scholarly journals Atherosclerosis risk factors may be underestimated in patients with pulmonary hypertension associated with congenital heart disease – results of Polish snapshot registry

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Mamzer ◽  
G Kopec ◽  
B Kusmierczyk-Droszcz ◽  
W Skowron ◽  
E Mroczek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Congenital Heart ◽  
Young Patients ◽  
Risk Of Death ◽  
Funding Sources ◽  
History Of ◽  
Atherosclerosis Risk Factors

Abstract Introduction Classic risk factors of atherosclerosis may contribute to cardiovascular (CV) risk in patients (pts) with pulmonary hypertension associated with congenital heart disease (PAH-CHD), but their prevalence is poorly studied. Purpose We evaluated a large cohort of Polish PAH-CHD patients (PAHpts) treated with specific therapies with regard to prevalence of classic risk factors for atherosclerosis. Methods A multicenter observational snapshot registry was conducted under the auspices of Polish Cardiac Society to study PAH pts, identified in centers treating >5 such pts in years 2008–2018. The analysis included 250 PAH-CHD pts, including non-corrected CHD – predominantly Eisenmenger Syndrome (Gr. 1, 224 pts, mean age 42±2 years, 63% females) and pts after heart disease correction (Gr. 2, 26 pts, mean age 42±6.5 years, 62% females). The incidence of classic CV risk factors was compared in both groups. Results The prevalence of risk factors was considerable considering young age of the cohort and statistically similar in both groups (Figure). Hypertension was present in 14% in Gr. 1 and 15% in Gr. 2. The incidence of diabetes was comparable in both groups (3% vs. 4%). Hyperlipidemia was nearly numerically twice as frequent in Gr. 1 (23% vs. 12%, p=0.18). Current smokers (1%) were only present in Gr. 1, while history of smoking was 4% in both groups. Symptomatic atherosclerosis of peripheral arteries was twice as frequent in Gr. 1 (8% vs. 4%, p=0,71). There was no difference regarding prior stroke (3,6% vs 4%, p=0,63). Chronic kidney disease and atrial fibrillation were one and a half more often in Gr. 1 (respectively, 12% vs. 8%, p=0,81; 12% vs. 8%, p=0.75). Mean heart rate was 72±2 bpm in Gr. 1 and 77±7 bpm in Gr. 2. Gastrointestinal bleeding was reported only in Gr. 1 (2.7%). SCORE calculated risks were low due to low age, but high risk was identified in 9.3% of Gr. 1 and 20% of Gr. 2 (p=0.096). Conclusions Based on our data from national survey, classic atherosclerosis CV risk factors are not uncommon in the population of relatively young patients with PAH-CHD, parallel to improved longevity. Selected pts from both groups present with elevated risk of death from atherosclerotic complications. This finding may influence the overall mortality risk in PAH-CHD population and reflects new challenges in management despite progress in specific therapies of pulmonary hypertension. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

scholarly journals Incidence and Risk Factors of Congenital Heart Disease in Qingdao: A Prospective Census Study

2020 ◽  
Author(s):  
Xiao Jin ◽  
Wei Ni ◽  
Guoju Li ◽  
Guolan Wang ◽  
Qin Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
High School ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Family History ◽  
Poisson Regression ◽  
Birth Defect ◽  
Congenital Heart ◽  
High School Degree ◽  
History Of

Abstract Background The incidence of congenital heart disease (CHD) were greatly inconsistent among many studies with a range from 4/1,000 to 50/1,000. A large prospective population study was performed to investigate the incidence and find risk factors of congenital heart disease (CHD) during fetal and neonatal period.Methods A prospective cohort study was conducted in Qingdao, China, from August 1, 2018 to April 30, 2019. All local registered pregnant were continuously investigated and followed from the first trimester to delivery, collecting the characteristics of pregnant and their newborns. A Poisson regression model was applied to assess the association between CHD and possible risk factors.Results The incidence of fetal CHD and neonatal CHD are 15.84 per 1000 fetuses and 7.32 per 1000 live births, respectively. Results from Poisson regression indicated that, countryside (0.821; 95% CI, 0.730-0.920) and first gestation (0.890; 95% CI, 0.813-0.975) was negatively associated with CHD. However, paternal factors such as multi-fetal infants (RR: 1.631, 95% confidence interval, CI: 1.276-2.036), greater than high school degree (1.390; 95% CI, 1.129-1.701), illness in 1st trimester (1.214; 95% CI, 1.080-1.359), family history of CHD (2.480; 95% CI, 1.362-3.967), and having a baby with birth defect before (1.780; 95% CI, 1.300-2.345) were positive associated with CHD.Conclusion The incidence of CHD in Qingdao was similar to existing research. Compared with neonate, the incidence of CHD is higher in fetal. Multi-fetal infants, greater than high school degree, illness in 1st trimester, family history of CHD and having a baby with birth defect before were correlated with an increased risk of CHD. This prospective study would provide great implications for on CHD intervention.

scholarly journals Mortality and morbidity in patients with congenital heart disease hospitalised for viral pneumonia

