International journal of cardiology. Congenital heart disease最新文献

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Safety of SGLT-2 inhibitors in the management of heart failure in the adult congenital heart disease patient population SGLT-2 抑制剂治疗成人先天性心脏病患者心力衰竭的安全性
International journal of cardiology. Congenital heart disease Pub Date : 2024-02-17 DOI: 10.1016/j.ijcchd.2024.100495
Ahmed Kheiwa , Brian Ssembajjwe , Payush Chatta , Stephen Nageotte , Dmitry Abramov
{"title":"Safety of SGLT-2 inhibitors in the management of heart failure in the adult congenital heart disease patient population","authors":"Ahmed Kheiwa ,&nbsp;Brian Ssembajjwe ,&nbsp;Payush Chatta ,&nbsp;Stephen Nageotte ,&nbsp;Dmitry Abramov","doi":"10.1016/j.ijcchd.2024.100495","DOIUrl":"10.1016/j.ijcchd.2024.100495","url":null,"abstract":"<div><h3>Background</h3><p>Sodium glucose transporter 2 inhibitors (SGLT-2i) have shown safety and efficacy in patients with heart failure (HF). However, evidence for the use of SGLT-2i in adult congenital heart disease (ACHD) patients with HF is limited.</p></div><div><h3>Methods</h3><p>We performed a retrospective, single center analysis of 18 patients (&gt;18 years of age) with ACHD and a diagnosis of HF who were initiated on an SGLT-2i. Patient characteristics, including vital signs, laboratory values, concomitant medications, clinical outcomes, and echocardiograms, were obtained as part of standardized clinical care at our ACHD program before and 2–6 months after initiation of SGLT-2i. The primary outcome was to demonstrate safety of SGLT-2i initiation via potential changes in systolic blood pressure, serum sodium, and serum creatinine.</p></div><div><h3>Results</h3><p>Of the 18 patients, 11 (61%) had moderate complexity congenital heart disease while 7 (39%) had great complexity congenital heart disease. Post initiation, there were no significant differences in systolic blood pressure (121.8 ± 20.8 mmHg to 114.4 ± 14.9 mmHg, p = 0.06), sodium level (138.7 ± 2.9 mMol/L to 138.0 ± 2.2 mMol/L, p = 0.75), and creatinine level (0.85 ± 0.18 mg/dL to 0.89 ± 0.18 mg/dL, p = 0.07). There was a statistically significant decline in weight (78.9 ± 22.9 kg to 76.0 ± 23.0 kg, p = 0.0039) but without a statistically significant change in NT-pro NBP (1358.2 ± 2735.0 pg/mL to 601.6 ± 786.1 pg/mL, p = 0.36).</p></div><div><h3>Conclusions</h3><p>We demonstrated the use of SGLT-2i in a small cohort of ACHD population, including patients with complex congenital heart disease, appears safe and well tolerated. The safety and potential efficacy of SGLT-2i in patients with ACHD will require further evaluation in prospective multicenter studies.</p></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666668524000041/pdfft?md5=84928302bbf28e005d906dd86e67f8e0&pid=1-s2.0-S2666668524000041-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139966018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Temporal change in cardiac function and clinical indices in adults with valvular pulmonic stenosis 瓣膜性肺动脉狭窄成人心功能和临床指标的时间变化
International journal of cardiology. Congenital heart disease Pub Date : 2024-02-16 DOI: 10.1016/j.ijcchd.2024.100501
Alexander C. Egbe, C. Charles Jain, Luke J. Burchill, Snigdha Karnakoti, Marwan H. Ahmed, Maan Jokhadar, Heidi M. Connolly
{"title":"Temporal change in cardiac function and clinical indices in adults with valvular pulmonic stenosis","authors":"Alexander C. Egbe,&nbsp;C. Charles Jain,&nbsp;Luke J. Burchill,&nbsp;Snigdha Karnakoti,&nbsp;Marwan H. Ahmed,&nbsp;Maan Jokhadar,&nbsp;Heidi M. Connolly","doi":"10.1016/j.ijcchd.2024.100501","DOIUrl":"https://doi.org/10.1016/j.ijcchd.2024.100501","url":null,"abstract":"<div><h3>Background</h3><p>Patients with palliated pulmonary valve stenosis (PVS) have less cardiac remodeling and symptoms as compared to patients with repaired tetralogy of Fallot (TOF) presenting with similar severity of right ventricular outflow tract (RVOT) disease. What is not known is whether patients with PVS versus TOF presenting with similar severity of RVOT disease at baseline, would have similar (or different) pace of cardiac remodeling and disease progression over time. The study objective was to compare temporal changes in clinical and cardiac function indices between adults with palliated PVS and repaired TOF presenting with moderate/severe RVOT disease.