scholarly journals Environmental Risk Factors and Congenital Heart Disease: An Umbrella Review of 165 Systematic Reviews and Meta-Analyses With More Than 120 Million Participants

2021 ◽  
Vol 8 ◽  
Author(s):  
Tie-Ning Zhang ◽  
Qi-Jun Wu ◽  
Ya-Shu Liu ◽  
Jia-Le Lv ◽  
Hui Sun ◽  
...  

Background: The etiology of congenital heart disease (CHD) has been extensively studied in the past decades. Therefore, it is critical to clarify clear hierarchies of evidence between types of environmental factors and CHD.Methods: Electronic searches in PubMed, Embase, Web of Science, Cochrane database were conducted from inception to April 20, 2020 for meta-analyses investigating the aforementioned topic.Results: Overall, 41 studies including a total of 165 meta-analyses of different environmental factors and CHD were examined, covering a wide range of risk factors. The summary random effects estimates were significant at P < 0.05 in 63 meta-analyses (38%), and 15 associations (9%) were significant at P < 10−6. Of these meta-analyses, eventually one risk factor (severe obesity; relative risk: 1.38, 95% confidence interval: 1.30–1.47) had significant summary associations at P < 10−6, included more than 1,000 cases, had 95% prediction intervals excluding the null value, and were not suggestive of large heterogeneity (I2 < 50%), small-study effects (P-value for Egger's test > 0.10), or excess significance (P > 0.10). Eight associations (5%) (including maternal lithium exposure, maternal obesity, maternal alcohol consumption, and maternal fever) had results that were significant at P < 10−6, included more than 1,000 cases, and had 95% prediction intervals excluding the null value (highly suggestive).Conclusion: This umbrella review shows that many environmental factors have substantial evidence in relation to the risk of developing CHD. More and better-designed studies are needed to establish robust evidence between environmental factors and CHD.Systematic Review Registration: [PROSPERO], identifier [CRD42020193381].

2021 ◽  
Vol 8 ◽  
Author(s):  
McKay Mullen ◽  
Angela Zhang ◽  
George K. Lui ◽  
Anitra W. Romfh ◽  
June-Wha Rhee ◽  
...  

Congenital heart disease (CHD) is a multifaceted cardiovascular anomaly that occurs when there are structural abnormalities in the heart before birth. Although various risk factors are known to influence the development of this disease, a full comprehension of the etiology and treatment for different patient populations remains elusive. For instance, racial minorities are disproportionally affected by this disease and typically have worse prognosis, possibly due to environmental and genetic disparities. Although research into CHD has highlighted a wide range of causal factors, the reasons for these differences seen in different patient populations are not fully known. Cardiovascular disease modeling using induced pluripotent stem cells (iPSCs) is a novel approach for investigating possible genetic variants in CHD that may be race specific, making it a valuable tool to help solve the mystery of higher incidence and mortality rates among minorities. Herein, we first review the prevalence, risk factors, and genetics of CHD and then discuss the use of iPSCs, omics, and machine learning technologies to investigate the etiology of CHD and its connection to racial disparities. We also explore the translational potential of iPSC-based disease modeling combined with genome editing and high throughput drug screening platforms.


2011 ◽  
Vol 24 (3) ◽  
pp. 246-258 ◽  
Author(s):  
Suzanne H. Long ◽  
Bev J. Eldridge ◽  
Mary P. Galea ◽  
Susan R. Harris

2017 ◽  
Vol 8 (2) ◽  
pp. 182-188
Author(s):  
Madurra Perinpanayagam ◽  
Signe H. Larsen ◽  
Kristian Emmertsen ◽  
Marianne B. Møller ◽  
Vibeke E. Hjortdal

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.


2018 ◽  
pp. 116-119
Author(s):  
T.I. Nelunova ◽  
T.E. Burtseva ◽  
V.G. Chasnyk ◽  
S.A. Evseeva

2010 ◽  
Vol 5 (1) ◽  
Author(s):  
Eva S Biewer ◽  
Christoph Zürn ◽  
Raoul Arnold ◽  
Martin Glöckler ◽  
Jürgen Schulte-Mönting ◽  
...  

Author(s):  
Samah Alasrawi ◽  
◽  
Hessa Almansoori ◽  

Objective: To investigate the association of maternal diabetes, maternal smoking and syndromes with congenital heart disease (CHD) in patients attending Aljalila cardiology clinic between January 2020 and May of 2020. Methods: A case control study to assess the association of maternal diabetes, maternal smoking and syndromes with CHD. All patients that presented to the clinic between January 2020 and May of 2020 were included. An interviewer administered questionnaire was used to record the presence of maternal diabetes, maternal smoking, and the type of syndrome and type of CHD. Patients with CHD were included in the case group and patients who did not have CHD were in the control group. Age, gender, and nationality were also collected from the hospital records. Fisher exact test and logistic regression was used to analyze the results. Results: A total of 177 cases and 211 controls were recruited. All the risk factors increase the risk of CHD, with maternal diabetes (OR 6.3, 95% CI 2.7-14.6) having the strongest association, then syndromes (OR 5.1, 95% CI 2.3-11.3) and lastly maternal smoking (OR 4.0, 95% CI 1.0-16.3). The most common type of CHD is ventricular septal defect. Conclusion: Maternal diabetes, maternal smoking and syndromes are significant risk factors of CHD in children visiting Aljalila cardiology clinic. Action needs to be taken in order to decrease these risk factors and so, decrease the incidence of CHD in the future. Clearly, more research is needed in order to identify other risk factors for patients in the United Arab Emirates (UAE)


2009 ◽  
Vol 103 (10) ◽  
pp. 1445-1450 ◽  
Author(s):  
Georgios Giannakoulas ◽  
Konstantinos Dimopoulos ◽  
Reto Engel ◽  
Omer Goktekin ◽  
Zekeriya Kucukdurmaz ◽  
...  

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