Arterial disease in the young

ESC CardioMed ◽  
2018 ◽  
pp. 775-778
Author(s):  
Marietta Charakida ◽  
John Deanfield
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Risk Factor ◽  
Congenital Heart ◽  
Cardiovascular Health ◽  
Adult Population ◽  
Arterial Disease ◽  
Ideal Cardiovascular Health ◽  
Reduce Risk ◽  
Reduce Risk Factor

The growing adult population with congenital heart disease (CHD) are getting older and their clinical presentation and outcomes are likely to be determined not only by their underlying CHD, but also by the development of acquired cardiovascular diseases such as atherosclerosis. This begins in childhood. The adult CHD population have multiple cardiovascular risk factors, as found in the general population, including obesity, smoking, and sedentary behaviour. Adults with complex congenital heart circulation are likely to be particularly vulnerable to the development of acquired arterial disease. Maintenance of ‘ideal cardiovascular health’ from childhood, is a key target, as leveraged gains can be achieved by early intervention to reduce risk factor exposure.

scholarly journals P1582 Outcomes, predictors and treatment of intraatrial reentrant tachycardias in Adult with Congenital Heart Disease

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Cambronero Cortinas ◽  
P Moratalla-Haro ◽  
A E Gonzalez-Garcia ◽  
P Avila-Alonso ◽  
M Bret-Zurita ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Tricuspid Regurgitation ◽  
Cardiovascular Events ◽  
Congenital Heart ◽  
Late Complication ◽  
Systolic Pressure ◽  
First Choice

Abstract Introduction and objectives Atrial tachycardia (AT) is a major late complication in congenital heart disease (CHD) after surgery. These arrhythmias arise between areas of anatomical barriers or in fibrotic tissue/scars. In our study we examined the clinical predictors of AT. Methods A retrospective study of cases and controls in adult patients with CHD was performed. We have included consecutively 71 patients with AT and 71 controls matched by gender, age and type of CHD located in the same database. Medical records, electrocardiograms and echocardiograms were reviewed. Multivariate analysis of the risk factor (logistic regression) and analysis of adverse cardiovascular events (Kaplan-Meier) were performed. Results Systolic pressure of subpulmonary ventricle ≥40mmHg (HR:7, 95%CI:2.4-18, p = 0.001), right atrium (RA) dilatation≥21cm2 (HR:3, 95%CI:1.2-7.6, p = 0.005), significant tricuspid regurgitation (HR:4, 95%CI:1.3-10, p = 0.018) were identified as main risk factors for AT. Patients with AT had worse outcomes with more major adverse cardiovascular events (86% vs 14%, P = 0.006), and a 58% free survival events compared to 98% of patients without AT at 8 years of follow-up (p = 0.01). The treatment of the first episode of AT was electrical cardioversion (38%), pharmacological cardioversion (13%), heart rate control (20%). Antiarrhythmic treatment was not been given in 30% of the patients 73% of them had percutaneous ablation as first choice treatment. Ablation was performed in 40 pacientes and 6 patients have recurrences. In total, 24 patients have recurrences of AT. Previous Maze (OR 9 (IC al 95% 1.5, 50), p = 0.016) and surgical paliative shunt (OR 21 (IC al 95% 2.3,192), p = 0.007) were identified as main risk factor for AT recurrences. Conclusions The main risk factors identified for AT were RA dilatation, raised systolic pressure of subpulmonary ventricle and significant tricuspid regurgitation. The main risk factors for AT recurrences were previous Maze and surgical paliative shunt. Early treatment of these arrhythmic problems is mandatory in order to improve the prognosis in this group of patients. Abstract P1582 Figure. Central illustration of AT in CHD

scholarly journals Using Cluster Analysis to Explore Associations between Cardiovascular Risk and Lifestyle Factors in a Workplace Wellness Program

