Sympathovagal imbalance decades after atrial septal defect repair: a long-term follow-up study

Alstrup, Mathias; Karunanithi, Zarmiga; Maagaard, Marie; Poulsen, Steen Hvitfeldt; Hjortdal, Vibeke E.

doi:10.1093/ejcts/ezab235

Cited by 4 publications

(1 citation statement)

References 30 publications

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“…Device closure of the atrial septal defect has been introduced as an alternative to open-heart surgical repair in the treatment of secundum atrial septal defects (ASD) (1)(2)(3). Transthoracic device occlusion surgery in the treatment of secundum atrial septal defects has the advantages of minimal trauma, no radiation, fewer complications, short operation time, and short postoperative recovery time (4,5). However, despite these notable bene ts, an accurate preoperative assessment to guide the choice of surgical approach for atrial septal defects remains a challenging proposition.…”

Section: Introductionmentioning

confidence: 99%

Three predictive models for transthoracic device closure of atrial septal defect: a comprehensive comparative analysis

Ruan,

Han,

Xie

et al. 2023

Preprint

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Background: Atrial Septal Defect (ASD) is a common congenital heart disease. Although transthoracic occlusion of ASD is increasingly seen as a less invasive alternative to traditional surgery, the choice of procedure often relies on the surgeon's experience and the insights gained from transesophageal echocardiography (TEE) images, lacking concrete, quantifiable standards. This study aims to guide clinical surgical decisions by developing and comparing predictive models. Methods: We analyzed 312 patients with secundum atrial septal defects who underwent either transthoracic device closure or open surgical repair. By measuring and analyzing preoperative TEE data and utilizing statistical and programming software, we developed three predictive models: logistic regression, random forest, and multiple linear regression. The original data were divided into a training dataset and a testing dataset, with each model trained on the training dataset and validated on the testing dataset. The predictive performance of each model was then evaluated on both adult and pediatric data. Results: Each model exhibited remarkable predictive power. The prediction accuracies in the training dataset for the logistic regression model, random forest model, and multiple linear regression model were 0.892, 0.888, and 0.868, respectively. In the testing dataset, the prediction accuracies were 0.9194, 0.871, and 0.9194, respectively. Conclusions: This study developed three predictive models to guide clinical surgical decisions for ASD closure surgery. Among them, the multivariate linear regression model demonstrated significant predictive accuracy, offering the potential to streamline the clinical decision-making process. This model does not require complex computations and is capable of providing quick, real-time predictions.

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Section: Introductionmentioning

confidence: 99%

Three predictive models for transthoracic device closure of atrial septal defect: a comprehensive comparative analysis

Ruan,

Han,

Xie

et al. 2023

Preprint

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Heart rate variability and cognitive functions in adolescents with complex congenital heart disease

Toyofuku,

Ehrler,

Naef

et al. 2024

Pediatr Res

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Background Heart Rate Variability (HRV) originates from the interplay between parasympathetic/sympathetic inputs to the heart, thus serving as an indicator of Autonomic Nervous System regulation. Prior research indicates that decreased HRV, marked by reduced autonomic balance, is related to poorer cognitive performance. While the population with congenital heart disease (CHD) show changes in HRV linked with the heart defect, the association between HRV and cognitive functions in CHD remains unexplored. Methods 46 adolescents with CHD who went through infant open-heart surgery and 64 healthy controls (50.9% males, 12.8 ± 1.4 years) underwent neurodevelopmental testing and photoplethysmograph acquisition. Group differences and associations with cognitive functions were analysed with linear regression. P values were FDR-corrected. Results Adolescents with CHD showed lower HRV (quantified by high-frequency power) compared to controls (p < 0.001). Lower HRV was correlated with worse executive function (β = 0.24, p = 0.044) and lower IQ (β = 0.26, p = 0.010) in the whole sample and with lower IQ (β = 0.35, p = 0.014) in the CHD group. These associations were robust to confounders, including age, sex, and socioeconomic status. Conclusion Our findings demonstrate an association between HRV and cognitive functions in adolescents with complex CHD. Early detection of alterations in HRV/autonomic regulation may help to identify children with CHD at risk for cognitive impairments. Impact Adolescents with congenital heart disease (CHD) showed lower heart rate variability (HRV), indicating an imbalanced autonomic nervous system. Lower HRV was associated with lower IQ and executive function (EF) in the whole sample. The association between HRV and IQ was significantly stronger in CHD than in healthy controls. This study provides the first evidence of a link between altered HRV and cognitive impairments in the CHD population. Neurodevelopmental impairments seen in adolescents with CHD could be linked to their altered cardiac autonomic nervous activity, marked by low HRV.

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Heart rate variability in congenital heart disease: looking and learning

Boris¹

2021

European Journal of Cardio-Thoracic Surgery

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Sympathovagal imbalance decades after atrial septal defect repair: a long-term follow-up study

Cited by 4 publications

References 30 publications

Three predictive models for transthoracic device closure of atrial septal defect: a comprehensive comparative analysis

Three predictive models for transthoracic device closure of atrial septal defect: a comprehensive comparative analysis

Heart rate variability and cognitive functions in adolescents with complex congenital heart disease

Heart rate variability in congenital heart disease: looking and learning

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