</p></div><div><h3>Methods</h3><p>Cardiac function indices (based on strain imaging) and clinical indices (N-terminal pro–B-type natriuretic peptide [NT-proBNP], model for end-stage liver disease excluding international normalized ratio [MELD-XI], peak oxygen consumption [VO<sub>2</sub>]), were assessed at baseline, 3 years, and 5 years. Temporal changes were calculated as relative changes from baseline (Δ). Cardiovascular adverse event was assessed as time-to-event outcome.</p></div><div><h3>Results</h3><p>Compared to TOF group (n = 173), the PVS group (n = 173) had less temporal change in right atrial reservoir strain (−9±4% versus −21 ± 6%, p &lt; 0.001), RV free wall strain (−8±4% versus −20 ± 5%, p &lt; 0.001), NT-proBNP (8 ± 5% versus 17 ± 6 %, p &lt; 0.001), MELD-XI (6 ± 4% versus 19 ± 4%, p = 0.008), and peak VO<sub>2</sub> (−7±3% versus −12 ± 7%, p &lt; 0.001) at 5 years. The 5-year freedom from cardiovascular adverse event was higher in the PVS group (76% versus 54%, p = 0.01).</p></div><div><h3>Conclusions</h3><p>These data suggest that a less frequent clinical and imaging follow-up may be appropriate in patients with PVS (as compared to patients with TOF).</p></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666668524000107/pdfft?md5=5cf22c4a0c6180466d2471be9e807e27&pid=1-s2.0-S2666668524000107-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139935650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Yellow fever vaccination and the thymus in adults with congenital heart disease 先天性心脏病成人的黄热病疫苗接种和胸腺
International journal of cardiology. Congenital heart disease Pub Date : 2024-02-02 DOI: 10.1016/j.ijcchd.2024.100494
Ella McDonnell , Hajar Habibi
{"title":"Yellow fever vaccination and the thymus in adults with congenital heart disease","authors":"Ella McDonnell ,&nbsp;Hajar Habibi","doi":"10.1016/j.ijcchd.2024.100494","DOIUrl":"https://doi.org/10.1016/j.ijcchd.2024.100494","url":null,"abstract":"<div><h3>Aim</h3><p>To highlight the potential lack of documentation of thymectomy on historic cardiac operation notes and how this impacts the safety of the yellow fever vaccination for patients who have had congenital heart surgery in childhood.</p></div><div><h3>Background</h3><p>With advances in treatment, the population of adults with congenital heart disease (ACHD) is ever growing. Consequently, increasing numbers of patients wish to travel and work abroad. In recent years, this has presented a unique challenge in terms of the safety of the yellow fever vaccine in this patient group.</p></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266666852400003X/pdfft?md5=c45e784c784ce9dbffff714fe9a0a91d&pid=1-s2.0-S266666852400003X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139694630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison in the adult congenital heart disease severity classification of ACC/AHA and ESC guidelines in a 3,459 Mexican population 在 3,459 名墨西哥人中比较 ACC/AHA 和 ESC 指南对成人先天性心脏病严重程度的分类
International journal of cardiology. Congenital heart disease Pub Date : 2024-01-19 DOI: 10.1016/j.ijcchd.2024.100492
Edgar García-Cruz , Montserrat Villalobos-Pedroza , Neftali Eduardo Antonio-Villa , Daniel Manzur-Sandoval , Daniel Alejandro Navarro-Martínez , Axel J. Barrera-Real , Elisa Mier y Terán-Morales , Stephanie Teresa Angulo-Cruzado , Naybeth Ediel García-González , Jorge Luis Cervantes-Salazar , Antonio Benita-Bordes , Linda Guieniza Díaz-Gallardo , Victor Alejandro Quiroz-Martinez , Julio César Sauza-Sosa , Isis Guadalupe Montalvo-Ocotoxtle , Jeyli Estrella Ferrer-Saldaña , Emmanuel A. Lazcano-Díaz , Nydia Ávila-Vanzzini , Francisco Martín Baranda-Tovar