2021 ◽  
Vol 5 (1) ◽  
pp. 30-41
Author(s):  
Heather Carter-Templeton ◽  
Gary Templeton ◽  
Barbara Ann Graves ◽  
Leslie G. Cole
Keyword(s):  
Risk Factors ◽  
Cluster Analysis ◽  
Risk Factor ◽  
Cardiovascular Health ◽  
The United States ◽  
Workplace Wellness ◽  
Wellness Program ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Ideal Cardiovascular Health

Background: Cardiovascular disease (CVD) is the number one cause of death in the United States with risk factors including hypertension, hyperlipidemia, diabetes, obesity, smoking, physical inactivity, age, genetics, and unhealthy diets. A university-based workplace wellness program (WWP) consisting of an annual biometric screening assessment with targeted, individualized health coaching was implemented in an effort to reduce these risk factors while encouraging and nurturing ideal cardiovascular health.Objective: The purpose of this study was to examine and describe the prevalence of single and combined, or multiple, CVD risk factors within a workplace wellness dataset.Methods: Cluster analysis was used to determine CVD risk factors within biometric screening data (BMI, waist circumference, LDL, total cholesterol, HDL, triglycerides, blood glucose age, ethnicity, and gender) collected during WWP interventions.Results: The cluster analysis provided visualizations of the distributions of participants having specific CVD risk factors. Of the 8,802 participants, 1,967 (22.4%) had no CVD risk factor, 1,497 (17%) had a single risk factor, and 5,529 (60.5%) had two or more risk factors. The majority of sample members are described as having more than one CVD risk factor with 78% having multiple.Conclusion: Cluster analysis demonstrated utility and efficacy in categorizing participant data based on their CVD risk factors. A baseline analysis of data was captured and provided understanding and awareness into employee health and CVD risk. This process and analysis facilitated WWP planning to target and focus on education to promote ideal cardiovascular health.

scholarly journals First-Trimester Maternal Folic Acid Supplementation Modifies the Effects of Risk Factors Exposures on Congenital Heart Disease in Offspring

Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 724
Author(s):  
Yanji Qu ◽  
Shao Lin ◽  
Michael S. Bloom ◽  
Ximeng Wang ◽  
Zhiqiang Nie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Risk Factor ◽  
Folic Acid ◽  
Congenital Heart ◽  
First Trimester ◽  
Folic Acid Supplementation ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
Maternal Risk Factor

This study aimed to examine effect modification of maternal risk factor exposures and congenital heart disease (CHD) by maternal folic acid supplementation (FAS)/non-FAS. We included 8379 CHD cases and 6918 CHD-free controls from 40 clinical centers in Guangdong Province, Southern China, 2004–2016. Controls were randomly chosen from malformation-free fetuses and infants and frequency matched to the echocardiogram-confirmed cases by enrollment hospital and year of birth. We used multiple regression models to evaluate interactions between FAS/non-FAS and risk factors on CHDs and major CHD categories, adjusted for confounding variables. We detected statistically significant additive and multiplicative interactions between maternal FAS/non-FAS and first-trimester fever, viral infection, and threatened abortion on CHDs. An additive interaction on CHDs was also identified between non-FAS and living in a newly renovated home. We observed a statistically significant dose-response relationship between non-FAS and a greater number of maternal risk factors on CHDs. Non-FAS and maternal risk factors interacted additively on multiple critical CHDs, conotruncal defects, and right ventricular outflow tract obstruction. Maternal risk factor exposures may have differential associations with CHD risk in offspring, according to FAS. These findings may inform the design of targeted interventions to prevent CHDs in highly susceptible population groups.

scholarly journals Frequency and risk factors of acute and permanent femoral arterial occlusion in neonates with congenital heart disease who undergo ultrasound˗guided femoral arterial access

2021 ◽  
Author(s):  
Mahmut GOKDEMIR ◽  
Nimet CINDIK
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Congenital Heart ◽  
Independent Risk Factor ◽  
Arterial Occlusion ◽  
Coarctation Of The Aorta ◽  
Arterial Access ◽  
Femoral Arterial Access

