Phenotype, management and predictors of outcome in a large cohort of adult congenital heart disease patients with heart failure

Bruaene, Alexander Van De; Hickey, Edward; Kovacs, Adrienne H.; Crean, Andrew M.; Wald, Rachel M.; Silversides, Candice K.; Redington, Andrew N.; Ross, Heather J.; Alba, Ana C.; Billia, Filio; Nair, Krishnakumar; Benson, Lee; Horlick, Eric; Osten, Mark; Colman, Jack M.; Heggie, Jane; Oechslin, Erwin; Roche, S. Lucy

doi:10.1016/j.ijcard.2017.10.086

Cited by 56 publications

(60 citation statements)

References 47 publications

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“…Those at risk for advanced HF were patients with shunts complicated by pulmonary hypertension, biventricular physiology with subaortic RV (2V-RV), rToF with right-sided or biventricular impairment, and single ventricle after Fontan opment strategieseration (figure 1). Of note, simple defects accounted only for 13% of cases and less than 40% of cases had biventricular physiology with subaortic left ventricle (LV) 9. Marked phenotypic differences were also observed across the underlying lesions.…”

Section: Specific Lesions At Risk For Hf In the Achd Populationmentioning

confidence: 99%

“…Overall, systemic LV ejection fraction was relatively well preserved in most ACHD subgroups as compared with that reported from the patients with acquired HF. Atrial arrhythmias, systemic ventricular systolic dysfunction or atrioventricular valve regurgitation (AVVR) occurred more consistently in patients with 2V-RV 9…”

Section: Specific Lesions At Risk For Hf In the Achd Populationmentioning

confidence: 99%

“…Moreover, HF symptoms in ACHD can be attributed to the residual haemodynamic lesions or to both systolic and diastolic ventricular dysfunction. Understanding this heterogeneity is critical and the most appropriate medical treatment for each clinical situation must be individualised, based on the anatomical substrate and the method of repair8 9 (figure 2).…”

Section: Specific Lesions At Risk For Hf In the Achd Populationmentioning

confidence: 99%

“…Whereas LV dysfunction is the main cause of the chronic HF syndrome in acquired heart disease, ACHD-related HF is predominantly right sided and more likely to be caused by RV dysfunction, tricuspid regurgitation, pulmonary hypertension or decreased ventricular compliance 7–9. As occurs in acquired HF with preserved ejection fraction, the use of HF therapies has not proven effectiveness 19.…”

Section: Rationale and Limitations For Applying Hf Medical Treatment mentioning

confidence: 99%

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Medical therapy for heart failure in adult congenital heart disease: does it work?

Gallego

Oliver

2019

Heart

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Section: Specific Lesions At Risk For Hf In the Achd Populationmentioning

confidence: 99%

Section: Specific Lesions At Risk For Hf In the Achd Populationmentioning

confidence: 99%

Section: Specific Lesions At Risk For Hf In the Achd Populationmentioning

confidence: 99%

Section: Rationale and Limitations For Applying Hf Medical Treatment mentioning

confidence: 99%

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Medical therapy for heart failure in adult congenital heart disease: does it work?

Gallego

Oliver

2019

Heart

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“…As these patients progress into adulthood, they continue to experience complications and medical complexities associated with their CHD. The dominant complication that the ACHD population faces is the development of heart failure, and this is currently recognized as the leading cause of death for ACHD patients [3].…”

Section: Introductionmentioning

confidence: 99%

Surgical Management for Advanced Heart Failure in Adults with Congenital Heart Disease

Valadon¹,

Schumer²,

Slaughter³

2018

Heart Transplantation

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Adults with congenital heart disease (ACHD) have emerged as a new patient population that poses a variety of treatment and management obstacles. This chapter discusses the diagnosis of heart failure and treatment challenges faced by ACHD specifically addressing when to initiate mechanical circulatory support versus heart transplantation. It is evident that the ACHD population presents with a variety of unique challenges and considerations that still need to be explored. Addressing each of these issues will vastly change and improve how ACHD patients are approached from a treatment standpoint and ultimately provide more advantageous clinical options that can successfully handle the complexities presented by this population.

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Heart failure related to adult congenital heart disease: prevalence, outcome and risk factors

Arnaert

Meester

Troost³

et al. 2021

ESC Heart Failure

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Aims Information on the prevalence, outcome and factors associated with heart failure in patients with adult congenital heart disease (CHD) (ACHD-HF) is lacking. We aimed at assessing the prevalence and outcome of ACHD-HF, the variables associated with ACHD-HF, and the differences between major anatomical/pathophysiological ACHD subgroups. Methods and resultsWe included 3905 patients (age 35.4 ± 13.2 years) under active follow-up in our institution (last visit >2010). Outcome of ACHD-HF cases was compared with sex-and age-matched cases. Univariable and multivariable binary logistic regression with ACHD-HF diagnosis as a dependent variable was performed. Overall prevalence of ACHD-HF was 6.4% (mean age 49.5 ± 16.7 years), but was higher in patients with cyanotic CHD (41%), Fontan circulation (30%), and a systemic right ventricle (25%). All-cause mortality was higher in ACHD-HF cases when compared with controls (mortality rate ratio 4.67 (2.36-9.27); P = 0.0001). In multivariable logistic regression analysis, age at latest follow-up [per 10 years; odds ratio (

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Phenotype, management and predictors of outcome in a large cohort of adult congenital heart disease patients with heart failure

Cited by 56 publications

References 47 publications

Medical therapy for heart failure in adult congenital heart disease: does it work?

Medical therapy for heart failure in adult congenital heart disease: does it work?

Surgical Management for Advanced Heart Failure in Adults with Congenital Heart Disease

Heart failure related to adult congenital heart disease: prevalence, outcome and risk factors

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