​The Real Cause Behind Mitral Stenosis

Research wins top award at two regional conferences

PULSE Issue 39 | June 2022

A research team from the National University Heart Centre, Singapore (NUHCS) recently won the top Young Investigator Award at two medical conferences – the American College of Cardiology Asia 2021-32nd Singapore Cardiac Society Annual Scientific Meeting 2021 (ACC Asia-SCS ASM) and the 25th ASEAN Federation of Cardiology Congress (AFCC) – for the team’s research on Mitral Stenosis, a condition whereby the heart’s mitral valve narrows and blocks blood flow into the main pumping chamber of the heart. It was once thought to be caused by rheumatic heart disease – a condition where the heart valves are permanently damaged due to rheumatic fever which is an inflammatory disease often developed when a bacterial infection has not been properly treated. 

The research was presented and led by Dr Ryan Leow, Senior Resident, Internal Medicine Residency, National University Hospital Singapore (NUHS), under the guidance of Asst Prof William Kong Kok Fai, Clinical Director of Echocardiography and Non-invasive Diagnostic Cardiology and Senior Consultant, Department of Cardiology, NUHCS, and Dr Sia Ching Hui, Associate Consultant, Department of Cardiology, NUHCS.

Using 25 years of echocardiographic data from Singapore, the team observed a change in the causation of Mitral Stenosis. The team successfully contextualised the importance of these findings for Asian populations that went through demographic changes similar to that of Singapore, such as an ageing population and rapid socioeconomic growth. However, Mitral Stenosis is now increasingly found to occur due to metabolic conditions such as diabetes and degenerative calcification associated with ageing. Calcification occurs when excessive calcium builds up and deposits in our body tissues. In severe consequences, it accumulates in the heart valves affecting blood flow. 

In recent years, degenerative Mitral Stenosis appears to be increasingly more prevalent behind heart valve diseases, especially in high-income countries. As the condition is less well-understood compared to rheumatic Mitral Stenosis, researchers are keen on studying the causation of the disease and examining the trends in disease burden to better manage patient health. “Degenerative Mitral Stenosis is an increasing problem in our ageing society for which we need to identify effective treatment strategies for our patients,” explained the research team’s senior author, Asst Prof Kong. “An Asian perspective adds valuable data to the ongoing research on this condition and our team is excited to build on this remarkable achievement.”