Abstract 17639: Predictors of Poor Neurocognitive Performance and Neuropsychological Phenotypes in Adolescents and Young Adults With Congenital Heart Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Maria Emilia G Areias ◽  
Bruno Peixoto ◽  
Ana Carolina Pinheiro ◽  
Helena Monteiro ◽  
Sara Filipa Araújo ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Psychiatric Morbidity ◽  
Attention Problems ◽  
The Other ◽  
Self Report ◽  
Healthy Controls ◽  
Neurocognitive Performance ◽  
Psychiatric Interview

Objectives: to determine the predictors of neurocognitive performance (NP) of patients with Congenital Heart Disease (CHD), analysing its relation to parameters of fetal development, as head circumference (HC), weight (W) and length (L) at birth, neonatal parameters (APGAR 1, 5), quality of life (QOL), psychiatric morbidity (PM), psychosocial adjustment (PSA) and traits of personality (TP); to identify different phenotypes of NP in CHD patients. Methods: 337 CHD patients, 189 male, ages 12 to 30 years (mean= 16.34 ± 3.12), 117 cyanotic, and 119 healthy controls (56 males, mean=18.41±3.20) participated. Clinical data were collected. Neuropsychological assessment included Wechsler’s Digit Test (direct and reverse) and Symbol Search, Rey’s Complex Figure, BADS’s Key Searching Test, Color-Word Stroop Test, Trail Making Test (A, B) and Logical Memory Task. Participants were interviewed on social support, family educational style, self-image, physical limitations, completed a psychiatric interview (SADS-L) and self-report questionnaires on QOL (WHOQOL-BREF), PSA (YSR and ASR) and TP (NEOPI-R). HC, W and L and APGAR were collected. Results: CHD patients had a significantly worse NP than healthy controls in all tests, and the cyanotic worse than the acyanotic patients. Several correlations were apparent between fetal parameters (HC, W and L) and neuropsychological abilities in CHD. However, the HC was the main predictor of bad NP later on in CHD patients (R=0.435; R2=0.189; F=14.692; p=0.000; β=0.201; t=2.487; p=0.016). We identified 3 neurocognitive phenotypes in CHD patients, minimally, moderately and globally impaired. The last showed lower HC (p=0.003), W (p=0.022) and L, and a bigger number of retentions in school (p=0.017) than the first. The last reported more aggressive behaviors.than the other 2 (p=0.007; p=0.006) and their caregivers reported more social (p=0.025), thought (p=0.041) and attention problems (p=0.001) in their children than the parents of the other 2. Conclusion: CHD patients have worse NP than controls; small HC at birth was the main predictor of poor NP; We identified 3 patterns of neurocognitive disability among CHD patients: mild, moderate and severely impaired, all showing significant differences compared to controls.

Abstract 18614: Long-term Psychosocial Outcomes of Congenital Heart Disease: Neurocognitive Performance, Quality of Life, Psychosocial Adjustment and Psychiatric Morbidity of Adolescents and Young Adults Surviving Their Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Maria Emilia G Areias ◽  
Stefanie Melo ◽  
João Pedro Lopes ◽  
Filipa Rodrigues ◽  
Ana Catarina Nascimento ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychosocial Adjustment ◽  
Psychiatric Morbidity ◽  
Male Gender ◽  
Self Report ◽  
Healthy Controls ◽  
Neurocognitive Performance ◽  
Psychiatric Interview ◽  
Low Weight

Objectives: to study neurocognitive performance (NP) of CHD patients and to determine whether is related to parameters of fetal development registered at birth, head circumference (HC), weight (W) and length (L) and neonatal parameters (APGAR 1, 5); to study their quality of life (QOL), psychiatric morbidity (PM), psychosocial adjustment (PSA) and traits of personality (TP). Methods: 266 CHD patients, 148 male, aged from 12 to 30 years (mean= 18.00 ± 3.22), 103 cyanotic, and 119 healthy controls (56 males, mean=18.41±3.20) participated. Clinical data were collected. Neuropsychological assessment included Wechsler’s Digit Test (direct and reverse) and Symbol Search, Rey’s Complex Figure, BADS’s Key Searching Test, Color-Word Stroop Test, Trail Making Test (A, B) and Logical Memory Task. Participants were interviewed on social support, family educational style, self-image, physical limitations, completed a psychiatric interview (SADS-L) and self-report questionnaires on QOL (WHOQOL-BREF), PSA (YSR and ASR) and TP (NEOPI-R). HC, W and L and APGAR were collected. Results: CHD patients had a significantly worse NP than healthy controls in all tests, and the cyanotic worse than the acyanotic patients (but not significantly). Several correlations were apparent between fetal parameters (HC, W and L) and neuropsychological abilities in CHD. However, low weight at birth, cyanosis and male gender are the main predictors of bad NP later on in CHD patients (R=0.414; R2=0.171; F=5.787; p=0.001; β=1.654; t=2.858; p=0.005; β=1.881; t=2.377; p=0.020; b=1.624; t=2.062; p=0.042). We found a 15.3% lifetime prevalence of psychopathology (18.5% in females). Comparing to normal population, our patients have better QOL in environmental (t=6.907; p=0.000), social relationships (t=5.102; p=0.000) and general dimensions (t=2.558; p=0.011). Complex CHD reported worse QOL in physical dimension (U=3576.500; p=0.001) than those with moderate/mild forms of disease; Female patients showed worse PSA, with more withdrawal, anxiety/depression and internalization. Conclusion: CHD patients have worse NP than controls; low weight at birth, male gender and the presence of cyanosis predict bad NP in CHD patients; patients seem to be more prone to PM, worse PSA and SP.

