The Burden and Trends of Degenerative Mitral Valve Disease at the Global, Regional, and National Levels From 1990 to 2021, With Projections to 2035

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Background: Degenerative mitral valve disease (DMVD) is a significant contributor to the global burden of disease. This study aimed to estimate the prevalence, mortality, and disability-adjusted life years (DALYs) rates of DMVD at global, regional, and national levels from 1990 to 2021 and to project its future burden. Methods: This study extracted three pivotal indicators, including the prevalence, mortality, and DALYs related to DMVD, from the Global Burden of Disease 2021. The average annual percentage change and rate change were utilized to evaluate the changes in the disease burden. Decomposition analyses were conducted to evaluate these changes. In addition, a Bayesian age-period-cohort analysis was performed to forecast the future burden of DMVD. Results: In 2021, the global age-standardized prevalence rates (ASPRs), age-standardized mortality rates (ASMRs), and age-standardized disability-adjusted life year rates (ASDRs) for DMVD were 182.13 per 100,000 persons [95% uncertainty interval (UI): 169.952, 196.070], 0.456 per 100,000 persons (95% UI: 0.394, 0.514), and 11.362 per 100,000 persons (95% UI: 9.867, 13.611), respectively. Regions with a high sociodemographic index exhibited the most substantial disease burden. Women exhibited lower ASPR than men, but higher ASMR. Decomposition analyses reveal that improvements in DMVD burden were primarily attributable to epidemiological changes; however, it was negatively affected by population growth and aging. Predictive analysis suggests that global projections for DMVD in 2035 estimate approximately 21.41 million (95% UI: 15,718,776, 27,102,848) cases of prevalence, 47,878 (95% UI: 28,449, 67,307) cases of mortality, and 1.20 million (95% UI: 793,487, 1,615,972) cases of DALYs. Conclusions: The global burden of DMVD, indicated in its age-standardized prevalence, mortality, and DALYs rates, exhibits significant declines. However, significant regional and national variations exist. Findings of our study emphasize the importance of devising targeted public health strategies tailored to different regions, countries, and populations, with the aim of further mitigating DMVD's global impact.

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