crossref","is-referenced-by-count":4,"title":["Follow-up of rheumatic carditis treated with steroids"],"prefix":"10.1017","volume":"22","author":[{"given":"Gesmar V. H.","family":"Herdy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael S.","family":"Gomes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna E. A.","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leandro S.","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e2nia G. S.","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2011,10,21]]},"reference":[{"key":"S1047951111001405_ref29","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.57.1.181"},{"key":"S1047951111001405_ref3","doi-asserted-by":"publisher","DOI":"10.1590\/S0066-782X1999000500007"},{"key":"S1047951111001405_ref14","first-page":"269","article-title":"Fatal active rheumatic disease. Study of 13 necropsy cases","volume":"56","author":"Velloso","year":"1991","journal-title":"Arq Bras Cardiol"},{"key":"S1047951111001405_ref6","unstructured":"6. American College of Cardiology Foundation, American Heart Association. Methodologies and policies from the ACCF\/AHA task force on practice guidelines. Methodology Manual for ACCF\/AHA Guideline Writing Committees. http:\/\/www.americanheart.org\/presenter.jhtml?identifier=3039683 (accessed on 1 June, 2010)."},{"key":"S1047951111001405_ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1992.03490150121036"},{"key":"S1047951111001405_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(86)90122-0"},{"key":"S1047951111001405_ref20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39031.420637.BE"},{"key":"S1047951111001405_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70359-3"},{"key":"S1047951111001405_ref25","doi-asserted-by":"publisher","DOI":"10.1590\/S0102-76381999000300002"},{"key":"S1047951111001405_ref12","first-page":"8","article-title":"Adherence to secondary prophylaxis and disease recurrence in 536 Brazilian children with rheumatic fever","volume":"26","author":"Pelajo","year":"2010","journal-title":"Pediatr Rheumatol Online"},{"key":"S1047951111001405_ref1","first-page":"317","article-title":"The challenge of secondary prophylaxis in rheumatic fever","volume":"67","author":"Herdy","year":"1996","journal-title":"Arq Bras Cardiol"},{"key":"S1047951111001405_ref10","first-page":"377","article-title":"Pulsoterapia (altas doses de metilprednisolona venosa) em crian\u00e7as com cardite reum\u00e1tica. Estudo prospectivo de 40 epis\u00f3dios","volume":"60","author":"Herdy","year":"1993","journal-title":"Arq Bras Cardiol"},{"key":"S1047951111001405_ref21","doi-asserted-by":"publisher","DOI":"10.1007\/s002469910017"},{"key":"S1047951111001405_ref9","volume-title":"Perfil cl\u00ednico de pacientes com cardiopatia reum\u00e1tica atendidos em hospital pedi\u00e1trico da rede p\u00fablica. Disserta\u00e7\u00e3o de Mestrado em Sa\u00fade da Crian\u00e7a e do Adolescente","author":"Ara\u00fajo e Silva","year":"2006"},{"key":"S1047951111001405_ref16","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e32833502e7"},{"key":"S1047951111001405_ref17","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1542\/peds.96.4.758","article-title":"Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals","volume":"96","author":"Dajani","year":"1995","journal-title":"Pediatrics"},{"key":"S1047951111001405_ref22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S146239940501015X","article-title":"Molecular pathogenesis of rheumatic fever and rheumatic heart disease","volume":"7","author":"Guilherme","year":"2006","journal-title":"Expert Rev Mol Med"},{"key":"S1047951111001405_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2009.09.011"},{"key":"S1047951111001405_ref30","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.30.3.429"},{"key":"S1047951111001405_ref13","first-page":"1","article-title":"Diretrizes Brasileiras para o diagn\u00f3stico, tratamento e preven\u00e7\u00e3o da Febre Reum\u00e1tica. Coord. Paulo Jos\u00e9 Bastos Barbosa e Regina Elizabeth M\u00fcller","volume":"93","year":"2009","journal-title":"Arq Bras Cardiol"},{"key":"S1047951111001405_ref31","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196704272761702"},{"key":"S1047951111001405_ref2","unstructured":"2. Minist\u00e9rio da Sa\u00fade. Datasus. www.datasus.gov (accessed on 1 June, 2010)."},{"key":"S1047951111001405_ref28","first-page":"320","article-title":"Aspetos de la cardiopatia reumatica apreciados con biopsia de las orejelas","volume":"53","author":"Decourt","year":"1966","journal-title":"Prensa Med Arg"},{"key":"S1047951111001405_ref15","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.191959"},{"key":"S1047951111001405_ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-009-9332-6"},{"key":"S1047951111001405_ref27","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951109003680"},{"key":"S1047951111001405_ref19","first-page":"CD003176","article-title":"Anti-inflammatory treatment for carditis in acute rheumatic in acute rheumatic fever","volume":"2","author":"Cillers","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"S1047951111001405_ref8","first-page":"1007","article-title":"Rheumatic heart disease: 15 years of clinical and immunological follow-up","volume":"3","author":"Sampaio","year":"2007","journal-title":"Vasc Health Risk Manag"},{"key":"S1047951111001405_ref7","volume-title":"Rheumatic fever and rheumatic heart disease: report of a WHO expert consultation on rheumatic fever and rheumatic heart disease","year":"2004"},{"key":"S1047951111001405_ref24","first-page":"400","article-title":"Plastia mitral cir\u00fargica em crian\u00e7as com febre reum\u00e1tica","volume":"92","author":"Rocha e Silva","year":"2009","journal-title":"Arq Bras Cardiol"},{"key":"S1047951111001405_ref4","first-page":"204A","article-title":"Jones criteria (revised) for guidance in the diagnosis and treatment of rheumatic fever","volume":"69","year":"1984","journal-title":"Circulation"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951111001405","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,12]],"date-time":"2021-12-12T04:33:33Z","timestamp":1639283613000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951111001405\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10,21]]},"references-count":31,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,6]]}},"alternative-id":["S1047951111001405"],"URL":"https:\/\/doi.org\/10.1017\/s1047951111001405","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,10,21]]}}}