Heart ◽  
2020 ◽  
pp. heartjnl-2020-317706
Author(s):  
Gerhard-Paul Diller ◽  
Dominic Enders ◽  
Astrid E Lammers ◽  
Stefan Orwat ◽  
Renate Schmidt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Admission ◽  
Congenital Heart ◽  
Viral Pneumonia ◽  
Morbidity And Mortality ◽  
Risk Of Death ◽  
Extracorporeal Lung Support ◽  
Cardiac Medication

ObjectivesData on the clinical outcome of patients with congenital heart disease (CHD) affected by severe viral pneumonia are limited. We analysed morbidity and mortality of viral pneumonia and evaluated the association between medical conditions, medication, vaccination and outcome specifically in patients with CHD requiring hospitalisation for viral pneumonia.MethodsBased on data from one of Germany’s largest health insurers, all cases of viral pneumonia requiring hospital admission (2005–2018) were studied. Mortality, and composites of death, transplantation, mechanical circulatory support, ventilation or extracorporeal lung support served as endpoints.ResultsOverall, 26 262 viral pneumonia cases occurred in 24 980 patients. Of these, 1180 cases occurred in patients with CHD. Compared with patients without CHD, mortality rate was elevated in patients with CHD. As a group, patients with CHD aged 20–59 years even exceeded mortality rates in patients without CHD aged >60 years. No mortality was observed in patients with CHD with simple defects <60 years of age without associated cardiovascular risk factors. On multivariable logistic regression analysis, age, CHD complexity, chromosomal anomalies, cardiac medication, use of immunosuppressants and absence of vaccination for influenza emerged as risk factors of adverse outcome.ConclusionsWe present timely data on morbidity and mortality of severe viral pneumonia requiring hospital admission in patients with CHD. Need for mechanical ventilation and risk of death in CHD increase early in life, reaching a level equivalent to non-CHD individuals >60 years of age. Our data suggest that except for patients with isolated simple defects, patients with CHD should be considered higher-risk individuals when faced with severe viral pneumonia.

Abstract 15592: Role of Electroanatomic Voltage Mapping for Risk Stratification in Patients With Repaired Congenital Heart Disease Involving the Right Ventricle

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Vincenzo Pazzano ◽  
Rosalinda Palmieri ◽  
Corrado Di Mambro ◽  
Mario S Russo ◽  
Massimo S Silvetti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Low Voltage ◽  
Scar Tissue ◽  
Adult Patients ◽  
Surface Ecg ◽  
Life Threatening ◽  
History Of

Introduction: Among adult patients with previous surgical correction for Tetralogy of Fallot or other repaired Congenital Heart Disease (rCHD) involving the RV, ventricular arrhythmias (VA) and sudden cardiac death (SCD) represent a late complication. The imparied haemodynamics that lead to RV dilatation and overload could also alterate its electroanatomic structure. Hypothesis: 3D electroanatomic mapping (EAM) of the RV could confirm the presence of myocardial electrical abnormalities, allowing to better identify patients at risk for life-threatening arrhythmias. Methods: 146 patients (age 19.2 ±7.0) with rCHD involving the RV were selected from a population undergoing routine post-surgical follow-up, according to the presence of VA or severe RV dilatation. These patients underwent 3D EAM of the RV. We tested the correlation between size of scar tissue (areas with voltage < 0.5 mV) and several parameters universally accepted by the literature as risk factors for VA in this particular patient population. Results: In 125 (85.6%) patients, EAM demonstrated areas of low voltage in the antero-lateral RVOT. In 20 of these (16%, 13.7% of the total) the scar extended to the septum. 72 (49.3%) had a peritricuspid scar, and in 20 (13.7%) other areas of the RV were interested. Total low-voltage area, expressed as % of total endocardial area, was significantly higher in patients with history of PVCs [3.2% (±2.6) vs 2.2% (±1.8), p<0.05], complex PVCs at 24h-Holter ECG (Lown class ≥2) [3.4 (±2.5) vs 2.6 (±2.3), p<0.05], exercise-inducible PVCs [3.8 (±2.4) vs 2.6 (±2.2), p=0.01] and history of previous shunt [4.0 (±2.7) vs 2.6 (±2.2), p=0.01]. Scar size was also positively correlated with age (p=0.01), age at correction (p=0.01) and QRS duration on surface ECG (p<0.05). Conclusions: In patients with rCHD involving the RV it is common to observe endocardial low-voltage areas with variable distribution, not always corresponding to the sites of surgical lesion. Morover, the size of the scar tissue area correlates with some of the parameters which have been already identified as risk factors for life-threatening arrhythmias and SCD in adult patients with CHD. We suggest that EAM should become part of the routine tests for the stratification of arrhythmic risk in this population.

scholarly journals Pulmonary hypertension after operations for congenital heart disease: Analysis of risk factors and management

1996 ◽  
Vol 112 (6) ◽  
pp. 1600-1609 ◽  
Author(s):  
Ko Bando ◽  
Mark W. Turrentine ◽  
Thomas G. Sharp ◽  
Yasuo Sekine ◽  
Thomas X. Aufiero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Congenital Heart ◽  
Disease Analysis

