Revision of the Jones criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography a scientific statement from the American heart association

Michael H. Gewitz, Robert S. Baltimore, Lloyd Y. Tani, Craig A. Sable, Stanford T. Shulman, Jonathan Carapetis, Bo Remenyi, Kathryn A. Taubert, Ann F. Bolger, Lee Beerman, Bongani M. Mayosi, Andrea Beaton, Natesa G. Pandian, Edward L. Kaplan

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: Acute rheumatic fever remains a serious healthcare concern for the majority of the world's population despite its decline in incidence in Europe and North America. The goal of this statement was to review the historic Jones criteria used to diagnose acute rheumatic fever in the context of the current epidemiology of the disease and to update those criteria to also take into account recent evidence supporting the use of Doppler echocardiography in the diagnosis of carditis as a major manifestation of acute rheumatic fever. 

    Methods and Results: To achieve this goal, the American Heart Association's Council on Cardiovascular Disease in the Young and its Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee organized a writing group to comprehensively review and evaluate the impact of population-specific differences in acute rheumatic fever presentation and changes in presentation that can result from the now worldwide availability of nonsteroidal anti-inflammatory drugs. In addition, a methodological assessment of the numerous published studies that support the use of Doppler echocardiography as a means to diagnose cardiac involvement in acute rheumatic fever, even when overt clinical findings are not apparent, was undertaken to determine the evidence basis for defining subclinical carditis and including it as a major criterion of the Jones criteria. This effort has resulted in the first substantial revision to the Jones criteria by the American Heart Association since 1992 and the first application of the Classification of Recommendations and Levels of Evidence categories developed by the American College of Cardiology/American Heart Association to the Jones criteria. 

    Conclusions: This revision of the Jones criteria now brings them into closer alignment with other international guidelines for the diagnosis of acute rheumatic fever by defining high-risk populations, recognizing variability in clinical presentation in these high-risk populations, and including Doppler echocardiography as a tool to diagnose cardiac involvement.

    Original languageEnglish
    Pages (from-to)1806-1818
    Number of pages13
    JournalCirculation
    Volume131
    Issue number20
    DOIs
    Publication statusPublished - 19 May 2015

    Fingerprint

    American Heart Association
    Rheumatic Fever
    Doppler Echocardiography
    Myocarditis
    Population
    Mucocutaneous Lymph Node Syndrome
    North America
    Endocarditis
    Epidemiology
    Anti-Inflammatory Agents
    Cardiovascular Diseases
    Guidelines
    Delivery of Health Care
    Incidence
    Pharmaceutical Preparations

    Cite this

    Gewitz, Michael H. ; Baltimore, Robert S. ; Tani, Lloyd Y. ; Sable, Craig A. ; Shulman, Stanford T. ; Carapetis, Jonathan ; Remenyi, Bo ; Taubert, Kathryn A. ; Bolger, Ann F. ; Beerman, Lee ; Mayosi, Bongani M. ; Beaton, Andrea ; Pandian, Natesa G. ; Kaplan, Edward L. / Revision of the Jones criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography a scientific statement from the American heart association. In: Circulation. 2015 ; Vol. 131, No. 20. pp. 1806-1818.
    @article{596799ffca974bdfa64cb977ca96c2b4,
    title = "Revision of the Jones criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography a scientific statement from the American heart association",
    abstract = "Background: Acute rheumatic fever remains a serious healthcare concern for the majority of the world's population despite its decline in incidence in Europe and North America. The goal of this statement was to review the historic Jones criteria used to diagnose acute rheumatic fever in the context of the current epidemiology of the disease and to update those criteria to also take into account recent evidence supporting the use of Doppler echocardiography in the diagnosis of carditis as a major manifestation of acute rheumatic fever. Methods and Results: To achieve this goal, the American Heart Association's Council on Cardiovascular Disease in the Young and its Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee organized a writing group to comprehensively review and evaluate the impact of population-specific differences in acute rheumatic fever presentation and changes in presentation that can result from the now worldwide availability of nonsteroidal anti-inflammatory drugs. In addition, a methodological assessment of the numerous published studies that support the use of Doppler echocardiography as a means to diagnose cardiac involvement in acute rheumatic fever, even when overt clinical findings are not apparent, was undertaken to determine the evidence basis for defining subclinical carditis and including it as a major criterion of the Jones criteria. This effort has resulted in the first substantial revision to the Jones criteria by the American Heart Association since 1992 and the first application of the Classification of Recommendations and Levels of Evidence categories developed by the American College of Cardiology/American Heart Association to the Jones criteria. Conclusions: This revision of the Jones criteria now brings them into closer alignment with other international guidelines for the diagnosis of acute rheumatic fever by defining high-risk populations, recognizing variability in clinical presentation in these high-risk populations, and including Doppler echocardiography as a tool to diagnose cardiac involvement.",
    keywords = "acute rheumatic fever, AHA Scientific Statements, Doppler echocardiography, Jones criteria, rheumatic heart disease, subclinical carditis",
    author = "Gewitz, {Michael H.} and Baltimore, {Robert S.} and Tani, {Lloyd Y.} and Sable, {Craig A.} and Shulman, {Stanford T.} and Jonathan Carapetis and Bo Remenyi and Taubert, {Kathryn A.} and Bolger, {Ann F.} and Lee Beerman and Mayosi, {Bongani M.} and Andrea Beaton and Pandian, {Natesa G.} and Kaplan, {Edward L.}",
    year = "2015",
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    Gewitz, MH, Baltimore, RS, Tani, LY, Sable, CA, Shulman, ST, Carapetis, J, Remenyi, B, Taubert, KA, Bolger, AF, Beerman, L, Mayosi, BM, Beaton, A, Pandian, NG & Kaplan, EL 2015, 'Revision of the Jones criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography a scientific statement from the American heart association', Circulation, vol. 131, no. 20, pp. 1806-1818. https://doi.org/10.1161/CIR.0000000000000205

