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- Andersson, Alva, et al.
(författare)
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Functional muscle power in the lower extremity in adults with congenital heart disease
- 2023
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Ingår i: International Journal of Cardiology Congenital Heart Disease. - : Elsevier BV. - 2666-6685. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to investigate functional muscular power in the lower extremity in adults with congenital heart disease (ACHD) and compare results with those of healthy persons. Secondarily, we set out to assess muscle power in relation to age, sex, and complexity of ACHD.Methods: Between 2013 and 2019, 1126 patients attended the ACHD Unit of Sahlgrenska University Hospital/Ostra and performed a test battery to determine physical fitness. Of these patients, 559 who performed the Timed-Stands Test (TST)-which requires 10 stands from a chair at the maximal possible speed-were included in the study.Results: Patients with ACHD performed the TST slower than reference (14.6 s [12.0-18.0] vs. 11.7 s [9.8-14.3], p < 0.001). Men with ACHD performed the TST more rapidly or according to reference in 8% of patients aged 18-39 years, 21% of patients aged 40-65 years, and 55% of patients aged >65 years. Women with ACHD performed the TST more rapidly or according to reference in 21% of patients aged 18-39 years, 56% of patients aged 40-65 years, and 32% of patients aged >65 years. Men with ACHD performed the TST significantly faster than women with ACHD (p < 0.001).Conclusions: Decreased functional muscle power was observed in patients with ACHD and was most pronounced in patients aged 18-39 years. Decreased muscle power is important to detect and requires further assessment because it may contribute to an increased risk of falling and developing lifestyle related diseases.
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| 5. |
- Daene, M, et al.
(författare)
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Outcome of Down patients with repaired versus unrepaired atrioventricular septal defect
- 2023
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Ingår i: International Journal of Cardiology Congenital Heart Disease. - : Elsevier BV. - 2666-6685. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims Patients with Down Syndrome (DS) are frequently born with an atrioventricular septal defect (AVSD). Surgical repair of the defect aims to minimize mortality and morbidity. However, a surgical intervention, specifically in DS patients, is not without risk and a subgroup of patients underwent only conservative non-surgical treatment. Outcome data of these different approaches are scarce. The aim of this retrospective study was to compare the long-term outcome of DS patients with and without surgery for AVSD. Methods DS patients registered with AVSD in the hospital's database from January 1980 till December 2020 were selected. Patient characteristics, peri-operative if appropriate, and follow-up data were obtained from the medical files. Results In total, 72 unrepaired (36 male, 50%) and 134 repaired patients (61 male, 46%) were included. After a maximum of 60 years of follow-up, the all-cause mortality was 45.8% and 17.1%, respectively. Thirty-six percent and 13%, respectively, were labeled as non-cardiovascular death. Mean survival time for unrepaired AVSD was 40.7 years (95% CI 36.1–45.2) and for repaired AVSD 38.5 years (95% CI 35.3–41.6) (Log rank p = 0.465). However, the survival rate 35 years after birth was 62.1% for unrepaired patients versus 81.7% for repaired patients. Mortality rates were the highest the first months after surgical repair. Conclusions The mean survival rate of Down patients, born with an AVSD, did not differ between repair or not. However, long-term survival rate was higher in patients who underwent surgical repair. Mortality was highest the first months after surgery.
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- Karagianni, Alexia, 1980, et al.
