Europe's heart beats for valvular heart disease: the urgent call to action

At a crucial moment for European public health, the Structural Heart Disease Coalition (SHD Coalition) is raising its voice, positioning valvular heart disease as an unavoidable priority on the European Union 's health agenda. Translated into Spanish as the Structural Heart Disease Coalition , it advocates for a coordinated and ambitious action plan for these patients.

The data reveal an alarming reality : despite their enormous prevalence and devastating impact on the quality of life of millions of Europeans, valvular heart disease remains underestimated and underdiagnosed . Up to 50% of severe cases are not diagnosed until advanced stages, resulting in avoidable hospitalizations , higher mortality , and a significant loss of quality of life. These diseases not only cause individual suffering but also impose a significant burden on national healthcare systems .

The SHD , a group that brings together patients, healthcare professionals, and industry, is contributing to awareness-raising and policy advocacy to ensure better care . Its main focus is on the urgent need to establish a European framework that ensures equitable access to early diagnosis, innovative treatments, and comprehensive rehabilitation programs for these patients.

The Coalition advocates for the explicit inclusion of structural heart disease in the European Cardiovascular Health Plan as a distinct area of action, ensuring that SHD-specific policy recommendations are reflected in the plan, and promoting a significant increase in EU and national funding for screening programs, public awareness, healthcare workforce training, and innovation.

The current European health program , known as EU4Health , has a defined duration: it began on January 1, 2021, and will remain in force until December 31, 2027. The next European health program has not yet been approved or formalized. Its content, objectives, and start date are yet to be defined, as they will largely depend on the new European political cycle following the 2024 elections and the configuration of the multiannual financial framework that will govern thereafter. However, it is known that, starting in 2025, the new EU health agenda for the period beyond 2027 has begun to take shape more clearly.

Valvulopathies, the great underestimated

The SHD Coalition explains to El Confidencial that valvular heart disease has remained underestimated "due to a combination of structural factors that affect both early detection and equity in access to care."

“First, early detection has not been prioritized in routine clinical practice, which means that the disease is often not identified until advanced stages , when therapeutic options are more limited and the impact on quality of life and healthcare costs is greater,” explains Rossina Funes of the SHD Coalition.

“Furthermore, its symptoms, such as fatigue , shortness of breath, or tiredness , are often confused with normal signs of aging , which significantly delays diagnosis . This confusion is especially common in older people, the most affected group,” he describes.

Furthermore, she adds as a reason that “ significant gender disparities persist : women experience delays in diagnosis , are underrepresented in clinical trials , and their symptoms are often misinterpreted , for example, by attributing them to menopause rather than heart disease, leading to worse health outcomes .”

“There is also a lack of sufficient public funding for systematic screening programs and for the creation of optimized referral pathways . All of this is exacerbated by the lack of coordination at the European Union level, which prevents a unified and effective response to this growing disease, especially in the context of Europe's aging population,” he concludes.

Among the Coalition's most notable proposals are the promotion of systematic cardiac auscultation in the population over 65 years of age, the analysis of evidence from echocardioscopy performed by non-cardiologist specialists in primary and hospital care , and the design of protocols for referral to hospital care for patients with suspected valvular disease and for follow-up in primary care .

Spain , with its Cardiovascular Health Strategy for the National Health System (ESCAV) , approved in 2022, is positioning itself as a European benchmark by explicitly including valvular heart disease as a strategic priority , promoting early diagnosis and shared protocols between primary and hospital care.

Among the coalition members is the prestigious Spanish cardiologist Jorge Solís , coordinator of the Cardiac Imaging Unit and Valvulopathy Unit at the 12 Octubre University Hospital and founding partner of Atria Clinic . Among his proposals, Dr. Solís emphasized the importance of a patient-centered approach , where prevention , early detection, and access to advanced therapies are fundamental pillars of any European strategy.

"In a continent seeking to protect the health of its citizens, including valvular heart disease as a priority in the European health plan is not only essential, but also a strategic investment in collective well-being," he noted in this regard.

Technologies, databases , AI and gender

Among the more tangible issues, they also addressed the use of new technological tools in diagnosis, treatment, monitoring, and clinical management. These include advanced echocardiography , minimally invasive valve interventions , and digital platforms for patient follow-up.

They have also highlighted the need to address databases, since the use of large volumes of clinical data (such as medical records, images, biomarkers , etc.) can be analyzed to improve knowledge and decision-making, which is key in personalized medicine .

In addition, they have highlighted in these meetings how AI algorithms allow for the automation of clinical tasks , the detection of patterns , the prediction of disease progression, and the support of diagnosis. For example, in valvular heart disease, AI can be used to analyze echocardiograms , predict risk of progression , or assist in selecting the type of intervention (surgical vs. transcatheter).

On the other hand, these meetings have also addressed the gender gap in cardiovascular diseases, including valvular heart disease, an aspect that is generating increasing attention in the medical community . Recognizing these differences is key because women often present atypical symptoms , receive later diagnoses , and have less access to certain treatments , which directly impacts their prognosis. Furthermore, many clinical studies have historically been based on male populations, limiting the applicability of current guidelines to women. Therefore, incorporating a gender perspective is not only a matter of equity, but also of improving the precision and effectiveness of cardiovascular care for all patients.

The meetings to achieve it

As part of this effort, the Coalition has actively participated in various high-level meetings, including a meeting held this July with European Commissioner Olivér Várhelyi . At this meeting, where the Coalition was represented by Eleonora Selvi and Dr. Jorge Solís, the Coalition presented its priorities for cardiovascular health .

Additionally, at the recent "SHD Coalition Advocacy Days" on June 24, the Spanish delegation, including Dr. Jorge Rodríguez-Roda Stuart , Dr. Maite San Saturnino , and Dr. Jorge Solís , met with key political figures: Lorena Boix Alonso , Margarita de la Pisa , Elena Nevado del Campo , Enrique Terol , and Nicolás González Casares .

At these meetings, the coalition's role has been to advocate for the inclusion of SHDs in the EPSCO Council (Ministers of Health). They have acted as a bridge between national parties, ministries, and the European Commission , building political support and providing specific reports and data for parliamentary work and public awareness .

Funes emphasizes that these meetings have left a "positive and encouraging" perception. "This political momentum represents a unique window of opportunity to ensure that cardiovascular diseases , specifically including structural heart disease (valve disease), are integrated into the strategic focus of the plan. Now is the time to translate this political will into concrete and sustainable actions," he adds.

In conclusion: the inclusion of valvular heart disease (VHD) in the European health agenda cannot wait . Clinical evidence, the drive of professionals and patients, and the current political momentum create a unique opportunity for the European Union to act decisively. Investing in early detection, technological innovation, a gender perspective, and patient-centered care will not only save lives but also reduce the healthcare and social costs of a still underestimated disease. The Structural Heart Disease Coalition has paved the way: now it is up to the European institutions to listen, prioritize, and act. Because the next European health program must also be the program that changes the destiny of millions of hearts .