Recommendations for organization of care for adults with congenital heart disease and for training in the subspecialty of ‘Grown-up Congenital Heart Disease’ in Europe: a position paper of the Working Group on Grown-up Congenital Heart Disease of the European Society of Cardiology

Thanks to a better knowledge of the genetic causes of many diseases and an improvement in genetic testing techniques, genetics has gained an important role in the multidisciplinary approach to diagnosis and management of congenital heart disease and aortic pathology. With the introduction of strategies for precision medicine, it is expected that this will only increase further in the future. Because basic knowledge of the indications, the opportunities as well as the limitations of genetic testing is essential for correct application in clinical practice, this consensus document aims to give guidance to care-providers involved in the follow-up of adults with congenital heart defects and/or with hereditary aortic disease. This paper is the result of a collaboration between the ESC Working Group of Grown-Up Congenital Heart Disease, the ESC Working Group on Aorta and Peripheral Vascular Disease and the European Society of Human Genetics. Throughout the document, the importance of correct counseling in the process of genetic testing is emphasized, indications and timing for genetic studies are discussed as well as the technical modalities of genetic testing. Finally, the most important genetic diseases in adult congenital heart disease and aortic pathology are also discussed.

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The impact of the COVID-19 pandemic on application of European Society of Cardiology (ESC) guidelines for exercise in adults with congenital heart disease: a data-based questionnaire

Cardiology in the Young ◽

10.1017/s1047951121001864 ◽

2021 ◽

pp. 1-20

Author(s):

Sophie E Thompson ◽

Caitlin A Whitehead ◽

Alex S Notley ◽

Isabel A Guy ◽

Chethan R Kasargod Prabhakar ◽

...

Keyword(s):

Physical Activity ◽

Congenital Heart Disease ◽

Heart Disease ◽

European Society ◽

Congenital Heart ◽

Activity Levels ◽

Guideline Compliance ◽

Physical Activity Levels ◽

Esc Guidelines ◽

European Society Of Cardiology

Abstract Introduction Regular physical activity is safe and effective therapy for adults with congenital heart disease (ACHD) and is recommended by European Society of Cardiology (ESC) guidelines. The COVID-19 pandemic poses enormous challenges to healthcare teams and patients when ensuring guideline compliance. We explored the implications of COVID-19 on physical activity levels in ACHD patients. Materials and methods A data-based questionnaire was distributed to ACHD patients at a regional tertiary centre from October to November 2020. Results Prior to the COVID-19 pandemic, 96 (79.3%) of 125 respondents reported participating in regular physical activity, with 66 (52.8%) meeting target levels (moderate physical activity for at least 150 minutes per week). Commonest motivations for physical activity were general fitness (53.6%), weight loss (36.0%) and mental health benefits (30.4%). During the pandemic, the proportion that met target levels significantly decreased from 52.8% to 40.8% (p=0.03). The commonest reason was fear of COVID-19 (28.0%), followed by loss of motivation (23.2%) and gym/fitness centre closure (15.2%). Discussion The COVID-19 pandemic has negatively impacted exercise levels of ACHD patients. Most do not meet recommended physical activity levels, mainly attributable to fear of COVID-19. Even before the pandemic, only half of respondents met physical activity guidelines. Availability of online classes can positively impact exercise levels so could enhance guideline compliance. This insight into health perceptions and behaviors of ACHD patients may help develop quality improvement initiatives to improve physical activity levels in this population.

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Position paper of the European Society of Cardiology–working group of coronary pathophysiology and microcirculation: obesity and heart disease

European Heart Journal ◽

10.1093/eurheartj/ehx181 ◽

2017 ◽

Vol 38 (25) ◽

pp. 1951-1958 ◽

Cited By ~ 27

Author(s):

Lina Badimon ◽

Raffaele Bugiardini ◽

Edina Cenko ◽

Judit Cubedo ◽

Maria Dorobantu ◽

...

Keyword(s):

Heart Disease ◽

European Society ◽

Working Group ◽

Position Paper ◽

European Society Of Cardiology

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ESC-Leitlinie 2020 zur Behandlung von Erwachsenen mit angeborenem Herzfehler (ACHD)

Herz ◽

10.1007/s00059-020-05003-0 ◽

2020 ◽

Author(s):

Francisco Javier Ruperti-Repilado ◽

Corina Thomet ◽

Markus Schwerzmann

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

European Society ◽

Congenital Heart ◽

Adult Congenital Heart Disease ◽

Diagnostik Und Therapie ◽

Adult Congenital ◽

European Society Of Cardiology

ZusammenfassungIm August 2020 veröffentlichte die European Society of Cardiology (ESC) neue Leitlinien zur Behandlung von Erwachsenen mit angeborenem Herzfehler („adult congenital heart disease“, ACHD). Die bisherigen Empfehlungen des Jahres 2010 wurden den Entwicklungen der letzten 10 Jahre in Diagnostik und Therapie angepasst. Nach wie vor entsprechen die Empfehlungen aber nahezu ausschließlich einem Evidenzgrad C (Expertenmeinung oder Erkenntnisse aus kleinen respektive retrospektiven Studien oder Registerstudien). Wir sprechen von einer heterogenen Patientenpopulation mit einer Vielzahl von unterschiedlichen Herzfehlern und Korrektureingriffen, die sich dank sinkender perioperativer Mortalität und weiterer medizinischer Fortschritte in konstantem Wachstum befindet und älter wird. Die aktuellen Leitlinien sind dementsprechend nicht nur auf die akute Behandlung kardialer Probleme fokussiert, sondern legen das Augenmerk auf eine gesamtheitliche longitudinale Betreuung. Ergänzt werden diese allgemeinen Aspekte durch defektspezifische Empfehlungen, wobei v. a. Fortschritte bei Arrhythmiediagnose und -behandlung, invasiver Kardiologie sowie pulmonalarterieller Hypertonie zu wesentlichen Anpassungen führten. Erstmalig wird in den Leitlinien 2020 auch die Thematik von Koronaranomalien aufgegriffen.

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