{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T18:40:39Z","timestamp":1788115239565,"version":"build-2803163510"},"reference-count":68,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,8,29]],"date-time":"2020-08-29T00:00:00Z","timestamp":1598659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The epidemiology and management of diseases can be influenced by social demographic factors. Gender and migration are among these factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We aimed at reviewing the impacts of gender and migration on rheumatic heart disease (RHD) epidemiology and management by a nonsystematic literature review of published studies on RHD worldwide. Our PubMed search terms included RHD pathophysiology, diagnosis, complications, management or prevention, combined with words \u2018rheumatic mitral stenosis (MS)\u2019, \u2018outcomes after percutaneous balloon mitral valvuloplasty (PBMV)\u2019, \u2018gender or sex difference\u2019 and \u2018migration\u2019. The reporting of this study conforms to SANRA (the Scale for Assessment of Narrative Review Articles) guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We retrieved eight studies about the impact of sex on outcomes after PBMV. All of these studies showed a female predominance for RHD. Two studies showed that there is no impact, three studies showed female sex as a predictor of poor outcomes, and the other three showed male sex a predictor of poor outcomes. Although RHD is reported to be eradicated in the developed countries, 2.1% of refugees recently screened for RHD in Italy were found to have subclinical RHD. This prevalence is similar to those found in India (2.0%), Cambodia (2.2%) and Mozambique (3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There are contradicting results for outcomes after PBMV between males and females. It is not clear whether sex difference plays a role in pathophysiology, diagnosis, management and prognosis of MS. Migration has impacts on epidemiology and management of RHD. Further studies are required in these two fields to explore their relationship to RHD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13374","type":"journal-article","created":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T12:04:58Z","timestamp":1597320298000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Rheumatic heart disease anno 2020: Impacts of gender and migration on epidemiology and management"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0928-8149","authenticated-orcid":false,"given":"Reuben K.","family":"Mutagaywa","sequence":"first","affiliation":[{"name":"School of Medicine Muhimbili University of Health and Allied Sciences Dar Es Salaam Tanzania"},{"name":"Division of Heart and Lung Department of Cardiology Faculty of Medicine University Medical Centre Utrecht Utrecht The 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