Eligibility Criteria:
Inclusion Criteria:
* patients over 60 years old meet one of the following conditions.
1. moderate or above valvular heart disease as defined by echocardiography: (1)aortic stenosis, moderate or above, or valve area ≤1.5cm2, or maximal jet velocity ≥3.0m/sec, or mean pressure gradient ≥20mmHg, (2)aortic regurgitation, moderate or above, or jet width ≥25% of left ventricular outflow tract, or regurgitant volume ≥30ml/beat, or regurgitant fraction ≥30%, (3)mitral stenosis, moderate or above, or valve area ≤1.5cm2, (4)mitral regurgitation, moderate or above, or effective regurgitant orifice ≥0.2cm2, or regurgitant volume ≥30ml/beat, or regurgitant fraction ≥30%, (5)tricuspid stenosis, moderate or above, or valve area ≤1.0cm2, (6)tricuspid regurgitation, moderate or above, or central jet area ≥5.0cm2, (7)pulmonic stenosis, moderate or above, or maximal jet velocity \>4m/sec, (8)pulmonic regurgitation, moderate or above,
2. or patients who had undergone any operation on a cardiac valve (percutaneous balloon commissurotomy, valve repair, valve replacement, transcatheter aortic valve implantation),
3. or diagnosis of endocarditis as assessed by Duke criteria.
Exclusion Criteria:
* Patients cannot be followed up for any reasons. Patients have been enrolled in this study.