International journal of cardiology. Congenital heart disease最新文献

{"title":"Mortality rates in adults with severe congenital heart disease: insights from the National Congenital Heart Disease Registry of Australia","authors":"Jason Chami MD ,&nbsp;Calum Nicholson ,&nbsp;David Baker ,&nbsp;Rachael Cordina ,&nbsp;Geoff Strange ,&nbsp;David S. Celermajer","doi":"10.1016/j.ijcchd.2025.100629","DOIUrl":"10.1016/j.ijcchd.2025.100629","url":null,"abstract":"<div><h3>Background</h3><div>Survival into adulthood with congenital heart disease (CHD) has improved, but premature mortality remains common. Long-term, multi-centre data are scarce. We used a validated complexity algorithm to select “severe CHD” patients from the National CHD Registry of Australia, quantifying mortality by ventricular physiology, residential remoteness and treating-centre location.</div></div><div><h3>Methods</h3><div>From 70185 CHD patient records, we identified 6557 patients classified as “severe” by 2020 European Society of Cardiology guidelines, born from 1980 onwards and alive at 16 years old. We found 2118 single-ventricle patients, 3674 two-ventricle and 765 with insufficient information for classification. Residence was grouped into Major Cities, Inner Regional, and Outer Regional/Remote. Vital status follow-up was to December 31, 2023. Kaplan–Meier curves were used to compare survival.</div></div><div><h3>Results</h3><div>Overall, 25-year survival was 96.9 % and 40-year survival was 89.0 %. Survival differed by physiology: single-ventricle survival was 96.4 % at 25 years and 88.2 % at 40 years, while two-ventricle survival was better, at 97.6 % at 25 years and 90.8 % at 40 years (p = 0.0015). Patients managed in Sydney/Melbourne fared better than those treated elsewhere, particularly after age 35 (25-year survival ∼97 % for both; 40-year survival 89.9 % vs 81.9 %; p = 0.027). Survival did not, however, vary with residential remoteness.</div></div><div><h3>Conclusion</h3><div>Adults with severe lesions, particularly single-ventricle physiology, remain at high risk of premature mortality. Patients managed in Sydney/Melbourne had better survival, possibly reflecting the influence of long-established specialist ACHD programs, although residual confounding cannot be excluded. Urban-rural outcome parity suggests that Australia's centralised care model mitigates geographical barriers.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100629"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rudimentary left ventricle does not impact on right ventricular size and function in hypoplastic left heart syndrome during serial follow up after Fontan completion","authors":"Abigail Burleigh ,&nbsp;Dominik Daniel Gabbert ,&nbsp;Yujiro Ide ,&nbsp;Anselm Uebing ,&nbsp;Inga Voges","doi":"10.1016/j.ijcchd.2025.100627","DOIUrl":"10.1016/j.ijcchd.2025.100627","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies in patients with hypoplastic left heart syndrome (HLHS) suggested that a larger left ventricle (LV) might negatively impact right ventricular (RV) function. This study aimed to analyse the impact of the presence of an LV remnant on RV size and function during serial follow up.</div></div><div><h3>Methods</h3><div>Serial cardiovascular magnetic resonance (CMR) examinations after completion of the total cavopulmonary connection were retrospectively analysed. Patients were divided into those with and those without a rudimentary LV. RV and LV end diastolic and end systolic volumes as well as stroke volume, ejection fraction (RVEF, LVEF) and end diastolic mass were measured.</div></div><div><h3>Results</h3><div>90 HLHS patients (female: 26) who had at least two CMR examinations were included. 51 patients had three examinations. 56 patients had an LV remnant, 34 did not. RV volumes and mass indexed to body surface area as well as RVEF did not differ significantly between both groups. LV volumes showed no association with RV volumes and RVEF.</div></div><div><h3>Conclusion</h3><div>Analysis of serial CMR examination suggests that the presence of an LV remnant does not have a major impact on RV size and function during longer-term follow-up. Future studies might focus on regional RV function.