Cognitive function in adults with Fontan palliation versus acyanotic CHD patients and association with health-related quality of life

Abstract

Background: Impairments and developmental delay are often reported in infants and young children with CHD. However, currently, there is no data regarding cognitive abilities assessed by standardised intelligence tests in adults with CHD. This study assesses the cognitive function in Fontan patients compared with acyanotic CHD patients whether restrictions in cognitive function are present in adulthood and its association with health-related quality of life. Methods: Forty-four adult CHD (female n = 21 (47.7%); mean age 34.7 ± 11.9 years), 22 with Fontan circulation and 22 with acyanotic CHD, underwent the Wechsler Intelligence Scale for adults as patients during routine follow-up in 2018. The Medical Outcomes Study Questionnaire Short-Form 36 Health Survey (SF-36) assessed health-related quality of life. Results: Fontan patients showed significantly better results in the FSIQ (p = 0.020) and perceptual reasoning (p = 0.017) in comparison with patients with acyanotic CHD. All adult CHD patients showed normal IQ in subscales and full-scale IQ (FSIQ). In health-related quality of life, no association with cognitive function was found and no significant difference between both CHD groups, but trends to reduced values in acyanotic adult CHD. Conclusions: Interestingly, our study results in adult Fontan patients showed that it is possible to live an adult life with normal cognitive function and good health-related quality of life with a univentricular heart. Thus, this study could be a guidepost for more in-depth studies on cognitive function in Fontan survivors. In addition, the focus should be on health-related quality of life of adult CHD with simple CHD in particular, since a reduced health-related quality of life is not only medically based.

Beyond the heart: Cognitive and verbal outcomes in Arab children with congenital heart diseases

“…The absence of a significant correlation between cognitive abilities and child‐reported QoL might indicate the complexity of children's self‐perception and expression regarding their well‐being in the context of a health condition like CHD. A recent study by Remmele et al (2023) showed also no association between cognitive function and self‐reported QoL in adults with CHD. It has been suggested that “relying solely on self‐reports of patients with CHDs might underestimate the severity of their challenges, at least in the domain of executive functions” (Bellinger et al, 2014, p. 9).…”