OCC-WCC 2024 | WCC风湿性心脏病论坛：应对RF与RHD全球疾病负担，究“源”防治新策略

风湿热（RF）和风湿性心脏病（RHD）的预测及防控，一直是全球公共卫生领域的重要挑战。2024年6月27日，在第十八届东方心脏病学会议（OCC）和世界心脏病学大会（WCC）设立的风湿性心脏病论坛上，来自全球各国专家们聚焦RF和RHD等疾病的全球负担，深入分析疾病流行趋势，并预测未来的防控挑战。专家们进行“头脑风暴”，共同为心血管疾病的防治事业出谋划策。让我们一起回顾WCC风湿性心脏病论坛的精彩瞬间和名家观点！

Prediction and prevention of rheumatic fever (RF) and rheumatic heart disease (RHD) have been important challenges in the field of global public health. On June 27, 2024, at the Rheumatic Heart Disease Forum established by the 18th Oriental Congress of Cardiology (OCC) and World Congress of Cardiology (WCC), experts from all over the world focused on the global burden of diseases such as RF and RHD, deeply analyzed disease epidemic trends, and predicted future prevention and control challenges. Experts carry out "brainstorming" to jointly make suggestions for the prevention and treatment of cardiovascular diseases. Let's review the wonderful moments and famous views of the WCC Rheumatic Heart Disease Forum together!

孟旭教授 :中国风湿性二尖瓣修复治疗理念的转变

来自首都医科大学附属北京安贞医院心外科的孟旭教授指出，外科修复手术为患者未来微创治疗获益创造良好基础，并能给患者最大获益的保障。他强调，中国风湿性心脏瓣膜外科治疗必须完成从人工瓣膜置换走向修复技术为主的观念转换，并具体介绍了“SCORE”手术在风湿性心脏病二尖瓣病变中的应用和预后，向国内外同道展示中国独有的、对风湿性心脏病二尖瓣治疗的理解和高超技巧。最后孟旭教授表示，100年前，我们的前辈正是从风湿性瓣膜病的修复开始的。未来，我们要做好中国风湿性瓣膜病二尖瓣的修复，为患者提供更理想的生存质量和远期生存。

Professor Meng Xu from the Department of Cardiac Surgery of Beijing Anzhen Hospital, Capital Medical University pointed out that surgical repair surgery creates a good basis for the benefits of minimally invasive treatment for patients in the future and can guarantee the greatest benefits for patients. He emphasized that surgical treatment of RHD in China must complete the concept conversion from prosthetic valve replacement to valve repairment. He specifically introduced the application and prognosis of "SCORE" surgery in mitral valve disease of rheumatic heart disease, showing a unique understanding of mitral valve treatment of rheumatic heart disease and superb skills from China to domestic and foreign colleagues. Finally, Professor Meng Xu said that our predecessors began with the repair of rheumatic valvular disease 100 years ago. In the future, we should continue our work in mitral valve repair for RHD in China to provide patients with a more ideal quality of life and long-term survival.

周珊珊教授 :RHD负担与社会经济发展状况密切相关

来自中国人民解放军总医院的周珊珊教授代陈韵岱教授发表讲课。周珊珊教授表示，尽管RHD是可以预防的，但由于其发病早、死亡率和致残率高，尤其是在低收入国家和地区，仍然是公共卫生领域的重大问题。RHD对患者及其家庭造成了巨大的身体和经济负担，除了直接影响患者健康外，还可能导致就业机会减少、教育受到干扰等间接影响。过去二十年来，全球努力已使RHD死亡率降低了50%，但各国和地区的下降速度各不相同。这表明，在应对RHD挑战方面存在着世界范围内的不平等现象。尽管诊断技术与手术治疗水平的提高已经改变了RHD在全球范围内的流行模式，但为进一步降低死亡率，相关国家和地区仍需要制定相关的政策和干预措施，更好地改善医疗条件。

Professor Zhou Shanshan from Chinese PLA General Hospital delivered a lecture on behalf of Professor Chen Yundai. Professor Zhou Shanshan said that although RHD can be prevented, it is still a major problem in the public health field due to its early onset, high mortality and disability rate, especially in low-income countries and regions. RHD imposes a substantial physical and financial burden on patients and their families and may lead to indirect impacts such as reduced employment opportunities and disrupted education, in addition to directly affecting patient health. Global efforts have reduced RHD mortality by 50% over the past two decades, but the rate of decline varies across countries and regions. This suggests that there are worldwide inequalities in responding to RHD challenges. Although improvements in diagnostic techniques and surgical treatment have changed the worldwide prevalence of RHD, relevant countries and regions need policies and interventions to better improve medical conditions to further reduce mortality.

Nikki Moreland教授:降低RHD发病率，Strep A疫苗需求迫切

新西兰奥克兰大学的Nikki Moreland教授表达了临床上对A族链球菌（Strep A）疫苗的迫切需求，并强调其在引起严重侵袭性感染和自身免疫性疾病 (如风湿性心脏病) 等各种疾病中的作用。Nikki Moreland教授介绍道，由于菌株多样性、缺乏对保护性免疫的了解以及安全问题，在开发疫苗方面面临的重大挑战。尽管有些许障碍，仍然希望和各国同道更广泛地、战略性合作，同步进行疫苗开发预防以及管理A型链球菌疾病和风湿热，以满足疾病防控的紧迫需求。

Professor Nikki Moreland of the University of Auckland, New Zealand, expressed the urgent clinical need for group A streptococcal vaccines and emphasized their role in causing various diseases such as severe invasive infections and autoimmune diseases (e.g., RHD). Professor Nikki Moreland introduced the major challenges faced in developing vaccines due to strain diversity, lack of understanding of protective immunity, and safety issues. Despite some obstacles, we hope to work more broadly, strategically, and synchronously with colleagues across countries on the vaccine development to prevent and manage Streptococcus A disease and rheumatic fever to meet the urgent need for disease prevention and control.

