Research Advances and Future Trends Supported by the National Natural Science Foundation
Imagine a 65-year-old woman in rural China who has been feeling increasingly breathless for months. She attributes it to aging, until a simple stethoscope examination reveals a heart murmur—the telltale sign of a malfunctioning heart valve.
Her case is far from unique. Across China, as the population rapidly ages, valvular heart disease (VHD) has emerged as a significant and growing public health challenge that affects millions 2 .
The heart's four valves function as precise one-way gates, ensuring blood flows in the correct direction through the heart's chambers. When these valves become narrowed (stenosis) or leaky (regurgitation), the heart must work harder to pump blood, potentially leading to heart failure, stroke, or sudden cardiac death.
Unlike in Western countries where age-related degeneration predominates, China presents a complex landscape of VHD, with both rheumatic and non-rheumatic forms contributing substantially to the disease burden 6 .
Thanks to the strategic funding from organizations like the National Natural Science Foundation of China (NSFC), established in 1986 as the main funding source for basic research in China, researchers are now unraveling the unique characteristics of valvular heart disease in the Chinese population 1 .
Diverse manifestations and geographic disparities characterize China's VHD landscape
Valvular heart disease encompasses several distinct conditions affecting different heart valves. The aortic valve controls blood flow from the heart to the body; the mitral valve regulates blood flow between the heart's left chambers; while the tricuspid and pulmonary valves manage blood flow on the right side of the heart.
What makes China's VHD landscape particularly complex are the striking geographic disparities in the disease's presentation. Research has revealed that multiple VHD is most common in eastern China, while isolated mitral regurgitation occurs most frequently in northern China 6 .
Multiple VHD
Isolated Mitral Regurgitation
Regional Variations
Overall Intervention Rate
The National Natural Science Foundation of China has played a pivotal role in advancing our understanding of valvular heart disease through its structured funding mechanisms. The NSFC's approach relies on expert review, collective decision-making, and merit-based selection to identify the most promising research directions 1 .
Designed to attract outstanding young talents from abroad to work in China, this program targets scholars born on or after January 1, 1985, who have obtained doctoral degrees and accumulated at least 36 months of consecutive overseas research experience 4 .
Supporting a broad range of scientific inquiry, these grants form the backbone of the NSFC's support system for established researchers pursuing innovative questions in cardiovascular science .
Recognizing that scientific progress thrives on global cooperation, these programs facilitate joint research initiatives between Chinese and international scientists 1 .
Recent analyses of cardiovascular research publications have identified several emerging hotspots in the field. Minimally invasive treatments for valve disease, circulatory hemodynamics, and hypertension prevention and control represent particularly active areas of investigation 5 .
To truly understand how valvular heart disease affects China's population, researchers launched the China-VHD Study—a prospective, multicenter, nationwide registry that enrolled 12,347 patients with moderate or severe native VHD from 46 tertiary hospitals across 31 provinces 2 .
Between April and June 2018, researchers consecutively enrolled adult patients presenting with moderate or severe VHD confirmed by echocardiography 6 .
Based on socioeconomic status, natural environments, and lifestyle factors, patients were categorized into five regional groups 6 .
Using standardized case report forms and electronic data capture systems, the study gathered detailed information on demographics and clinical characteristics 6 .
Patients were monitored for two years, with assessments tracking all-cause mortality, rehospitalization for heart failure, myocardial infarction, and stroke 6 .
Interactive chart showing regional distribution of VHD types and treatment rates
Perhaps the most striking finding concerned treatment disparities across regions. The overall rate of valve interventions was just 32.67%, meaning approximately two-thirds of patients with significant VHD did not receive procedural treatment 2 .
| Geographic Region | Valve Intervention Rate | Transcatheter Intervention Adoption | 2-Year Mortality/Rehospitalization Rate |
|---|---|---|---|
| Eastern China | Data not specified | Relatively low | Data not specified |
| Southern China | 48.46% (highest) | Relatively low | Data not specified |
| Western China | Data not specified | Relatively low | Highest |
| Northern China | Data not specified | Relatively low | Data not specified |
| Central China | Data not specified | Relatively low | Data not specified |
Source: China-VHD Study 2
Modern valvular heart disease research relies on a sophisticated array of technologies and methodologies
Primary method for diagnosing VHD severity, assessing cardiac chamber dimensions, and evaluating treatment success 6 .
Identifying research trends and hotspots by analyzing publication patterns across millions of scientific articles 5 .
Ensuring consistent, reliable data collection in large multicenter studies like the China-VHD registry 6 .
Enabling less invasive treatment approaches, particularly for high-risk surgical patients 2 .
These tools have enabled researchers to move beyond simple observation to predictive modeling and personalized treatment approaches. For instance, artificial intelligence techniques are now being used to analyze more than 2.5 million cardiovascular publications, helping identify emerging frontiers in VHD research 5 .
Already identified as one of the current research hotspots, with transcatheter approaches offering hope for patients who cannot undergo traditional open-heart surgery 5 .
The integration of health monitoring and artificial intelligence is poised to transform how we detect and manage valve disorders in their earliest stages 5 .
Initiatives like the Best of ESC Congress 2025 – China will bring the latest international guidelines and trial results directly to Chinese cardiology professionals 3 .
The interdisciplinary nature of modern cardiovascular research is particularly evident in valvular heart disease studies. Recent analyses have revealed extensive crossover relationships among document clusters from different research domains, highlighting how collaboration across traditional boundaries is driving innovation 5 . This integration of insights from basic science, clinical research, and public health approaches will be essential for addressing the complex challenges of valvular heart disease in China's diverse population.
The journey to understand and effectively treat valvular heart disease in China has revealed a condition of remarkable complexity and geographic diversity. Through the sustained support of organizations like the National Natural Science Foundation of China and the dedication of researchers across the nation, we have moved from a one-size-fits-all approach to recognizing the need for regionally tailored strategies that account for differences in disease patterns, healthcare resources, and patient characteristics.
While significant challenges remain—particularly in addressing treatment disparities and improving access to advanced therapies—the future of valvular heart disease care in China is promising. With ongoing research, international collaboration, and a commitment to translating scientific discoveries into clinical practice, we move closer to a day when every Chinese patient with valvular heart disease will receive timely, appropriate, and effective treatment, regardless of where they live.
This article was developed based on analysis of scientific publications and funding information from the National Natural Science Foundation of China. The content is intended for educational purposes and reflects the research available as of October 2025.