(författare)
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Long-term outcome after closure of an atrial shunt in patients aged 60 years or older with ischemic stroke: A nationwide, registry-based, case-control study
- 2023
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Ingår i: International Journal of Cardiology Congenital Heart Disease. - Amsterdam : Elsevier. - 2666-6685. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: According to the current guidelines, evidence of the effects of transcatheter closure in patients aged ≥60 years with an atrial shunt and cryptogenic stroke is still limited. Methods: Using Swedish health registries, patients aged ≥60 years who had previously developed a cryptogenic cerebrovascular event and undergone transcatheter closure were identified. Patients with atrial fibrillation were excluded, and the remaining patients were propensity score-matched with patients of the same age and risk profile who had only undergone medical treatment and with controls from the general population. They were then followed up until 2017 (mean period of 7.1 ±3.9 years). Results: In total, 100 patients of the intervention group were matched with 100 patients of the medical treatment group and with 100 controls and followed up. The hazard ratio for a recurrent ischemic stroke in the intervention group compared with the medical treatment group was 0.8 (95% confidence interval, 0.3–2.1), and that compared with the controls was 2.3 (95% confidence interval, 0.6–8.9). Atrial fibrillation occurred at the same rate in the two treatment groups (odds ratio, 0.8; 95% confidence interval, 0.4–1.7). However, patients in the intervention group developed vascular disease at a lower rate (odds ratio, 0.5; 95% confidence interval, 0.25–0.85). Conclusions: Patients aged ≥60 years with cryptogenic stroke may undergo transcatheter closure of an atrial shunt after thorough screening for other potential causes of stroke. The incidence of vascular disease seems to be mitigated in these patients relative to medically treated patients. © 2023 The Authors. Published by Elsevier B.V.
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- Leibold, Allison, et al.
(författare)
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Pain in adults with congenital heart disease : An international perspective
- 2021
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Ingår i: International Journal of Cardiology Congenital Heart Disease. - : Elsevier. - 2666-6685. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with adult congenital heart disease (ACHD) have many risk factors for chronic pain such as prior cardiac interventions and adult comorbidities. However, the prevalence of chronic pain has not been well described in this population. We sought to determine the prevalence of pain in a large international cohort of patients with ACHD.Methods: Data from the APPROACH-IS dataset was utilized for this study which includes 4028 patients with ACHD from 15 different countries. The prevalence of pain was assessed under the health status patient reported outcome domain utilizing the EuroQol-5D 3 level version tool. Multivariable logistic regression was used to assess differences across countries in pain, taking into account country-level random effects for clustering across observations within each country.Results: A total of 3832 patients with ACHD met the study criteria, median age 32 years [IQR 25, 42], 52.6% females. The prevalence of at least moderate pain was reported by 28.9% (95% CO 27.5 = 30.3%) of participants. Pain was associated with country of origin, age, gender, background, education and marital status as well as several clinical variables including disease complexity, cardiac device presence, history of heart failure, psychiatric conditions and presence of other medical conditions. Those with pain had lower levels of perceived health and a lower quality of life score.Conclusion: Pain in patients with ACHD is common, impacting nearly one-third of patients. Given the far reaching implications of pain in patients with ACHD, further study of pain characteristics and treatment management appear warranted.
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- Nielsen, Susanne, 1969, et al.
(författare)
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Risk for first onset depression in adults with congenital heart disease
- 2022
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Ingår i: INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE. - : Elsevier BV. - 2666-6685. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: The long-term risk for depression among adults with congenital heart disease (ACHD) is unclear. Therefore, we assessed the risk for first onset of serious depression in patients with ACHD compared with a sex and age-matched control population without a congenital heart disease (CHD) diagnosis.Methods: We extracted all patients with CHD born from 1970 to 1999 who survived until age 18 years from the Swedish National Patient Register. For each case, 10 random controls without CHD were selected from the general population and matched by birth year and sex. Participants were followed-up until the first diagnosis of new onset serious depression requiring hospital or specialist outpatient care.Results: This study included 22,912 patients with ACHD and 224,259 controls. The mean age at depression onset was 30.1 years in the ACHD group and 30.3 years in controls. The overall associated risk for serious depression was higher among patients with ACHD compared with controls, with an adjusted hazard ratio (aHR) of 1.32 (95% confidence interval [CI]: 1.20-1.44). Patients in the complex lesion group had a 54% higher risk for depression (aHR 1.54, 95% CI: 1.10-2.18) compared with the control group. The corresponding result for the non-complex lesion group was aHR 1.30 (95% CI: 1.18-1.43).Conclusion: The long-term risk for serious depression was higher among young and middle-aged patients with ACHD compared with matched controls. The risk was particularly elevated among patients with complex lesions. Patients with ACHD need support through strategies to prevent depression.
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