陈纪言教授:风湿性心脏病的中国趋势

广东省人民医院心内科陈纪言教授强调，在过去三十年中，中国风湿性心脏病的发病率、患病率和死亡率正在下降，这是一个了不起的成就。陈纪言教授表示，手术治疗仍然是重度瓣膜性心脏病的金标准，同时我们也观察到微创手术及瓣膜修复术比例正不断增加。通过球囊瓣膜成形术、二尖瓣缘对缘修复术和瓣膜置换术对患有风湿性瓣膜性心脏病的患者进行经皮介入治疗安全有效。最后，陈纪言教授对未来表达了憧憬，风湿性心脏病创新设备和新的治疗方式正不断涌现，我们也将不断拓展相关的诊疗方法惠及患者。

Professor Chen Jiyan, Department of Cardiology, Guangdong Provincial People's Hospital, stressed that it has been a remarkable achievement that the incidence, prevalence, and mortality of rheumatic heart disease in China have been declining over the past three decades. Professor Chen Jiyan said that surgical treatment remains the gold standard for severe valvular heart disease, and they observed an increasing use of minimally invasive surgery and valve repairment. Percutaneous intervention by balloon valvuloplasty, mitral valve edge-to-edge repair, and valve replacement is safe and effective in patients with rheumatic valvular heart disease. Finally, Professor Chen Jiyan expressed his vision for the future. He mentioned that innovative equipment and new treatment methods for rheumatic heart disease continue to emerge, and they will also continuously expand the relevant diagnosis and treatment methods to benefit patients.

Liesl Zuhlke教授:RHD的最新标准带来的积极影响

南非开普敦大学Liesl Zuhlke教授系统介绍了2023年世界心脏联盟（WHF）更新的关于RHD的最新标准。RHD最新标准包括筛查和确认阶段、心力衰竭分期和管理策略，重点是早期发现和干预，以防止进展到严重疾病状态。Liesl Zuhlke教授肯定了手持式超声心动图的使用以及AI在提高诊断准确性方面的积极作用。更新后的新标准，旨在更好地识别高风险患者，从而提前干预心力衰竭的发展。这些变化预计将推动临床实践中更准确的疾病管理和治疗策略的实施，进而为全球RHD的防控工作提供新的思路和策略。

Professor Liesl Zuhlke, University of Cape Town, South Africa, systematically presented the latest criteria for RHD updated by the World Heart Federation (WHF) in 2023. The most recent criteria for RHD include screening, diagnosis, staging of heart failure, and management strategies. It is important to focus on early detection and intervention to prevent progression to severe disease states. Prof. Liesl Zuhlke affirmed the use of handheld echocardiography and the important role of AI in improving diagnostic accuracy. The updated new criteria aimed to better identify high-risk patients and thereby intervene early in the development of heart failure. These changes are expected to drive the implementation of more accurate disease management and treatment strategies in clinical practice and provide new ideas and strategies for the prevention and control of RHD worldwide.

Mark Engel博士:南部非洲Strep A流行病学的更新

A族链球菌是引发RHD的主要病原体之一。Mark Engel博士介绍了有关在南非建立AfroStrep注册表及其为政策提供信息和促进全球对A组链球菌知识方面的作用的见解。Mark Engel博士强调，地方驱动的研究对于确保疫苗和公共卫生战略在全球范围内有效具有重要意义。针对儿童咽喉炎免疫反应的纵向调查，揭示了对无症状感染和成人保护作用的重要见解。Mark Engel博士强调需要进行更全面的全球流行病学研究，以弥补在气体生物反应器知识方面的差距，以及分子流行病学和收集分离物供进一步分析的必要性。

Group A Streptococcus is one of the major pathogens causing RHD. Dr. Mark Engel presented insights on the establishment of the AfroStrep Registry in South Africa and its role in informing policy and promoting global knowledge of group A streptococci. Dr. Mark Engel stressed that local-based research is important to ensure that vaccines and public health strategies are effective worldwide. A longitudinal investigation of the immune response to pharyngitis in children revealed important insights into asymptomatic infection and protection in adults. Dr. Mark Engel highlighted the need for more comprehensive global epidemiological studies to bridge gaps in knowledge about gas bioreactors. He also highlighted the need for molecular epidemiology and collection of isolates for further analysis.

本次风湿性心脏病论坛汇聚国内外顶尖专家，内容涵盖RHD防控领域多个重要议题。专家们共同探RHD的防控策略，分享最新的研究成果和临床经验。本次论坛成功举办标志着风湿性心脏病领域学术交流达到了新高度，必将对我国风湿性心脏病患者防控工作带来启示和积极推动力。

This Forum on RHD brings top experts domestic and abroad together, covering several important topics in the field of RHD prevention and control. Experts jointly explore the prevention and control strategies for RHD and share the latest research results and clinical experience. The successful convening of this forum marks a new height of academic exchange in the field of RHD. And this will certainly bring enlightenment and actively promote the prevention and control of patients with RHD in China.

【大会微官网】

审核：陈纪言

全面工作

传播矩阵

FOLLOW US

苏州工业园区东方华夏心血管健康研究院

电话：0512-68295918

邮箱：info@ccahouse.org

网址：https://www.ccahouse.org

地址：苏州工业园区水坊路36号姑苏会平江馆心脏之家