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100627"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of interruption in medical follow-up among patients with complex adult congenital heart disease","authors":"Ryotaro Maeda ,&nbsp;Naohiko Nakanishi ,&nbsp;Tomoyuki Nagai ,&nbsp;Hideo Tsubata ,&nbsp;Michiyo Yamano ,&nbsp;Tetsuhiro Yamano ,&nbsp;Takeshi Nakamura ,&nbsp;Yoko Kawai ,&nbsp;Yo Kajiyama ,&nbsp;Kazuyuki Ikeda ,&nbsp;Shuhei Fujita ,&nbsp;Shinichiro Oda ,&nbsp;Tomoko Iehara ,&nbsp;Satoaki Matoba","doi":"10.1016/j.ijcchd.2025.100630","DOIUrl":"10.1016/j.ijcchd.2025.100630","url":null,"abstract":"<div><h3>Background</h3><div>Many patients with adult congenital heart disease (ACHD) experience interruptions in medical follow-up, leading to a worsening life prognosis, particularly among those with moderate-to-severe complexity. However, the risk factors associated with interruption remain unclear.</div></div><div><h3>Methods</h3><div>In this questionnaire-based study, we sent postcards containing a QR code linking to the questionnaire to 1226 patients who underwent surgery for congenital heart disease between 1997 and 2023 and were &gt;15 years old at registration. We analyzed the causative factors for interruption in medical follow-up among patients with moderate or severe ACHD complexity.</div></div><div><h3>Results</h3><div>Of 785 patients who received questionnaire, 211 patients provided valid responses. Among them, 144 patients with moderate-to-severe complexity were included in the analysis to identify factors associated with interruption in medical follow-up. We found that 19.4 % of patients experienced interruptions. 64.0 % of patients discontinued hospital visits between 15 and 19 years old. Multivariate analysis revealed that the perceived need for continued hospital visits was an independent factor associated with interruption.</div></div><div><h3>Conclusions</h3><div>Our study identified inadequate communication regarding the necessity of continued follow-up as an independent factor contributing to the interruption of medical care. These findings highlight the need for better education for both ACHD specialists and general healthcare providers.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100630"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcome of invasive electrophysiological studies and catheter ablation in patients with patent foramen ovale and atrial septal defect–A single-center retrospective cohort study","authors":"Pieter-Jan Lewandowski ,&nbsp;Thomas Rosseel ,&nbsp;Peter Haemers ,&nbsp;Els Troost ,&nbsp;Christophe Garweg ,&nbsp;Werner Budts ,&nbsp;Joris Ector ,&nbsp;Pieter De Meester ,&nbsp;Alexander Van De Bruaene ,&nbsp;Bert Vandenberk","doi":"10.1016/j.ijcchd.2025.100615","DOIUrl":"10.1016/j.ijcchd.2025.100615","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with atrial septal defect (ASD) and patent foramen ovale (PFO) are prone to atrial arrhythmias due to structural and surgical alterations. While radiofrequency catheter ablation (RFCA) is a common treatment, arrhythmia recurrence remains a clinical challenge. This study aimed to assess arrhythmia patterns, procedural outcomes, and long-term recurrence following electrophysiological interventions.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was performed at a tertiary center including patients with ASD or PFO undergoing invasive electrophysiological procedures. Clinical and procedural data were extracted from medical records. Arrhythmias were classified based on electrocardiographic and electrophysiological findings. Kaplan-Meier analysis was used to assess event-free survival for arrhythmia recurrence.</div></div><div><h3>Results</h3><div>Among 87 patients (57.5 % female, median age 46.4 years), 82.8 % underwent RFCA as the first intervention. The most common arrhythmias were non-cavo-tricuspid isthmus (CTI) dependent intra-atrial reentrant tachycardia (35.4 %) and atrial fibrillation (18.6 %). Acute procedural success was achieved in 97.2 % of patients. Recurrence-free survival after the first RFCA was 83.6 % at 1 year, 64.2 % at 3 years, and 60.0 % at 5 years. After the last RFCA, recurrence-free survival improved to 88.3 % at 1 year and 74.3 % at 5 years.