LONDON, November 5, 2014 /PRNewswire/ --

• Heart Valve Voice's White Paper reveals under-diagnosis, treatment gaps and postcode lotteries across the country, with our nation lagging behind Europe in treating heart valve disease
• The White Paper calls for greater priority on diagnosing and treating the condition and greater investment in valve replacement and repair to provide an effective and ageless service for patients with heart valve disease

Leading physicians and patients today launched a White Paper highlighting a worrying trend of under diagnosis, low referrals and inadequate treatment of heart valve disease amongst the UK's over 65s^[1]; the age group most commonly affected by the condition. The paper from Heart Valve Voice also shows that our nation lags well behind Europe in treating this condition.^[1]

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"We have an ageing population in the UK and the number of people with heart valve disease is set to increase," states Professor Ben Bridgewater, Heart Valve Voice Chair and Consultant Cardiac Surgeon, University Hospital of South Manchester. "However, reversing the condition with valve replacement is eminently possible and can have a significant impact, greatly improving and lengthening the lives of those with the disease. It is unacceptable that when effective treatments for heart valve disease are available, all patients in the UK do not receive timely diagnosis, effective referral and equal access to such treatment."

Evidence shows that nearly two thirds (59%) of people over the age of 60 do not have their heart checked with a stethoscope - the simplest way to identify heart valve disease.^[1] Late diagnosis in primary care is often accompanied by low levels of referral to specialists with more than half (54%) of patients in some parts of the UK not referred to a cardiac surgeon despite their diagnosis being confirmed by echocardiography.^[1]Many people who are referred have already developed damage to the heart which can impact the optimal benefit of surgery. A gap in treatment has also been identified - at least a third (30%) of those with heart valve disease are left untreated despite available treatment options.^[1]

The White Paper reveals that not all patients receive optimal treatment and there are disparities in intervention rates according to where patients live.^[1] The number of those who receive aortic valve procedures varies regionally. In 2013, whilst a small number of regions experienced valve replacement rates in line with European standards, the majority had significantly lower rates (see attached CCG jpeg data).^[2]

France, for example, sees more than double the UK rate of surgical aortic valve replacements and TAVIs in recent years.^[1] Commenting on this, Professor Bridgewater says: "To realise that UK patients with heart valve disease may well be missing out on treatment, not only compared to their neighbours in different UK regions, but also to patients in other European countries is simply not good enough. Our goal is to put treating heart valve disease on the agenda, especially as it will help the UK to manage our ageing population."

Heart valve disease is a debilitating and potentially fatal condition which affects more than one million people over the age of 65 in the UK alone.^[3] If severe aortic stenosis, the most common form of heart valve disease, is left untreated, half of symptomatic patients will die within two years.^[4] Surgical aortic valve replacement is the gold standard and has been a successful, life-saving treatment for many decades, but some patients were too sick or old to be eligible. However, with the advent of innovative treatment options, such as minimally invasive valve replacement and TAVI, many more patients can now be treated if diagnosed, referred and managed in a timely and effective manner.^[1]

Fred Whowell, an 87 year old patient supporter of Heart Valve Voice, comments: "Without intervention I couldn't have returned to the level of life that I'd really enjoyed. I'm raring to go. Within a month of having the procedure, I was doing three hours a day outside [in the garden] with absolutely no trouble at all." He goes on to say that he's "back to almost 100% now [since treatment]".

NOTES TO EDITORS 

Calls to action from the White Paper

Heart Valve Voice calls for greater priority to be placed on heart valve disease accompanied by increased investment in providing curative valve repair and replacement for the UK’s older people suffering from heart valve disease.

The group wants:

1. Heart valve disease to be included in current strategies for cardiovascular disease

2. An awareness campaign for healthcare professionals and potential patients on the symptoms of heart valve disease and the importance of early diagnosis and treatment

3. 15 minute GP consultations for the over 75s

4. Appropriate referral and follow-up between primary, secondary and tertiary care with a key role played by a multidisciplinary team (MDT) to inform treatment decisions in partnership with patients

5. The same level of surgical and transcatheter valve treatments as other leading European countries

6. The same access to heart valve replacement treatment wherever a patient lives within the UK

For more information on the White Paper, Heart Valve Voice and heart valve disease please visit the Heart Valve Voice website at: http://www.heartvalvevoice.co.uk

Follow us on Twitter @HeartValveVoice #HeartValveDisease #HeartValveVoice

About Heart Valve Voice 

Heart Valve Voice is a multi-disciplinary group of experts in the field of heart valve disease including patients and representatives from cardiac societies, cardio-thoracic surgery, interventional cardiology, primary care and cardiac patient groups.