{"title":"Comparison in the adult congenital heart disease severity classification of ACC/AHA and ESC guidelines in a 3,459 Mexican population","authors":"Edgar García-Cruz ,&nbsp;Montserrat Villalobos-Pedroza ,&nbsp;Neftali Eduardo Antonio-Villa ,&nbsp;Daniel Manzur-Sandoval ,&nbsp;Daniel Alejandro Navarro-Martínez ,&nbsp;Axel J. Barrera-Real ,&nbsp;Elisa Mier y Terán-Morales ,&nbsp;Stephanie Teresa Angulo-Cruzado ,&nbsp;Naybeth Ediel García-González ,&nbsp;Jorge Luis Cervantes-Salazar ,&nbsp;Antonio Benita-Bordes ,&nbsp;Linda Guieniza Díaz-Gallardo ,&nbsp;Victor Alejandro Quiroz-Martinez ,&nbsp;Julio César Sauza-Sosa ,&nbsp;Isis Guadalupe Montalvo-Ocotoxtle ,&nbsp;Jeyli Estrella Ferrer-Saldaña ,&nbsp;Emmanuel A. Lazcano-Díaz ,&nbsp;Nydia Ávila-Vanzzini ,&nbsp;Francisco Martín Baranda-Tovar","doi":"10.1016/j.ijcchd.2024.100492","DOIUrl":"10.1016/j.ijcchd.2024.100492","url":null,"abstract":"<div><h3>Background</h3><p>Latin American registries of clinical and demographic profiles of ACHD are scarce. International guidelines classify disease complexity with different approaches. With these two regards, a registry was carried out to examine factors associated with mortality and to compare severity classifications in our population.</p></div><div><h3>Methods and results</h3><p>Cross-sectional study conducted on ACHD between 2018 and 2022 to evaluate clinical and demographic characteristics and to assess the agreement between the 2020 ESC Guidelines and 2018 AHA/ACC Guidelines for the Management of Adults with Congenital Heart Disease using the <em>kappa</em> method. Binomial logistic regression models were used to examine correlates of mortality. 3459 patients were included [56 % women, median age 34 years (IQR 24–50)]; 83.41 % were alive and 4.11 % died. The subjects had the following characteristics: 74.18 % were in NYHA I FC, 87.30 % had SVEF ≥50 %, 18.42 % developed arrhythmias, 58.92 % were surgically repaired, 7.05 % received palliative management, and 0.03 % were in heart transplant protocol. The agreement between ESC and AHA/ACC complexity classifications was low (43.29 %) in moderate ACHD, and high (83.10 %) in severe disease. Mortality was higher in patients with NYHA III-IV FC, arrhythmias and under palliative care.</p></div><div><h3>Conclusion</h3><p>This study found that ESC and AHA/ACC complexity classifications have limited concordance in categorizing moderate complexity CHD. Reparative procedures had lower mortality odds than palliative care.</p></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666668524000016/pdfft?md5=41bd0a6c3db66290e05606b69ef95ffd&pid=1-s2.0-S2666668524000016-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atrial arrhythmia predicts late events and mortality in patients with D-transposition of the great arteries and atrial switch repair 心房心律失常可预测大动脉 D 型横位和心房转换修复术患者的晚期事件和死亡率
International journal of cardiology. Congenital heart disease Pub Date : 2024-01-02 DOI: 10.1016/j.ijcchd.2023.100491
Anca Chiriac , Davide Giardi , Kamal P. Cheema , Samantha Espinosa , Goyal Umadat , David O. Hodge , Malini Madhavan , Samuel Asirvatham , Sabrina D. Phillips , Christopher J. McLeod
