Valvular heart disease, which affects the function of any of the heart's four valves, impacts 2.5% of the U.S. population and 13% of those aged 80 and over. Often, the disease remains undetected until it progresses to the point of causing symptoms like shortness of breath, chest pain, or fatigue. Early identification can significantly improve life quality through treatments that halt disease progression. Traditionally, the presence of valvular heart disease has been determined through stethoscope examination, though emerging technologies promise enhanced diagnostic capabilities.

In a paper published in The Lancet, researchers from Rutgers Health (New Brunswick, NJ, USA) and other institutions shed light on current and future technologies that could soon help doctors reduce the number of Americans who die each year from valvular heart disease (roughly 25,000). The research highlights how artificial intelligence (AI) can identify heart murmurs at infrasonic frequencies, imperceptible to the human ear. Additionally, electrocardiograms and wearable devices, by recording the heart's electrical activity and collecting data on heart rate, blood pressure, and blood oxygen levels, can aid AI in detecting early-stage valvular heart disease and monitoring its progression post-diagnosis.

The role of primary care physicians in the early detection of valvular heart disease could also be expanded. Currently, few have the necessary tools and knowledge for diagnosis; however, recent studies indicate that portable ultrasound devices combined with AI could facilitate the diagnosis of heart diseases. This approach could enable the integration of valvular heart disease screenings into regular check-ups, especially for those at increased risk. AI can also enhance patient care by creating a digital twin for each patient, utilizing ultrasound and other imaging data. This virtual model can predict individual responses to therapies and surgeries, thereby refining treatment choices.

The paper also discusses advancements in surgical treatments and the advent of transcatheter valve replacements as a less invasive option for some patients, eliminating the need for major chest openings. Although prosthetic valves currently do not match the performance of natural valve tissue over time due to their inability to regenerate, research is underway on a new generation of more adaptable prosthetics and resorbable valvular prostheses in clinical trials. These innovative prostheses are designed to be replaced by the body with functional organic valves over time, offering a promising solution, particularly for younger patients likely to need multiple valve replacements throughout their lives.

“We are witnessing a paradigm shift in how valvular heart diseases are diagnosed and treated,” said Partho Sengupta, Henry Rutgers Professor of Cardiology and chief of the Division of Cardiovascular Disease and Hypertension at Rutgers Robert Wood Johnson Medical School. “The innovation, discovery and future of clinical care that we have envisioned at Rutgers now find their way in The Lancet, and it’s heartening that this road map may also be incorporated globally in our fight against valvular heart disease.”

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