# The global, regional, and national burden of non-rheumatic degenerative mitral valve disease from 1990 to 2021 and forecast for 2050

## TL;DR

This study analyzes global trends in non-rheumatic degenerative mitral valve disease from 1990 to 2021 and forecasts future patterns, highlighting rising cases and gender-specific differences.

## Contribution

The study provides updated global epidemiological trends and forecasts for DMVD, emphasizing gender disparities and the need for targeted public health strategies.

## Key findings

- DMVD incidence and death cases increased significantly from 1990 to 2021, despite declining age-standardized rates.
- Males have a higher incidence rate, while females face higher death rates from DMVD.
- Higher socio-demographic index countries bear a greater DMVD burden, with significant cross-country inequalities in lower-SDI regions.

## Abstract

Given the changing epidemiological and burden trends of non-rheumatic degenerative mitral valve disease (DMVD), it is crucial to re-examine geographical differences and trends. Here, we describe the current trends of DMVD epidemiology using data from the Global Burden of Diseases (GBD) study from 1990 to 2021, with forecasts extending to 2050.

Annual case numbers and age-standardized rates (ASR) of incidence, prevalence, deaths, and disability-adjusted life years (DALYs) for DMVD between 1990 and 2021, as well as their estimated annual percentage changes (EAPC), were derived from the 2021 GBD study. Exponential smoothing and autoregressive integrated moving average models are employed for forecasting the future trends of DMVD.

Between 1990 and 2021, the number of DMVD incidence cases increased from 566,261 (95% uncertainty interval [UI]: 523,330–609,607) to 1,162,558 (1,084,358–1,244,874), corresponding to a 105.3% (77.9–137.9) rise. Additionally, DMVD-related death cases rose by 53.8% (21.2–97.7), from 23,954 (21,032–26,296) to 36,844 (31,883–41,572). However, there is a decline in ASR of incidence and death. Stratified analysis revealed that the age-standardized incidence rate (ASIR) in males is nearly twice that of females, while the age-standardized death rate (ASDR) is higher in females. These trends are not expected to improve significantly by 2050. Concurrently, the ASIR peaks in individuals aged 65–69 and 70–74. In 2021, higher socio-demographic index (SDI) countries bore a greater DMVD burden, while lower-SDI countries faced greater cross-country inequalities.

The number of DMVD epidemiological indicators is rising annually. Higher-SDI countries need to adjust healthcare policies to address aging populations and support lower-SDI countries with medical resources and cardiology expertise. This study suggests that age 65 is a meaningful threshold for screening. Additionally, Our findings advocate for stratified public health interventions: incidence-based screening targeting males and mortality-focused treatment intensification for females.