{"title":"Atrial arrhythmia predicts late events and mortality in patients with D-transposition of the great arteries and atrial switch repair","authors":"Anca Chiriac ,&nbsp;Davide Giardi ,&nbsp;Kamal P. Cheema ,&nbsp;Samantha Espinosa ,&nbsp;Goyal Umadat ,&nbsp;David O. Hodge ,&nbsp;Malini Madhavan ,&nbsp;Samuel Asirvatham ,&nbsp;Sabrina D. Phillips ,&nbsp;Christopher J. McLeod","doi":"10.1016/j.ijcchd.2023.100491","DOIUrl":"https://doi.org/10.1016/j.ijcchd.2023.100491","url":null,"abstract":"<div><h3>Aims</h3><p>Patients with D-transposition of the great arteries (D-TGA) and atrial switch experience late morbidity and mortality related to atrial arrhythmias and systemic right ventricular (SRV) failure. We sought to analyze the influence of atrial arrhythmias on long-term outcomes in this group.</p></div><div><h3>Methods</h3><p>A retrospective review of all patients with D-TGA and atrial switch followed at a tertiary care center was performed.</p></div><div><h3>Results</h3><p>148 patients (63.5 % male; age 30.4 ± 10.6 years) were followed for 12 ± 9.8 years. Death or cardiac transplantation occurred in 22(15 %) patients and heart failure hospitalization occurred in 30(20 %) patients.</p><p>Atrial arrhythmias were documented in 82(55.4 %) patients. Atrial fibrillation at the first visit (Kaplan-Meier estimate, p = 0.003) and atrial fibrillation as a time-dependent variable (HR 3.50, p = 0.006) predicted increased risk of death or cardiac transplantation. A triad of atrial fibrillation, prolonged QRS duration/RBBB, and severe SRV dysfunction (SRV EF &lt; 35 %) emerged as a unique signature of a higher-risk population.</p><p>Atrial tachycardia and flutter, while not associated with mortality, increased the risk of heart failure hospitalization (HR 3.5, p = 0.001). Moreover, 2/6 cases of resuscitated sudden cardiac arrest were caused by atrial flutter, and more patients received inappropriate shocks for atrial arrhythmias(16 %) than appropriate shocks(2.3 %).</p></div><div><h3>Conclusion</h3><p>In D-TGA patients with atrial switch, there is a complex interplay between atrial arrhythmias and the SRV. Key ECG parameters, arrhythmia events and sequelae create a unique patient-specific fingerprint strongly associated with future events and mortality. This higher-risk cohort will need further characterization to delineate who may benefit from preemptive arrhythmia intervention.</p></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666668523000538/pdfft?md5=3dd25d1adfbb60879a031abaa6344b4e&pid=1-s2.0-S2666668523000538-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139111781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of permanent pacemakers and implantable cardioverter-defibrillators in an adult congenital heart disease population 成人先天性心脏病患者使用永久起搏器和植入式心律转复除颤器的疗效
International journal of cardiology. Congenital heart disease Pub Date : 2023-12-18 DOI: 10.1016/j.ijcchd.2023.100490
Jason Chami , Benjamin M. Moore , Calum Nicholson , Rachael Cordina , David Baker , David S. Celermajer
{"title":"Outcomes of permanent pacemakers and implantable cardioverter-defibrillators in an adult congenital heart disease population","authors":"Jason Chami ,&nbsp;Benjamin M. Moore ,&nbsp;Calum Nicholson ,&nbsp;Rachael Cordina ,&nbsp;David Baker ,&nbsp;David S. Celermajer","doi":"10.1016/j.ijcchd.2023.100490","DOIUrl":"https://doi.org/10.1016/j.ijcchd.2023.100490","url":null,"abstract":"<div><h3>Background</h3><p>Brady- and tachyarrhythmias commonly complicate adult congenital heart disease (ACHD). Permanent pacemakers (PPMs) or implantable cardioverter–defibrillators (ICDs) are often utilised to prevent morbidity or mortality related to arrhythmia, but can also be associated with significant morbidity themselves.</p></div><div><h3>Methods</h3><p>We analysed outcomes from patients in our comprehensive ACHD database who were seen at least twice since 2000 and once since 2018. Of 1953 ACHD patients, 134 had a PPM and 78 had an ICD (47 for primary and 31 for secondary prevention).</p></div><div><h3>Results</h3><p>For PPM patients, 41% had a pacing percentage below 33%, 13% had 33–66%, and 46% had above 66%. One fifth required PPM upgrade, most to cardiac resynchronisation therapy, the rest to ICD. There were 33 appropriate ICD shocks in 15 patients (19%) and 34 inappropriate shocks in 13 patients (17%) over a median follow up of 4.6 years (IQR 0.9–8.3 years). Anti-tachycardia pacing was delivered appropriately for 28% of patients and inappropriately for 9%.