Formed in 2013, the group exists to help support people with heart valve disease and to drive change in the diagnosis, treatment and management of the condition in the UK to ultimately provide patients with longevity and quality of life. Further information on the group and heart valve disease can be found at http://www.heartvalvevoice.co.uk.  

The development of the Heart Valve Voice White Paper has been supported with funding from Edwards Lifesciences. Edwards Lifesciences is the global leader in the science of heart valves and hemodynamic monitoring. Additional company information can be found at http://www.edwards.com.

About heart valve disease 

Heart valve disease is a condition caused by either wear or disease of the heart valve(s), affecting the flow of blood through the heart.^[5] When diseased or defective, heart valves may not open or close properly and can interfere with the flow of blood. The most common valve problems involve the mitral and aortic valves, which are located on the left side of the heart.^[5]

Aortic valve stenosis is most often due to age-related degeneration or hardening (calcification) of the aortic valve, leading to progressive narrowing (stenosis) or leakage - changes which compromise valve function and impair normal blood flow through the heart.^[5]

Heart valve disease is almost always detected during a medical visit. A heart "murmur" or "click-murmur" heard through a physician's stethoscope is usually the first indication of a valve disorder.

Current clinical guidelines on the management of aortic stenosis make a clear distinction between symptomatic and asymptomatic conditions - however, what they identify is the need to treat severe aortic stenosis as early as possible. Without treatment, patients with severe disease face reduced longevity, and impairments in physical and social functioning and emotional well-being that contribute to poor quality of life.^{[6],[7],[8],[9]}

Many heart valve disease patients present in hospital with advanced heart failure^[10],[11] and are ultimately denied optimal outcomes due to late access to surgery. Disease intervention data shows that nearly a quarter (24%) of all isolated aortic valve replacement surgery patients and 36% of isolated mitral valve repair patients display advanced symptoms of heart failure at the time of surgery.

The development of the White Paper has been supported with funding from Edwards Lifesciences. 

References 

1. Giving a Voice to Those with Heart Valve Disease - A Heart Valve Voice White Paper. November 2014. 

2. Health & Social Care Information Centre (HSCIC): Hospital Episode Statistics. Available at: http://www.hscic.gov.uk/hes. Accessed November 2014 

3. Office for National Statistics. Available at: http://www.statistics.gov.uk. Accessed October 2014. 

4. Spaccarotella C et al. Pathophysiology of aortic stenosis and approach to treatment with percutaneous valve implantation. Circulation Journal. 2011;75:11-19. 

5. Patient.co.uk. Available at: http://www.patient.co.uk/health/heart-valves-and-valve-disease. Accessed 24 April 2014. 

6. Badran AA, Vohra HA, Livesey SA. Unoperated severe aortic stenosis: decision making in an adult UK-based population. Ann R Coll Surg Engl 2012;94:416-21. 

7. Lancellotti P, Rosenhek R, Pibarot P, et al. ESC Working Group on Valvular Heart Disease Position Paper--heart valve clinics: organization, structure, and experiences. Eur Heart J 2013. 

8. van Geldorp MW, Heuvelman HJ, Kappetein AP, et al. Quality of life among patients with severe aortic stenosis. Neth Heart J 2013;21:21-7. 

9. van Geldorp MW, Heuvelman HJ, Kappetein AP, Busschbach JJ, Takkenberg JJ, Bogers AJ. The effect of aortic valve replacement on quality of life in symptomatic patients with severe aortic stenosis. Neth Heart J 2013;21:28-35. 

10. Society for Cardiothoracic Surgery in Great Britain and Northern Ireland. Blue Book online (6th edtn.). Available at: http://bluebook.scts.org/. Accessed 24 April 2014.

11. Society for Cardiothoracic Surgery in Great Britain and Northern Ireland.  Available at: http://www.scts.org/. Accessed 24 April 2014. 

For further information, please contact the Heart Valve Voice Secretariat:

Heart Valve Voice Secretariat
Tonic Life Communications
Telephone: +44-(0)207-798-9900
Email: HeartValveVoice@toniclc.com

SOURCE Heart Valve Voice