Risk factors for loss to follow-up among children and young adults with congenital heart disease

2011 ◽  
Vol 22 (3) ◽  
pp. 307-315 ◽  
Author(s):  
Andrew S. Mackie ◽  
Gwen R. Rempel ◽  
Kathryn N. Rankin ◽  
David Nicholas ◽  
Joyce Magill-Evans
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Congenital Heart ◽  
Family Income ◽  
Loss To Follow Up ◽  
History Of

AbstractObjectiveTo identify risk factors for loss to cardiology follow-up among children and young adults with congenital heart disease.MethodsWe used a matched case-control design. Cases were born before January, 2001 with moderate or complex congenital heart disease and were previously followed up in the paediatric or adult cardiology clinic, but not seen for 3 years or longer. Controls had been seen within 3 years. Controls were matched 3:1 to cases by year of birth and congenital heart disease lesion. Medical records were reviewed for potential risk factors for loss to follow-up. A subset of cases and controls participated in recorded telephone interviews.ResultsA total of 74 cases (66% male) were compared with 222 controls (61% male). A history of missed cardiology appointments was predictive of loss to follow-up for 3 years or longer (odds ratio 13.0, 95% confidence interval 3.3–51.7). Variables protective from loss to follow-up were higher family income (odds ratio 0.87 per $10,000 increase, 0.77–0.98), cardiac catheterisation within 5 years (odds ratio 0.2, 95% confidence interval 0.1–0.6), and chart documentation of the need for cardiology follow-up (odds ratio 0.4, 95% confidence interval 0.2–0.8). Cases lacked awareness of the importance of follow-up and identified primary care physicians as their primary source of information about the heart, rather than cardiologists. Unlike cases, controls had methods to remember appointments.ConclusionsA history of one or more missed cardiology appointments predicted loss to follow-up for 3 or more years, as did lack of awareness of the need for follow-up. Higher family income, recent catheterisations, and medical record documentation of the need for follow-up were protective.

scholarly journals Evolution of biventricular T1 values in patients with right-sided congenital heart disease

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
O Burdet ◽  
AG Pavon ◽  
J Bouchardy ◽  
C Blanche ◽  
P Monney ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Interstitial Fibrosis ◽  
Pulmonary Stenosis ◽  
Pulmonary Regurgitation ◽  
Native T1 ◽  
Funding Sources ◽  
Basal Slice ◽  
Relationship Of

Abstract Funding Acknowledgements Type of funding sources: None. Background Conflicting reports exist on the prevalence and clinical impact of interstitial fibrosis in right ventricular (RV) congenital heart disease (CHD). This study evaluates the longitudinal evolution of native myocardial T1 relaxation time (T1) in RV CHD. Methods On a 1.5T scanner, an ECG-triggered modified Look-Locker inversion recovery sequence (scheme 3(3)3(3)5) was acquired on a short-axis basal slice covering the RV and left ventricle (LV) on two consecutive CMR exams. Global and segmental (LV = 6, RV = 4) RV and LV T1 values  were calculated (Figure). Results Mean time between CMR exams for 36 included patients (age 34 ± 2y) was 22 ± 2 months. All LV segments and 81/88% of RV segments of first and second CMR could be analyzed, respectively.  T1 increased mildly but not significantly (table). There was no relationship of T1 to pulmonary regurgitation fraction, pulmonary stenosis or RV enddiastolic volume (p &gt; 0.05). Global RV T1 of the second CMR was related to RV ejection fraction (RVEF): r = 0.353, 3.0 ± 1.4, p = 0.038. T1 of the infero-septal LV segment of first and second CMR, global LV T1 of second CMR and increase of T1 of global LV, anterior, antero-lateral and –septal LV segments, were related to age at CMR: r = 0.333 - 0.463, p &lt; 0.05, respectively. Conclusions Native T1 values increased mildly in patients with stable RV CHD, which was not statistically significant probably due to the short to median follow-up. Global RV T1 appears to be related to RVEF which could be sign of increasing interstitial fibrosis whereas the relationship of LV T1 to age might be a physiological finding. First CMR native T1 (ms) Second CMR native T1 (ms) p LV Global 1007 ± 37 1014 ± 39 0.413 LV Anterior 994 ± 53 999 ± 54 0.710 LV Antero-lateral 965 ± 63 981 ± 58 0.186 LV Infero-lateral 1000 ± 52 1004 ± 63 0.695 LV Inferior 1035 42 1037 ± 50 0.744 LV Infero-septal 1028 ± 35 1036 ± 43 0.282 LV Antero-septal 1016 ± 38 1024 ± 48 0.347 RV Global 1091 ± 90 1096 ± 85 0.410 RV Inferior 1112 ± 104 1115 ± 118 0.696 RV Infero-lateral 1061 ± 130 1077 ± 115 0.425 RV Antero-lateral 1046 ± 127 1080 ± 109 0.088 RV Anterior 1088 ± 156 1108 ± 154 0.410 Abstract Figure. Determination of biventricular T1 values

Sign in / Sign up

Export Citation Format

Share Document