Background: In neonates, securing femoral arterial access is challenging and time consuming even in experienced hands. Data on frequency and risk factors of ALAP and PFAO are scarce in neonates with CHD. We investigated frequency and risk factors of acute loss of the arterial pulse (ALAP) and permanent femoral arterial occlusion (PFAO) in neonates with congenital heart disease (CHD) underwent ultrasound˗guided femoral arterial access (US˗GFAA). Methods: We divided the patients into groups according to the presence of ALAP and PFAO. We obtained data related to patient characteristics and access variables of US˗GFAA from our database of pediatric cardiac catheterization between August 2017 and May 2021. We used an echocardiography˗S6, 12˗MHz linear probe, 21˗gauge needle, and a 0.018”guidewire for arterial access. A 4˗French sheath (7cm) was placed in all patients. Results: US˗GFAA was obtained in 323(98.8%) of the 327 neonates. We identified ALAP in 130(40.2%) patients and PFAO in 19(5.9%) patients. Median weight was 3.05(IQR: 2.80˗3.40) kg, first attempt success rate was 88.2% and median access time was 46 sec (IQR: 23˗94). Logistic regression analysis identified coarctation of the aorta (Odds ratio: 2.46; 95% CI: 1.30˗4.66; P=0.006) as independent risk factor for ALAP, but did not identify any independent risk factors for PFAO. Conclusion: This study showed that coarctation of the aorta is an independent risk factor for ALAP in neonates with CHD underwent US˗GFAA and placed a 4˗French sheath. Although most cases of ALAP resolve in the early period, the frequency of PFOA remains high despite effective treatment.

Abstract MP01: Ideal Cardiovascular Health is Low Among U.S. Workers 45 Years and Older: Results of a National Population-based Cohort Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Leslie A MacDonald ◽  
Stephen Bertke ◽  
Misty J Hein ◽  
Suzanne Judd ◽  
Sherry Baron ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Racial Differences ◽  
Older Workers ◽  
Cardiovascular Health ◽  
Population Based ◽  
Office Work ◽  
Service Workers ◽  
Ideal Cardiovascular Health ◽  
Occupation Group

Purpose: We examined the prevalence of ideal cardiovascular health of workers within a national U.S. population-based cohort. Methods: Participants included 5,566 black and white men and women age 45 and older who were employed and free of CHD/stroke when enrolled into the REasons for Geographic and Racial Differences in Stroke Study. Clinical and behavioral cardiovascular risk factor data were obtained at enrollment. Ideal CVH (iCVH) was assessed from seven modifiable CVD risk factors based on the AHA’s Life’s Simple 7. Three clinical (blood pressure (BP), total cholesterol, fasting glucose) and 4 behavioral (physical activity, smoking, diet quality, BMI) factors were each scored according to AHA criteria. Jobs held at enrollment were grouped into aggregate standard occupational groups. National prevalence estimates were computed using SAS Survey Logistic with weights based on actual sampling probabilities of the sub-sample. In significance testing, each occupation group was compared with all other groups combined, adjusting for age, race, sex, and region (stroke-belt, other). Results: The prevalence of iCVH among older workers free of CHD/stroke is low. Although 88% were non-smokers and 78% had ideal glucose, 41% or less achieved ideal levels of all other risk factors. Management/professionals had higher ideal BP and BMI, and were more likely to be non-smokers and physically active; however those employed in business and finance were more likely to have a poor diet (72%). Ideal BP was highest for healthcare practitioners (43%) and those employed in the arts, entertainment, sports and media (47%). Service workers were more likely to have uncontrolled BP, glucose and cholesterol, have lower ideal BMI, and smoke. Uncontrolled BP was high among sales workers (23%) and highest (35%) among those in protective services (e.g., police, firefighters). Dyslipidemia was highest (22%) among personal care and service workers. Obesity was highest among those employed in healthcare support (54%) and food preparation and serving (55%). Those in sales and low status office work were more likely to smoke (17%) and be inactive (38%). Skilled laborers in installation, maintenance and repair had low dyslipidemia (5%), but had the lowest ideal BMI (10%). Transportation and material moving workers had high uncontrolled BP (24%) and the highest smoking prevalence (22%). Conclusions: The prevalence of iCVH among older workers free of CHD/stroke is low, but substantial differences in CVH exist by occupation. Targeted screening and health promotion is warranted to accommodate the information, resource, and schedule needs of older workers employed in diverse occupational settings with different clinical and behavioral risk factor profiles.