</p><p>Apart from inappropriate therapy, one third of PPM and ICD patients had other device-related complications. Acute PPM complications included lead dysfunction requiring revision (2%), pneumothorax (2%), pleural effusion (2%) and pocket infection (2%). ICDs were also acutely complicated by lead dysfunction (4%) as well as pocket hematoma (3%). The most common long-term complication overall was lead dysfunction, affecting one sixth of both PPM and ICD patients. Finally, the rate of device insertion increased significantly with disease severity.</p></div><div><h3>Conclusions</h3><p>Anti-arrhythmic devices can be lifesaving in ACHD patients, but inappropriate therapy and device-related complications are very common.</p></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666668523000526/pdfft?md5=86ea742125e5707ab0149a3e98963d2c&pid=1-s2.0-S2666668523000526-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139050066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aortic growth rates in a Swedish cohort of women with Turner syndrome 瑞典特纳综合征妇女队列中的主动脉生长率
International journal of cardiology. Congenital heart disease Pub Date : 2023-12-15 DOI: 10.1016/j.ijcchd.2023.100489
Sofia Thunström , Odd Bech-Hanssen , Emily Krantz , Inger Bryman , Kerstin Landin-Wilhelmsen
{"title":"Aortic growth rates in a Swedish cohort of women with Turner syndrome","authors":"Sofia Thunström ,&nbsp;Odd Bech-Hanssen ,&nbsp;Emily Krantz ,&nbsp;Inger Bryman ,&nbsp;Kerstin Landin-Wilhelmsen","doi":"10.1016/j.ijcchd.2023.100489","DOIUrl":"10.1016/j.ijcchd.2023.100489","url":null,"abstract":"<div><h3>Background</h3><p>Aortic dilation, cardiac malformations and hypertension are known risk factors for aortic dissection in Turner syndrome (TS). In the current guidelines, rapid growth of the aorta has been added as a risk marker. This study aimed to estimate the growth of the ascending aorta over time, to identify risk factors of aortic growth, and to describe aortic complications in TS.</p></div><div><h3>Methods</h3><p>A transthoracic echocardiogram was performed at least twice in 101 women with TS, mean age 28 years, with a mean follow-up of 8.3 ± 3.4 (range 1–17) years. The investigator was blinded to the clinical status. Logistic regression analysis was used to identify risk factors of aortic growth.</p></div><div><h3>Results</h3><p>The prevalence of ascending aortic dilation (ASI &gt;20 mm/m<sup>2</sup>) was 26 % and the mean ascending aortic diameter was 27.0 ± 4.8 mm at baseline. Significant aortic growth was found at sinus of Valsalva 1.08 (±2.11) mm, sinotubular junction 1.07 (±2.23) mm, and the ascending aorta 2.32 (±2.93) mm, p &lt; 0.001. The mean ascending aortic growth rate was 0.25 (±0.35) mm/year, and higher compared to the general female population, 0.12 (±0.05) mm/year, p &lt; 0.0001. No risk factors for aortic growth (bicuspid aortic valve, coarctatio, hypertension or karyotype) other than body weight could be identified, Odds ratio 1.05 (95 % CI 1.00–1.09), p = 0.029. Eight women had an aortic event of whom all had bicuspid aortic valves.</p></div><div><h3>Conclusions</h3><p>The growth rate of the ascending aorta in TS was increased compared to the general female population. Congenital cardiovascular malformations were not predictive of aortic growth.</p></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666668523000514/pdfft?md5=d33c70403dd4470417e5fa0e179be00c&pid=1-s2.0-S2666668523000514-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139190788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting cardiac and pregnancy outcomes in women with adult congenital heart disease using the Anatomic and Physiological (AP) Classification System: How much does physiology matter? 使用解剖和生理(AP)分类系统预测患有成人先天性心脏病的妇女的心脏和妊娠结局:生理学有多重要?
