{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T23:52:45Z","timestamp":1794009165345,"version":"4.8.0"},"reference-count":30,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"unspecified","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL153447"],"award-info":[{"award-number":["R01HL153447"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2022,8,16]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The burden of valvular heart disease (VHD) has increased significantly among ageing populations, yet remains poorly understood in the present-day context of percutaneous and surgical interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To define the incidence, clinical correlates and associated mortality of VHD in the UK Biobank cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We interrogated data collected in the UK Biobank between 1 January 2000 and 30 June 2020. VHD incidence was determined using International Classification of Disease-10 codes for aortic stenosis (AS), aortic regurgitation (AR), mitral stenosis, mitral regurgitation (MR) and mitral valve prolapse. We calculated HRs for incident VHD and all-cause mortality. Clinical correlates of VHD included demographics, coronary artery disease, heart failure and atrial fibrillation. Surgical and percutaneous interventions for mitral and aortic VHD were considered time-dependent variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 486\u2009187 participants, the incidence of any VHD was 16 per 10\u2009000 person-years, with highest rates for MR (8.2), AS (7.2) and AR (5.0). Age, heart failure, coronary artery disease and atrial fibrillation were significantly associated with all types of VHD. In our adjusted model, aortic and mitral VHD had an increased risk of all-cause death compared with no VHD (HR 1.62, 95%\u2009CI 1.44 to 1.82,\u2009p&lt;0.001\u2009and HR 1.25, 95%\u2009CI 1.09 to 1.44, p=0.002 for aortic and mitral VHD, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VHD continues to constitute a significant public health burden, with MR and AS being the most common. Age and cardiac comorbidities remain strong risk factors for VHD. In the modern era of percutaneous and surgical interventions, mortality associated with VHD remains high.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2022-002039","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T11:50:44Z","timestamp":1663156244000},"page":"e002039","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Valvular disease burden in the modern era of percutaneous and surgical interventions: the UK Biobank"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0508-0359","authenticated-orcid":false,"given":"Monica","family":"Tung","sequence":"first","affiliation":[{"name":"Department of Medicine, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Nah","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Marcus","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiovascular Division), University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca N","family":"Delling","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiovascular Division), University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"2025081710013222000_9.2.e002039.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69208-8"},{"key":"2025081710013222000_9.2.e002039.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.046677"},{"key":"2025081710013222000_9.2.e002039.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103510"},{"key":"2025081710013222000_9.2.e002039.4","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.amjcard.2020.10.065","article-title":"Trends in outcomes of transcatheter and surgical aortic valve replacement in the United States (2012-2017)","volume":"141","author":"Saad","year":"2021","journal-title":"Am J Cardiol"},{"key":"2025081710013222000_9.2.e002039.5","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1016\/j.carrev.2020.05.021","article-title":"Temporal trends and outcomes of transcatheter 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