</div></div><div><h3>Conclusion</h3><div>In patients with ASD and PFO, RFCA is safe and acutely effective but followed by arrhythmia recurrence in a quarter of patients. The evolving arrhythmic substrate highlights the need for early intervention strategies and emerging technologies to optimize long-term outcomes in this patient population.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100615"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The PAH patient's perspective","authors":"Daniel A. Jeffery ,&nbsp;Wendy Gin-Sing ,&nbsp;Radwa Bedair ,&nbsp;Luke S. Howard","doi":"10.1016/j.ijcchd.2025.100596","DOIUrl":"10.1016/j.ijcchd.2025.100596","url":null,"abstract":"<div><div>Pulmonary Hypertension is a serious condition which can occur in adults living with congenital heart disease. Due to advances in the care of patients with congenital heart disease, patients are living longer with the condition. Unfortunately, patients living with Pulmonary Arterial Hypertension associated with Congenital Heart Disease (PAH-CHD) face a number of different issues directly related to their condition, which range from physical limitations and uncertainty over their diagnosis, which in some cases cause significant depression and anxiety, to impact on their relationships with friends and family, financial challenges and family planning.</div><div>In this article, we interview two patients living with PAH-CHD and discuss the numerous issues that patients may face as a direct result of their condition.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"21 ","pages":"Article 100596"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A detailed profiling study from the national Australian Congenital Heart Disease registry: rationale and design","authors":"Tanya Badal ,&nbsp;Calum Nicholson ,&nbsp;Julian Ayer ,&nbsp;Michael Cheung ,&nbsp;Leeanne Grigg ,&nbsp;David S. Celermajer ,&nbsp;Geoff Strange","doi":"10.1016/j.ijcchd.2025.100595","DOIUrl":"10.1016/j.ijcchd.2025.100595","url":null,"abstract":"<div><h3>Background</h3><div>Previous research has outlined significant gaps in the care of children and adults with Congenital Heart Disease (CHD). The Australian Study of the Burden and Outcomes of CHD will assess medical, psychological, social and economic issues affecting CHD patients and carers and provide a detailed account of CHD patients’ healthcare utilisation.</div></div><div><h3>Methods</h3><div>A random sample of patients aged ≥5 years, equally split between genders, CHD complexity (mild, moderate, severe) and rural and remote locations (20–25%) was extracted from the National Australian CHD Registry (n = 68,214) from four large participating CHD centres (2 adult and 2 child). Patients and their carers were invited to participate in an in-person study visit for physical assessment and for a series of surveys questioning physical and mental health, neurodevelopment, and quality of life.</div></div><div><h3>Results</h3><div>Of 6,726 contacted patients, 1,911 (28%) consented, with 99.5% of surveys completed online. 1,658 consented participants completed at least one study activity (87% response rate). Proxies/carers completed surveys for 11% of participants (primarily those under age 8 or with intellectual disability). All study activities were completed by 750 respondents (45%). Respondents were older (median age 24 [IQR 12–41 years] vs 18 [IQR 11–35 years], p = 0.005) and had a higher proportion of severe CHD (28%) compared to non-respondents (23%). No significant differences in disease complexity were observed between respondents and non-respondents.</div></div><div><h3>Conclusion</h3><div>This multi-site study of over 1600 CHD patients aims to offer the first comprehensive profiling of the burdens and outcomes faced by Australia's growing CHD population.