Intra-atrial re-entrant tachycardia in patients with congenital heart disease: factors associated with disease severity

AbstractObjectives: The purpose of this study was to investigate whether the objective medical parameters related to congenital heart disease and patients’ ratings of cardiac disease severity were related to psychological well-being and illness behaviour during the pre-operative period.Methods: A total of 143 patients (63 male patients; 16–73 years old) with congenital heart disease evaluated the severity of their cardiac condition using a numerical rating scale ranging from 0, indicating the least severe condition, to 100, indicating the most severe condition. Psychological well-being was assessed using the Psychological General Well-Being Index (total score ≤60 indicating severe distress) and illness behaviour using the Illness Behavior Questionnaire.Results: Pre-operative psychological well-being was not related to the objective medical parameters reflecting cardiac disease severity. In contrast, total psychological well-being scores correlated significantly with patients’ subjective ratings of disease severity (p < 0.001). When compared with the reference values from the Italian population, the mean scores of the patients on psychological well-being were similar. As regards the Illness Behavior Questionnaire, the scores on denial were higher and those on hypochondria were lower compared with other hospitalised patients.Conclusions: This study shows that the perception of cardiac disease severity, and not the medical parameters in congenital heart disease, is related to the patients’ pre-operative psychological state. Thus, more importance needs to be given to assessing the patients’ pre-operative perception and psychological state independently of cardiac severity. Targeted interventions with regard to the cardiac condition are recommended.

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A United Network for Organ Sharing analysis of heart transplantation in adults with congenital heart disease: Outcomes and factors associated with mortality and retransplantation

Yearbook of Cardiology ◽

10.1016/j.ycar.2011.04.010 ◽

2011 ◽

Vol 2011 ◽

pp. 168-169 ◽

Cited By ~ 3

Author(s):

V.H. Thourani

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Heart Transplantation ◽

Congenital Heart ◽

Factors Associated ◽

Disease Outcomes ◽

United Network

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Abstract 14215: Cognitive Impairment in Adult Congenital Heart Disease Survivors: A Pilot Study

Circulation ◽

10.1161/circ.142.suppl_3.14215 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Carla P Rodriguez Monserrate ◽

Rajeshwari Jakkam ◽

Emily Clay ◽

Kimberlee Gauvreau ◽

Michelle Z GURVITZ

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Pilot Study ◽

General Population ◽

Ventricular Function ◽

Congenital Heart ◽

Education Level ◽

Factors Associated

Introduction: The most common comorbidities in children with congenital heart disease (CHD) are neurodevelopmental and psychosocial impairments, particularly in areas of executive function, memory, attention, and behavioral control. Limited studies in the adult CHD population suggest similar impairments exist and adults with CHD may be at increased risk for dementia. No studies have screened specifically for mild cognitive impairment and dementia in adult CHD patients. Methods: We performed a prospective cross-sectional study of adult CHD patients, ages 30-65 years, who were coming for routine clinic visits. We administered the Mini-Mental State Exam (MMSE) and scores were compared with population norms adjusted by age and education level. We also evaluated the association of MMSE scores with CHD complexity, demographic and clinical risk factors. Results: A total of 125 patients were recruited (55% male). The median age was 40 years (range 30-65). Almost all participants (97%) had a high school degree and 75% had some college education or advanced degrees. The majority of patients (94%) had moderate or complex CHD. Adjusting for age and education, CHD participants scored significantly lower than the general population (median 1 point lower, p=0.001). The greatest impairments occurred in recall and orientation. Factors associated with lower scores included decreased systemic ventricular function (p=0.028) and having ≥2 cardiac catheterizations (p=0.006). Five percent of the total cohort met the general threshold for mild cognitive impairment (MMSE<24). Clinical factors associated with this degree of cognitive impairment were duration of cyanosis (p=0.005) and decreased systemic ventricular function (p=0.003). Conclusions: Our pilot study showed that, when adjusted for age and education level, adult CHD patients had significantly lower MMSE scores than the general population, with 5% meeting criteria for mild cognitive impairment. These findings suggest that subtle and early neurodevelopmental changes are present in the adult CHD population. Further studies are needed to investigate those changes and evaluate potential disease modifying therapies that might influence long-term outcomes in the adult CHD population.

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