International journal of cardiology. Congenital heart disease Pub Date : 2023-12-07 DOI: 10.1016/j.ijcchd.2023.100486
Richard Kha , Sarah J. Melov , Thushari I. Alahakoon , Adrienne Kirby , Preeti Choudhary
{"title":"Predicting cardiac and pregnancy outcomes in women with adult congenital heart disease using the Anatomic and Physiological (AP) Classification System: How much does physiology matter?","authors":"Richard Kha ,&nbsp;Sarah J. Melov ,&nbsp;Thushari I. Alahakoon ,&nbsp;Adrienne Kirby ,&nbsp;Preeti Choudhary","doi":"10.1016/j.ijcchd.2023.100486","DOIUrl":"https://doi.org/10.1016/j.ijcchd.2023.100486","url":null,"abstract":"<div><h3>Background</h3><p>Pregnancy in women with congenital heart disease (CHD) is associated with an increased risk of adverse maternal and fetal events. Despite the physiological impact of CHD on pregnancy, current risk stratification scores primarily consider anatomical lesions. We assessed the performance of the novel American Heart Association Anatomic and Physiological (AP) classification system in predicting adverse maternal cardiac, obstetric and fetal events, and compared it with established risk models.</p></div><div><h3>Methods</h3><p>This retrospective cohort study enrolled pregnant women with CHD managed by the Westmead Hospital high-risk pregnancy team. Preconception risk stratification scores (AP classification, mWHO classification, CARPREG II and ZAHARA scores) were retrospectively assigned to each pregnancy by an adult CHD cardiologist and compared with the primary outcome measures, which were maternal cardiac, obstetric and fetal complications.</p></div><div><h3>Results</h3><p>We analysed 176 pregnancies in 120 women with CHD. Maternal cardiac risk significantly increased between AP class 2 and 3 (p = 0.001). Within class 3, higher physiological status correlated with maternal cardiac events (p &lt; 0.001). Increasing AP severity correlated with lower fetal birthweight percentiles (p = 0.003). The AP classification was similar to mWHO at predicting maternal cardiac outcomes (AUC 0.787 vs 0.777, p &lt; 0.001), but the CARPREG II (AUC 0.852, p &lt; 0.001) and ZAHARA scores (AUC 0.864, p &lt; 0.001) had higher discriminatory ability within our cohort.</p></div><div><h3>Conclusion</h3><p>The AP classification system shows non-inferior preconception maternal cardiac risk prediction compared to current validated scores. Consideration of physiological status has additive predictive value in the most complex patients (Stage III). Prospective, multicenter studies are required for further validation for preconception risk estimation.</p></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666668523000484/pdfft?md5=7223e5b4614b364c557e265f0f85a77c&pid=1-s2.0-S2666668523000484-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138570108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Percutaneous balloon atrial septostomy for left heart decompression post-repair of partial anomalous pulmonary venous drainage and aortic valve replacement 经皮房间隔球囊造口术治疗左心减压术后部分肺静脉引流修复及主动脉瓣置换术
International journal of cardiology. Congenital heart disease Pub Date : 2023-12-01 DOI: 10.1016/j.ijcchd.2023.100482
Karla Sue América Hurtado Belizario , Gian Manuel Jimenez Rodriguez , Edgar García Cruz , Jose A. García Montes , Luis Antonio Falcón Quispe , María Fernanda León Blanchet , Antonio Reyes Ortega , Patricia Espinosa González , Gustavo Rojas Velasco