Subclinical atherosclerosis in children and adolescents with congenital heart disease

2020 ◽  
pp. 1-8
Author(s):  
Silvia M. Cardoso ◽  
Michele Honicky ◽  
Yara M. F. Moreno ◽  
Luiz R. A. de Lima ◽  
Matheus A. Pacheco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Clinical Characteristics ◽  
Congenital Heart ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness

Abstract Background: Subclinical atherosclerosis in childhood can be evaluated by carotid intima-media thickness, which is considered a surrogate marker for atherosclerotic disease in adulthood. The aims of this study were to evaluate carotid intima-media thickness and, to investigate associated factors. Methods: Cross-sectional study with children and adolescents with congenital heart disease (CHD). Socio-demographic and clinical characteristics were assessed. Subclinical atherosclerosis was evaluated by carotid intima-media thickness. Cardiovascular risk factors, such as physical activity, screen time, passive smoke, systolic and diastolic blood pressure, waist circumference, dietary intake, lipid parameters, glycaemia, and C-reactive protein, were also assessed. Factors associated with carotid intima-media thickness were analysed using multiple logistic regression. Results: The mean carotid intima-media thickness was 0.518 mm and 46.7% had subclinical atherosclerosis (carotid intima-media thickness ≥ 97th percentile). After adjusting for confounding factors, cyanotic CHD (odds ratio: 0.40; 95% confidence interval: 0.20; 0.78), cardiac surgery (odds ratio: 3.17; 95% confidence interval: 1.35; 7.48), and be hospitalised to treat infections (odds ratio: 1.92; 95% confidence interval: 1.04; 3.54) were associated with subclinical atherosclerosis. Conclusion: Clinical characteristics related to CHD were associated with subclinical atherosclerosis. This finding suggests that the presence of CHD itself is a risk factor for subclinical atherosclerosis. Therefore, the screen and control of modifiable cardiovascular risk factors should be made early and intensively to prevent atherosclerosis.

Risk Factors for Gross Motor Dysfunction in Infants With Congenital Heart Disease

2011 ◽  
Vol 24 (3) ◽  
pp. 246-258 ◽  
Author(s):  
Suzanne H. Long ◽  
Bev J. Eldridge ◽  
Mary P. Galea ◽  
Susan R. Harris
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Motor Dysfunction ◽  
Gross Motor

Nineteen Years of Adult Congenital Heart Surgery in a Single Center

2017 ◽  
Vol 8 (2) ◽  
pp. 182-188
Author(s):  
Madurra Perinpanayagam ◽  
Signe H. Larsen ◽  
Kristian Emmertsen ◽  
Marianne B. Møller ◽  
Vibeke E. Hjortdal
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Postoperative Complications ◽  
Adverse Events ◽  
Congenital Heart ◽  
Postoperative Bleeding ◽  
Registration System ◽  
Growing Population

Background: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort. Methods: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System. Results: Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%). Conclusion: Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.

Socio-hygienic and biomedical risk factors for congenital heart disease in children

2018 ◽  
pp. 116-119
Author(s):  
T.I. Nelunova ◽  
T.E. Burtseva ◽  
V.G. Chasnyk ◽  
S.A. Evseeva
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart
Sign in / Sign up

Export Citation Format

Share Document