scholarly journals ADHD symptomatology of children with congenital heart disease 10 years after cardiac surgery: the role of age at operation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nikoletta R. Czobor ◽  
Zsófia Ocsovszky ◽  
György Roth ◽  
Szabolcs Takács ◽  
Márta Csabai ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Adhd Symptom ◽  
Symptom Severity ◽  
Congenital Heart ◽  
Self Report ◽  
Control Group ◽  
Healthy Controls ◽  
Adhd Symptomatology

Abstract Background The aim of the present study was to investigate the differences in ADHD symptomatology between healthy controls and children who underwent cardiac surgery at different ages. Methods Altogether, 133 children (54 patients with congenital heart disease undergoing first cardiac surgery under 3 years of age, 26 operated at the age of 3 or later, and 53 healthy controls) were examined. Patients completed the Youth Self Report (YSR), while their parents completed the Child Behaviour Checklist (CBCL) and the ADHD Rating Scale-IV. Results Children receiving surgery for the first time under the age of 3 years were more likely diagnosed with cyanotic type malformation and have undergone to a greater number of operations. However, ADHD symptoms of those treated surgically at or above 3 years of age were more severe than that of the control group or those who were treated surgically at a younger age. The control group and those treated surgically below the age of three did not differ across any of the ADHD symptom severity indicators. Conclusions The age at the time of cardiac surgery might be associated with later ADHD symptom severity – with lower age at operation associated with better outcomes. Further, adequately powered studies are needed to confirm these exploratory findings and investigate the moderators of this relationship.

Publishing patterns and citation performance of manuscripts relating to paediatric cardiology and congenital heart disease: comparison of paediatric and adult cardiology journals

2021 ◽  
pp. 1-5
Author(s):  
Rohit S. Loomba ◽  
Danielle Sheikholeslami ◽  
Aaron Dyson ◽  
Saul Flores ◽  
Enrique Villarreal ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Median Number ◽  
Lower Number ◽  
The Other ◽  
Google Scholar ◽  
H Index ◽  
Paediatric Cardiology ◽  
Number Of Citations

Abstract Background: Manuscripts pertaining to paediatric cardiology and CHD have been published in a variety of different journals. Some of these journals are journals dedicated to paediatric cardiology, while others are focused on adult cardiology. Historically, it has been considered that manuscripts published in journals devoted to adult cardiology have greater citation potential. Our objective was to compare citation performance between manuscripts related to paediatric cardiology and CHD published in paediatric as opposed to adult cardiology journals. Methods: We identified manuscripts related to paediatric cardiology and CHD published in five journals of interest during 2014. Of these journals, two were primarily concerned with adult cardiology, while the other three focused on paediatric cardiology. The number of citations for these identified manuscripts was gathered from Google Scholar. We compared the number of citations (median, mean, and 25th, 75th, 90th, and 95th percentiles), the potential for citation, and the h-index for the identified manuscripts. Results: We identified a total of 828 manuscripts related to paediatric cardiology and congenital heart as published in the 5 journals during 2014. Of these, 783 (95%) were published in journals focused on paediatric cardiology, and the remaining 45 (5%) were published in journals focused on adult cardiology. The median number of citations was 41 in the manuscripts published in the journals focused on adult cardiology, as opposed to 7 in journals focused on paediatric cardiology (p < 0.001). The h-index, however, was greater for the journals dedicated to paediatric cardiology (36 versus 27). Conclusion: Approximately one-twentieth of the work relating to paediatric cardiology and CHD is published in journals that focus predominantly on adult cardiology. The median number of citations is greater when manuscripts concerning paediatric cardiology and CHD are published in these journals focused on adult cardiology. The h-index, however, is higher when the manuscripts are published in journals dedicated to paediatric cardiology. While such publications in journals that focus on adult cardiology tend to generate a greater number of citations than those achieved for works published in specialised paediatric cardiology journals, the potential for citation is no different between the journals. Due to the drastically lower number of manuscripts published in journals dedicated to adult cardiology, however, median performance is different.

