Prevalence and composition of CHD at different altitudes in Tibet: a cross-sectional study

Zheng, Jie; Qiu, Yi-Gang; Li, Dongtao; He, Jiangchun; Chen, Yu; Cao, Yu; Liu, Yingming; Li, Xianfeng; Hai-tao, Chi; Li, Tianchang

doi:10.1017/s1047951117000567

Cited by 17 publications

(18 citation statements)

References 14 publications

(31 reference statements)

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“…The influence of high-altitude has not been revealed as a causative factor, which corresponds to the international data obtained in different years and in different altitudes (9)(10)(11)(12). Based on the obtained results, the most common forms of CHD (in children under 1 year old and newborn babies) in our country are "acyanotic" heart defects, such as the patent ductus arteriosus (12.5% and 35.42%), atrial septal defect (11.25% and 8.34%), ventricular septal defect (32% and 12%) and their combinations.…”

Section: Discussionsupporting

confidence: 78%

The results of a three-year research program on assessment of primary diagnostic issue of congenital heart defects in children under 1 year and the availability of cardiac surgical care in the Kyrgyz Republic

Kudaiberdiev¹,

Akhmedova²,

Imanov³

et al. 2019

HVT

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Section: Discussionsupporting

confidence: 78%

The results of a three-year research program on assessment of primary diagnostic issue of congenital heart defects in children under 1 year and the availability of cardiac surgical care in the Kyrgyz Republic

Kudaiberdiev¹,

Akhmedova²,

Imanov³

et al. 2019

HVT

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“…Since newborns with moderate or severe CHD are prone to have other serious illness and admitted to the NICU and subsequently die at young age at high altitude before the screening age in most of the previous studies, our data reveals a truer picture of CHD with the widest spectrum of moderate and severe types to date, in addition to the simple CHD as previously reported [3][4][5][6][7].…”

Section: Discussionsupporting

confidence: 71%

“…Almost all the CHDs previously reported are the simple forms with left to right shunt, with the predominance of secundum atrial septal defect (ASD) and patent ductus arteriosus (PDA). Notably, most of the previous studies were conducted in children older than 2 years of age [3][4][5][6][7]. Children with complex and severe CHD may most likely have died at younger age.…”

Section: Introductionmentioning

confidence: 99%

“…There was only one more study paid attention to critically ill in a small group of children (n=383), and some more types of complex CHD were found (e.g. tetralogy of Fallot, double outlet right ventricle, etc) with the incidence of 5.2% [5]. There were also other mild and moderate forms of CHD, including tricuspid, aortic and pulmonary valve abnormalities, etc.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Spectrum of Complex Congenital Heart Disease in the Neonatal Intensive Care Unit at high Altitude in China

Li¹,

Wang²,

Liu³

et al. 2020

Preprint

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Background: Previous studies from high altitudes have reported significantly higher prevalence of congenital heart disease (CHD), consisting almost solely of simple CHD. Little is known about the occurrence of complex CHD. Neonates with complex CHD are likely admitted to NICU. We examined the prevalence and spectrum of complex CHD in NICU in order to depict a truer picture of CHD at high altitude.Methods: We reviewed charts of 4,214 neonates admitted to NICU in Qinghai province (average altitude 3,000m). Echocardiography was performed in 1,943 babies when CHD was suspected based on clinical examinations.Results: CHD was diagnosed in 1,093(56.3% of echoed babies). Mild CHD in 96.8%(1058 babies). Moderate CHD in 0.8%(9) included 1(0.1%) large secundum atrial septal defect, 3(0.3%) moderate pulmonary stenosis, 2(0.2%) aortic stenosis and 3(0.3%) partial anomalous pulmonary venous connection. Severe CHD in 2.4%(26) included 6(0.5%) complete atrioventricular septal defect, 5(0.5%) complete transposition of the great arteries, 5(0.5%) hypoplastic right heart, 3(0.3%) hypoplastic left heart, 3(0.3%) double outlet right ventricle, 3(0.3%) tetralogy of Fallot, 2(0.2%) truncus arteriosus, 2(0.2%) total anomalous pulmonary venous connection, 2(0.2%) severe aortic stenosis, 2(0.2%) Interrupted aortic arch and 2(0.2%) severe pulmonary stenosis and 1(0.1%) single-ventricle abnormality. At two-years follow-up in 737(67.4%) patients, 18(90%) with severe CHD and 38(5.3%) with mild and moderate CHD died, and 15 underwent cardiac surgery with 1 early death.Conclusions: At high altitude, a wide spectrum of CHD exists, with many heretofore unreported complex CHD. There is urgent need for routine echocardiography and early interventions in newborns particularly in NICU.

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“…Exposure of Nkx2-5 null heterozygous embryos to hypoxia in utero exacerbates this effect, resulting in an increased penetrance of heart defects (Moumne et al 2018) or embryonic death (Moreau et al 2019). This geneenvironment interaction may explain the curious clinical observation that complex CHD rates are significantly reduced in high-altitude populations than in those at sea level (Zheng et al 2017). This perhaps suggests that at high altitudes, there is an increased mortality rate of fetuses with complex CHD.…”

Section: Hypoxiamentioning

confidence: 99%

Environmental Risk Factors for Congenital Heart Disease

Kalisch-Smith

Ved

Sparrow

2019

Cold Spring Harb Perspect Biol

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Congenital heart disease (CHD) has many forms and a wide range of causes. Clinically, it is important to understand the causes. This allows estimation of recurrence rate, guides treatment options, and may also be used to formulate public health advice to reduce the population prevalence of CHD. The recent advent of sophisticated genetic and genomic methods has led to the identification of more than 100 genes associated with CHD. However, despite these great strides, to date only one-third of CHD cases have been shown to have a simple genetic cause. This is because CHD can also be caused by oligogenic factors, environmental factors, and/or gene-environment interaction. Although solid evidence for environmental causes of CHD have been available for almost 80 years, it is only very recently that the molecular mechanisms for these risk factors have begun to be investigated. In this review, we describe the most important environmental CHD risk factors, and what is known about how they cause CHD.

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Prevalence and composition of CHD at different altitudes in Tibet: a cross-sectional study

Abstract: A wide variation in CHD prevalence and composition existed in Tibetan children among different altitudes.

Cited by 17 publications

References 14 publications

The results of a three-year research program on assessment of primary diagnostic issue of congenital heart defects in children under 1 year and the availability of cardiac surgical care in the Kyrgyz Republic

The results of a three-year research program on assessment of primary diagnostic issue of congenital heart defects in children under 1 year and the availability of cardiac surgical care in the Kyrgyz Republic

Prevalence and Spectrum of Complex Congenital Heart Disease in the Neonatal Intensive Care Unit at high Altitude in China

Environmental Risk Factors for Congenital Heart Disease

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