{"title":"Percutaneous balloon atrial septostomy for left heart decompression post-repair of partial anomalous pulmonary venous drainage and aortic valve replacement","authors":"Karla Sue América Hurtado Belizario ,&nbsp;Gian Manuel Jimenez Rodriguez ,&nbsp;Edgar García Cruz ,&nbsp;Jose A. García Montes ,&nbsp;Luis Antonio Falcón Quispe ,&nbsp;María Fernanda León Blanchet ,&nbsp;Antonio Reyes Ortega ,&nbsp;Patricia Espinosa González ,&nbsp;Gustavo Rojas Velasco","doi":"10.1016/j.ijcchd.2023.100482","DOIUrl":"10.1016/j.ijcchd.2023.100482","url":null,"abstract":"","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666668523000447/pdfft?md5=ede05d450844f98d8017692bb2659f97&pid=1-s2.0-S2666668523000447-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135850267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of fetal pulmonary valvuloplasty in in-utero critical pulmonary stenosis: A systematic review and meta-analysis 胎儿肺动脉瓣成形术对胎儿重度肺动脉狭窄的影响:系统回顾和荟萃分析
International journal of cardiology. Congenital heart disease Pub Date : 2023-11-18 DOI: 10.1016/j.ijcchd.2023.100485
Brian Mendel , Kelvin Kohar , Defin Allevia Yumnanisha , Richie Jonathan Djiu , Justin Winarta , Radityo Prakoso , Sisca Natalia Siagian
{"title":"Impact of fetal pulmonary valvuloplasty in in-utero critical pulmonary stenosis: A systematic review and meta-analysis","authors":"Brian Mendel ,&nbsp;Kelvin Kohar ,&nbsp;Defin Allevia Yumnanisha ,&nbsp;Richie Jonathan Djiu ,&nbsp;Justin Winarta ,&nbsp;Radityo Prakoso ,&nbsp;Sisca Natalia Siagian","doi":"10.1016/j.ijcchd.2023.100485","DOIUrl":"https://doi.org/10.1016/j.ijcchd.2023.100485","url":null,"abstract":"<div><h3>Background</h3><p>Untreated critical pulmonary stenosis may develop into pulmonary atresia with intact ventricular septum, which is associated with a high risk of morbidity and mortality both in fetuses and neonates. In this meta-analysis, we sought to discover the potential of fetal pulmonary valvuloplasty that might affect patients' survival compared to other available procedures.</p></div><div><h3>Methods</h3><p>This systematic review and meta-analysis were conducted based on the PRISMA guideline. The authors thoroughly searched the recognized and potential interventions for PA-IVS, including FPV, total ventricular repair, and palliative procedures. The primary outcome was the mortality rate. We used R software (version 4.1.3) to calculate the overall proportion using the random-effects model of proportional meta-analysis.</p></div><div><h3>Results</h3><p>The FPV procedure was performed at a mean gestational age of 26.28 weeks (95%CI: 24.83–27.73) and was successful in 87.6 % (95 % CI: 78.3–96.3 %) of patients. A total of 52.9 % patients attained biventricular circulation postnatally (95 % CI: 31.2–74.7 %). Successful FPV was associated with a slightly higher overall mortality rate [periprocedural death 4.7 % (95%CI: 0–10.7 %) and postnatal death 8 % (95%CI: 3–13 %)] compared to the three currently available definitive therapies, namely the Fontan procedure [10 % (95%CI: 4–17 %)], 1.5V repair [11 % (95%CI: 5–17 %), and 2V repair [8 % (95%CI: 1–15 %)].</p></div><div><h3>Conclusion</h3><p>FPV can potentially increase the likelihood of biventricular circulation in fetuses with critical pulmonary valve stenosis.</p></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666668523000472/pdfft?md5=9577944a7385f8845ea3e0161abe4f33&pid=1-s2.0-S2666668523000472-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138577818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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