THE TREATMENT OF THE PIERRE ROBIN SYNDROME

PEDIATRICS ◽  
1962 ◽  
Vol 30 (3) ◽  
pp. 450-458
Author(s):  
Marvin H. Goldberg ◽  
Roger H. Eckblom
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Clinical Symptoms ◽  
The Other ◽  
Pierre Robin Syndrome ◽  
Traction Device ◽  
Method Of Production ◽  
Traction System ◽  
Pierre Robin

The diagnosis of the Pierre Robin Syndrome, cleft palate, micrognathia, and golssoptosis is re-emphasized. The clinical symptoms are discussed. The treatments advocated in the literature are described. A simple traction device, employing a horizontal suture through the mid-body of the tongue and an elastic traction system, is explained. Five cases of the syndrome are reported. In one the condition was mild; in the other four the tongue traction device was employed. In one sick infant with a congenital heart disease a tracheotomy had to be performed. Much difficulty was experienced following this, and the operation is only recommended when traction alone does not control the handling of the profusion of mucus and bouts of apnea. A removable acrylic palatine obturator was used as an adjunct to nipple feedings in three patients, with excellent results. The method of production of this "false palate" is described.

scholarly journals Health behaviours reported by adults with congenital heart disease across 15 countries

2019 ◽  
Vol 27 (10) ◽  
pp. 1077-1087 ◽  
Author(s):  
Christina E Holbein ◽  
James Peugh ◽  
Gruschen R Veldtman ◽  
Silke Apers ◽  
Koen Luyckx ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Educational Attainment ◽  
Health Behaviour ◽  
Congenital Heart ◽  
Health Behaviours ◽  
Self Report ◽  
Optimal Health ◽  
Higher Educational ◽  
Higher Educational Attainment

Background Health behaviours are essential to maintain optimal health and reduce the risk of cardiovascular complications in adults with congenital heart disease. This study aimed to describe health behaviours in adults with congenital heart disease in 15 countries and to identify patient characteristics associated with optimal health behaviours in the international sample. Design This was a cross-sectional observational study. Methods Adults with congenital heart disease ( n = 4028, median age = 32 years, interquartile range 25–42 years) completed self-report measures as part of the Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study (APPROACH-IS). Participants reported on seven health behaviours using the Health Behaviors Scale-Congenital Heart Disease. Demographic and medical characteristics were assessed via medical chart review and self-report. Multivariate path analyses with inverse sampling weights were used to investigate study aims. Results Health behaviour rates for the full sample were 10% binge drinking, 12% cigarette smoking, 6% recreational drug use, 72% annual dental visit, 69% twice daily tooth brushing, 27% daily dental flossing and 43% sport participation. Pairwise comparisons indicated that rates differed between countries. Rates of substance use behaviours were higher in younger, male participants. Optimal dental health behaviours were more common among older, female participants with higher educational attainment while sports participation was more frequent among participants who were younger, male, married, employed/students, with higher educational attainment, less complex anatomical defects and better functional status. Conclusions Health behaviour rates vary by country. Predictors of health behaviours may reflect larger geographic trends. Our findings have implications for the development and implementation of programmes for the assessment and promotion of optimal health behaviours in adults with congenital heart disease.

Behaviour and emotions of children and young people with congenital heart disease: A literature review

2019 ◽  
Vol 24 (2) ◽  
pp. 317-332
Author(s):  
Nada Dahlawi ◽  
Linda Jane Milnes ◽  
Veronica Swallow
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Young People ◽  
Literature Review ◽  
Congenital Heart ◽  
Attention Problems ◽  
Older Children ◽  
Eligibility Criteria ◽  
Children And Young People ◽  
The Impact

Congenital heart disease (CHD) is one of the common types of birth defects. Children and young people (CYP) with CHD might exhibit behavioural and emotional changes related to undergoing different medical treatments and hospitalization. Therefore, a literature review was conducted from January 2000 to June 2017 that aimed to understand and evaluate current international literature focusing on CYP’s behavioural and emotional status as patients with CHD. A comprehensive search of Medline, PsycINFO and CINAHL databases was undertaken. Eight quantitative studies were reviewed following strict eligibility criteria. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the reviewed studies. Parents provided proxy reports on their children’s behaviour and emotions in all studies. Half of the reviewed studies presented the self-perceptions of children who were over seven years old. CYP with CHD exhibited internalizing and externalizing behavioural problems, withdrawal, depression, social, and attention problems. CYP with more severe CHD reported greater behavioural and emotional problems than CYP with less severe CHD. Moreover, younger children developed more problems than older children. Future more depth research using qualitative designs is required to explore the personal views of children younger than seven years old on the impact of CHD on their behaviour and emotions.