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"21 ","pages":"Article 100595"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic effects of sodium-glucose cotransporter 2 inhibitors in single ventricle circulatory failure","authors":"Ralph M.L. Neijenhuis ,&nbsp;Madelien V. Regeer ,&nbsp;Niki L. Walker ,&nbsp;Amanda Hunter ,&nbsp;Philippine Kiès ,&nbsp;Eduard R. Holman ,&nbsp;J. Wouter Jukema ,&nbsp;Monique R.M. Jongbloed ,&nbsp;Gruschen R. Veldtman ,&nbsp;Anastasia D. Egorova","doi":"10.1016/j.ijcchd.2025.100603","DOIUrl":"10.1016/j.ijcchd.2025.100603","url":null,"abstract":"<div><h3>Background</h3><div>Single ventricle patients are at high risk of developing circulatory failure. There is limited evidence for pharmacological treatment. This study assessed the echocardiographic changes in ventricular function during sodium-glucose cotransporter 2 inhibitor (SGLT2i) therapy in patients with single ventricle failure (SVF).</div></div><div><h3>Methods</h3><div>SVF patients with a baseline transthoracic echocardiogram within six months before starting SGLT2i and at least one echocardiographic examination within twelve months follow-up were included from a real-world international registry of adult congenital heart disease patients on SGLT2i. Mixed models were used to evaluate longitudinal changes in ventricular function and differences between patients with SVF with ≥ moderately reduced systolic function (SVFrEF) and with ≤ mildly reduced function (SVFpEF).</div></div><div><h3>Results</h3><div>Thirteen patients were included. The median age was 21 [20–42] years, 8 (61.5 %) were female, 10 (76.9 %) had a Fontan circulation, 8 (61.5 %) had SVFrEF, and 5 (38.5 %) SVFpEF at the start of SGLT2i. The mean follow-up was 7.6 ± 3.3 months. End-systolic area decreased significantly in all patients (−1.6 cm² per month, p = 0.007) in the first 100 days. Fractional area change improved in the first 100 days in SVFrEF patients (3.5 %-point per month, p &lt; 0.001), while SVFpEF patients remained stable. There was a significant improvement in the free wall strain in all patients (−0.3 %-point per month, p = 0.036) but not in global longitudinal strain (p = 0.087). Isovolumic acceleration also improved in the first 100 days (0.5 m/s² per month, p = 0.010).</div></div><div><h3>Conclusions</h3><div>Echocardiographic signals of improved ventricular function were observed in the first year of SGLT2i therapy in patients with SVF.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"21 ","pages":"Article 100603"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of prosthetic dysfunction in the diagnosis of endocarditis associated to prosthetic pulmonary valve and pulmonary conduit","authors":"Andrés Cano Pérez ,&nbsp;Larraitz Orive Melero ,&nbsp;Jose Félix Larrea Egurbide ,&nbsp;Jagoba Larrazábal López ,&nbsp;Luis Fernández González ,&nbsp;Roberto Blanco Mata ,&nbsp;Josune Arriola Meabe ,&nbsp;Leire Artiñano Mendizábal ,&nbsp;Ane Josune Goikoetxea Agirre ,&nbsp;María José Blanco Vidal ,&nbsp;Javier Ayala Curiel ,&nbsp;Pedro María Montes Orbe","doi":"10.1016/j.ijcchd.2025.100591","DOIUrl":"10.1016/j.ijcchd.2025.100591","url":null,"abstract":"<div><h3>Introduction</h3><div>The number of cases of infective endocarditis associated to prosthetic pulmonary valves and pulmonary conduits (PPVIE) is likely to increase in the future. Transthoracic echocardiography (TTE) presents challenges in visualizing lesions suggestive of endocarditis in these patients. However, TTE may provide additional findings, such as prosthetic dysfunction, which can guide the diagnosis of this condition. The main objective of this study is to analyze prosthetic pulmonary valve dysfunction as an echocardiographic manifestation of PPVIE.</div></div><div><h3>Methods</h3><div>All cases of PPVIE (definite and possible, according to the modified Duke criteria) at Cruces University Hospital (Baracaldo, Spain) between January 2014 and July 2024 were included. Prosthetic dysfunction was defined as a peak transvalvular gradient (PTG) ≥25 mmHg for homografts and ≥40 mmHg for prosthetic pulmonary valves and bovine pulmonary conduits (stenosis) and/or pulmonary regurgitation (PR) moderate or severe. Number of cases of prosthetic dysfunction between the PPVIE episode and prior to the episode were compared. We analyzed the mechanisms of prosthetic dysfunction in the PPVIE episode.