    Revision of the Jones criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography a scientific statement from the American heart association. / Gewitz, Michael H.; Baltimore, Robert S.; Tani, Lloyd Y.; Sable, Craig A.; Shulman, Stanford T.; Carapetis, Jonathan; Remenyi, Bo; Taubert, Kathryn A.; Bolger, Ann F.; Beerman, Lee; Mayosi, Bongani M.; Beaton, Andrea; Pandian, Natesa G.; Kaplan, Edward L.

    In: Circulation, Vol. 131, No. 20, 19.05.2015, p. 1806-1818.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Revision of the Jones criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography a scientific statement from the American heart association

    AU - Gewitz, Michael H.

    AU - Baltimore, Robert S.

    AU - Tani, Lloyd Y.

    AU - Sable, Craig A.

    AU - Shulman, Stanford T.

    AU - Carapetis, Jonathan

    AU - Remenyi, Bo

    AU - Taubert, Kathryn A.

    AU - Bolger, Ann F.

    AU - Beerman, Lee

    AU - Mayosi, Bongani M.

    AU - Beaton, Andrea

    AU - Pandian, Natesa G.

    AU - Kaplan, Edward L.

    PY - 2015/5/19

    Y1 - 2015/5/19

    N2 - Background: Acute rheumatic fever remains a serious healthcare concern for the majority of the world's population despite its decline in incidence in Europe and North America. The goal of this statement was to review the historic Jones criteria used to diagnose acute rheumatic fever in the context of the current epidemiology of the disease and to update those criteria to also take into account recent evidence supporting the use of Doppler echocardiography in the diagnosis of carditis as a major manifestation of acute rheumatic fever. Methods and Results: To achieve this goal, the American Heart Association's Council on Cardiovascular Disease in the Young and its Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee organized a writing group to comprehensively review and evaluate the impact of population-specific differences in acute rheumatic fever presentation and changes in presentation that can result from the now worldwide availability of nonsteroidal anti-inflammatory drugs. In addition, a methodological assessment of the numerous published studies that support the use of Doppler echocardiography as a means to diagnose cardiac involvement in acute rheumatic fever, even when overt clinical findings are not apparent, was undertaken to determine the evidence basis for defining subclinical carditis and including it as a major criterion of the Jones criteria. This effort has resulted in the first substantial revision to the Jones criteria by the American Heart Association since 1992 and the first application of the Classification of Recommendations and Levels of Evidence categories developed by the American College of Cardiology/American Heart Association to the Jones criteria. Conclusions: This revision of the Jones criteria now brings them into closer alignment with other international guidelines for the diagnosis of acute rheumatic fever by defining high-risk populations, recognizing variability in clinical presentation in these high-risk populations, and including Doppler echocardiography as a tool to diagnose cardiac involvement.

    AB - Background: Acute rheumatic fever remains a serious healthcare concern for the majority of the world's population despite its decline in incidence in Europe and North America. The goal of this statement was to review the historic Jones criteria used to diagnose acute rheumatic fever in the context of the current epidemiology of the disease and to update those criteria to also take into account recent evidence supporting the use of Doppler echocardiography in the diagnosis of carditis as a major manifestation of acute rheumatic fever. Methods and Results: To achieve this goal, the American Heart Association's Council on Cardiovascular Disease in the Young and its Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee organized a writing group to comprehensively review and evaluate the impact of population-specific differences in acute rheumatic fever presentation and changes in presentation that can result from the now worldwide availability of nonsteroidal anti-inflammatory drugs. In addition, a methodological assessment of the numerous published studies that support the use of Doppler echocardiography as a means to diagnose cardiac involvement in acute rheumatic fever, even when overt clinical findings are not apparent, was undertaken to determine the evidence basis for defining subclinical carditis and including it as a major criterion of the Jones criteria. This effort has resulted in the first substantial revision to the Jones criteria by the American Heart Association since 1992 and the first application of the Classification of Recommendations and Levels of Evidence categories developed by the American College of Cardiology/American Heart Association to the Jones criteria. Conclusions: This revision of the Jones criteria now brings them into closer alignment with other international guidelines for the diagnosis of acute rheumatic fever by defining high-risk populations, recognizing variability in clinical presentation in these high-risk populations, and including Doppler echocardiography as a tool to diagnose cardiac involvement.

    KW - acute rheumatic fever

    KW - AHA Scientific Statements

    KW - Doppler echocardiography

    KW - Jones criteria

    KW - rheumatic heart disease

    KW - subclinical carditis

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