Parental decision-making in congenital heart disease

2004 ◽  
Vol 14 (3) ◽  
pp. 309-314 ◽  
Author(s):  
K. Sarah Hoehn ◽  
Gil Wernovsky ◽  
Jack Rychik ◽  
Zhi-yun Tian ◽  
Denise Donaghue ◽  
...  
Keyword(s):  
Decision Making ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Life Events ◽  
Congenital Heart ◽  
Self Report ◽  
Lower State ◽  
Parental Distress ◽  
Parental Decision Making ◽  
Congenital Cardiac Malformation

Objective:To explore whether prenatal diagnosis of congenital heart disease is associated with lower levels of parental distress and greater satisfaction with decisions about cardiothoracic surgery when compared to postnatal diagnosis.Methodology:A combined quantitative–qualitative design was used. Participants included the parents of 31 neonates (30 mothers and 22 fathers) admitted to the cardiac intensive care unit between 1 November 2001 and 1 May 2002 for repair of congenital cardiac malformations. Participants completed self-report measures of anxiety, optimism, and life events pre-operatively, and semi-structured qualitative interviews assessing satisfaction with decision-making within 1 week of the operation.Results:At the time of surgery, mothers of neonates receiving the diagnosis prenatally did not differ from mothers of neonates receiving the diagnosis postnatally on measures of anxiety, optimism, and life events. Fathers of neonates receiving the diagnosis prenatally, however, reported more optimism, lower state and trait anxiety, and fewer negative life events than fathers of neonates receiving the diagnosis postnatally. When we analyzed the interviews, we found that, regardless of the timing of the diagnosis, parents felt as though they made a genuine choice for their baby to have surgery.Conclusions:In this pilot study, fathers who learned prenatally that their child had a congenital cardiac malformation were less distressed than those who discovered this fact only postnatally. From the parental perspective, nonetheless, distress and urgency do not impair their ability to make decisions about neonatal cardiac surgery.

Outcomes and Prognostic Factors for Adult Patients With Congenital Heart Disease Undergoing Primary or Reoperative Systemic Atrioventricular Valve Surgery

2017 ◽  
Vol 8 (3) ◽  
pp. 346-353
Author(s):  
Elizabeth H. Stephens ◽  
Jiho Han ◽  
Jonathan Ginns ◽  
Marlon Rosenbaum ◽  
Paul Chai ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Prognostic Factors ◽  
Adverse Events ◽  
Congenital Heart ◽  
Atrioventricular Septal Defect ◽  
The Other ◽  
Mitral Valve Stenosis ◽  
Atrioventricular Valve ◽  
Exact Test

Background: Adults with congenital heart disease (ACHD) undergoing systemic atrioventricular valve (SAVV) surgery are a complex, understudied population. We assessed midterm outcomes and prognostic factors in ACHD undergoing SAVV surgery. Methods: We performed retrospective evaluation of ACHD undergoing SAVV surgery from January 2005 to February 2016: 14 (33%) patients with congenital mitral valve stenosis/regurgitation, 15 (35%) with atrioventricular septal defect (AVSD), and 14 (33%) with congenitally corrected transposition of the great arteries (ccTGA) with systemic tricuspid valve regurgitation. Adverse events were defined as mortality, reoperation on SAVV, and late more-than-moderate (> moderate) SAVV regurgitation. Statistical analysis was performed using Fisher’s exact test and one-way analysis of variance as well as univariate and multivariate risk factor analysis. Results: Fifteen (35%) patients had preoperative systemic ventricular dysfunction, including 13 patients with ccTGA (93%, P < .001). Twenty-three (54%) patients underwent valve repair, 20 (47%) patients underwent replacement, and 20 (47%) patients underwent an associated procedure. Replacement was higher in patients with ccTGA (86%) than the other groups ( P < 0.01). Thirty-seven patients (91% of survivors) were free of significant SAVV regurgitation at last follow-up, with patients with AVSD having greater regurgitation grades compared to the other groups ( P < 0.01). In-hospital mortality, late mortality, late > moderate SAVV regurgitation, and SAVV reoperation rates were 5% (n = 2), 2% (n = 1), 9% (n = 3), and 7% (n = 3), respectively. On multivariate analysis, predischarge SAVV regurgitation grade was the only significant predictor of adverse events (odds ratio = 8.2, 95% confidence interval: 1.1-63.8, P = .045). Conclusion: Overall outcomes in this challenging population are good. The single factor associated with adverse events was predischarge SAVV regurgitation grade.

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