Congenital Heart Disease and Risk of Central Nervous System Infections: A Nationwide Cohort Study

Bagge, Carina N.; Smit, Jesper; Madsen, Nicolas; Olsen, Morten

doi:10.1007/s00246-020-02324-z

Cited by 3 publications

(3 citation statements)

References 39 publications

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“…Fontan patients are considered to be at increased risk for hematogenous spread of pathogens to the central nervous system due to shunting ( 37 ). In a nationwide cohort study in Denmark the risk of CNS infections (not limited to cerebral abscesses) was 0.93 per 1,000 person years for univentricular CHD patients ( 38 ). This represents a 3-fold (1.13–8.17) increased risk compared to the general population.…”

Section: Resultsmentioning

confidence: 99%

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Fontan Circulation Associated Organ Abnormalities Beyond the Heart, Lungs, Liver, and Gut: A Systematic Review

Ritmeester

Veger

Ven

et al. 2022

Front. Cardiovasc. Med.

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IntroductionPatients with a Fontan circulation are at risk for sequelae of Fontan physiology during follow-up. Fontan physiology affects all organ systems and an overview of end-organ damage is needed.MethodsWe performed a systematic review of abnormalities in multiple organ systems for patients with a longstanding Fontan circulation. We searched online databases for articles describing abnormalities in multiple organ systems. Cardio-pulmonary abnormalities, protein losing enteropathy, and Fontan associated liver disease have already extensively been described and were excluded from this systematic review.ResultsOur search returned 5,704 unique articles. After screening, we found 111 articles relating to multiple organ systems. We found abnormalities in, among others, the nervous system, pituitary, kidneys, and musculoskeletal system. Pituitary edema—relating to the unique pituitary vasculature- may affect the thyroid axis. Renal dysfunction is common. Creatinine based renal function estimates may be inappropriate due to myopenia. Both lean muscle mass and bone mineral density are decreased. These abnormalities in multiple organ systems may be related to Fontan physiology, cyanosis, iatrogenic factors, or lifestyle.ConclusionsHealth care providers should be vigilant for hypothyroidism, visual or hearing deficits, and sleep disordered breathing in Fontan patients. We recommend including cystatin C for assessment of renal function. This review may aid health care providers and guide future research.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232461, PROSPERO, identifier: CRD42021232461.

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Section: Resultsmentioning

confidence: 99%

“…Fontan patients are at 3-fold increased risk of CNS infections compared to healthy peers ( 38 ). This may relate to hematogenous spread of pathogens due to shunting.…”

Section: Discussionmentioning

confidence: 99%

Fontan Circulation Associated Organ Abnormalities Beyond the Heart, Lungs, Liver, and Gut: A Systematic Review

Ritmeester

Veger

Ven

et al. 2022

Front. Cardiovasc. Med.

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“…Congenital heart disease (CHD) is a common birth defect, afflicting approximately 2% of live newborns globally, and remains a significant contributor to infant morbidity and mortality [ 1 , 2 ]. Despite advancements in medical technologies that have led to a decline in CHD‐related deaths, patients with CHD face an elevated risk of neurodevelopmental disabilities, immune dysfunctions, infections, and cancer [ 3 , 4 , 5 , 6 ]. These potential complications have severe implications for the long‐term well‐being of CHD‐affected individuals and underscore the ongoing challenges in managing this complex congenital disease.…”

Section: Introductionmentioning

confidence: 99%

From heart to gut: Exploring the gut microbiome in congenital heart disease

Liu,

Huang,

et al. 2023

iMeta

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Congenital heart disease (CHD) is a prevalent birth defect and a significant contributor to childhood mortality. The major characteristics of CHD include cardiovascular malformations and hemodynamical disorders. However, the impact of CHD extends beyond the circulatory system. Evidence has identified dysbiosis of the gut microbiome in patients with CHD. Chronic hypoxia and inflammation associated with CHD affect the gut microbiome, leading to alterations in its number, abundance, and composition. The gut microbiome, aside from providing essential nutrients, engages in direct interactions with the host immune system and indirect interactions via metabolites. The abnormal gut microbiome or its products can translocate into the bloodstream through an impaired gut barrier, leading to an inflammatory state. Metabolites of the gut microbiome, such as short‐chain fatty acids and trimethylamine N‐oxide, also play important roles in the development, treatment, and prognosis of CHD. This review discusses the role of the gut microbiome in immunity, gut barrier, neurodevelopment, and perioperative period in CHD. By fostering a better understanding of the cross‐talk between CHD and the gut microbiome, this review aims to contribute to improve clinical management and outcomes for CHD patients.

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