</div></div><div><h3>Results</h3><div>14 cases of PPVIE were identified. In cases prior to the PPVIE episode, 42.9 % had prosthetic dysfunction, while in the PPVIE episode, 92.3 % had prosthetic dysfunction. Stenosis was a more frequent cause of valve dysfunction than PR.</div></div><div><h3>Conclusions</h3><div>Prosthetic dysfunction (due to stenosis or regurgitation) is a relevant finding in the diagnosis of PPVIE in cases where lesions suggestive of endocarditis are not visualised. Although not included in the Duke criteria, stenosis is a more frequent mechanism of dysfunction than PR.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"21 ","pages":"Article 100591"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kawasaki disease with persistent severe psoriatic-like skin manifestations and sudden cardiac death","authors":"Aso F. Salih ,&nbsp;Trifa M. Qadir ,&nbsp;Nagib Dahdah","doi":"10.1016/j.ijcchd.2025.100604","DOIUrl":"10.1016/j.ijcchd.2025.100604","url":null,"abstract":"<div><div>This case report describes a 1.3-year-old infant with an atypical presentation of Kawasaki Disease (KD) following exposure to COVID-19 within the family and positive SARS-CoV-2 IgG antibodies. The clinical course was marked by significant left ventricular (LV) dysfunction, progressive coronary artery involvement, and complicated by severe dermatologic manifestations including Steven-Johnson-like lesions and psoriatic-like eruptions. Despite initial improvement in cardiac function, the infant developed multiple coronary aneurysms and succumbed to sudden cardiac death. This case highlights the diagnostic and therapeutic challenges in managing atypical KD in the context of COVID-19. We describe the case and review the literature related to the associated severe skin lesions.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"21 ","pages":"Article 100604"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue in adults with congenital heart disease aged over 40 years","authors":"Linda Ternrud ,&nbsp;Bengt Johansson ,&nbsp;David Sparv ,&nbsp;Zacharias Mandalenakis ,&nbsp;Christina Christersson ,&nbsp;Liesbet Van Bulck ,&nbsp;Philip Moons ,&nbsp;Camilla Sandberg ,&nbsp;Joanna Hlebowicz","doi":"10.1016/j.ijcchd.2025.100601","DOIUrl":"10.1016/j.ijcchd.2025.100601","url":null,"abstract":"<div><h3>Background</h3><div>Fatigue is a symptom that has been described among adult patients with congenital heart disease (CHD)<strong>,</strong> but the prevalence and impact of fatigue on the patient's daily life has been poorly studied. This study (i) examines the prevalence of fatigue in patients aged over 40 years with moderately complex or complex congenital heart disease compared to controls and (ii) explores the relationship between fatigue, heart disease complexity, clinical characteristics and self-reported New York Heart Association Functional Class (self-reported NYHA class).</div></div><div><h3>Methods</h3><div>The Multidimensional Fatigue Inventory (MFI-20) was applied in 166 patients with moderately complex CHD or complex CHD (44 % females, median age 55.3 years, IQR 47.6–64.8) along with 89 controls (43 % female, median age 54.0, IQR 46.0–65.9). MFI-20 measured general fatigue, physical fatigue, mental fatigue, reduced motivation and reduced activity.</div></div><div><h3>Results</h3><div>Physical fatigue (severe to very severe) was more common in complex CHD compared with moderately complex CHD (25 % <em>vs.</em> 52 %, <em>p</em> = 0.006). Complex CHD was associated with severe to very severe physical fatigue (odds ratio 3.1 (95 % CI 1.1–9.1). Patients with complex CHD had higher levels of self-reported NYHA class than patients with moderately complex CHD. All dimensions of fatigue were positively associated with self-reported NYHA class.</div></div><div><h3>Conclusions</h3><div>Patients over the age of 40 with complex CHD were three times more likely to report severe to very severe physical fatigue and reported higher levels of self-reported NYHA class than patients with moderately complex CHD. This highlights the importance of considering CHD complexity in clinical practice.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"21 ","pages":"Article 100601"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}