Document Detail


Incidence and risk distribution of heart failure in adolescents and adults with congenital heart disease after cardiac surgery.
MedLine Citation:
PMID:  16616033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Heart failure (HF) is a major problem in the long-term follow-up of adults with congenital heart disease (CHD) after cardiac surgery. The purpose of this study was to evaluate risk factors for HF in patients with CHD. N-terminal-pro-brain natriuretic peptide and maximal oxygen uptake (VO2max) were measured in 345 consecutive patients with CHD. HF was defined as an elevated N-terminal-pro-brain natriuretic peptide level (> or = 100 pg/ml) and reduced VO2max (< or = 25 ml/kg/min). The HF criteria were met by 89 patients. These patients were significantly older (mean +/- SEM 30.8 +/- 0.9 vs 24.8 +/- 0.5 years), had significantly lower maximal heart rates (149 +/- 3 vs 164 +/- 1 beats/min), and had larger end-diastolic right ventricular diameters (36 +/- 1 vs 27 +/- 1 mm) and right ventricular pressure estimated by Doppler flow velocities of tricuspid valve regurgitation (2.9 +/- 0.1 vs 2.3 +/- 0.03 m/s). Mean fractional shortening of the left ventricle was within the normal range. To estimate risk stratification, odds ratios for HF were determined for the most frequently occurring types of congenital heart defects and surgical procedures. In conclusion, HF in adults with CHD predominately depends on diagnosis, age, the frequency of reoperation, and right ventricular function and may be related to chronotropic incompetence indicated by lower maximal heart rates.
Authors:
Kambiz Norozi; Armin Wessel; Valentin Alpers; Jan Ole Arnhold; Siegfried Geyer; Monika Zoege; Reiner Buchhorn
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-03-03
Journal Detail:
Title:  The American journal of cardiology     Volume:  97     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-17     Completed Date:  2006-06-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1238-43     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany. norozi.kambiz@mh-hannover.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Biological Markers / blood
Cardiac Surgical Procedures
Diastole / physiology
Echocardiography
Exercise Test
Female
Heart Defects, Congenital / epidemiology,  surgery*
Heart Failure / blood*,  epidemiology*,  physiopathology
Heart Ventricles / ultrasonography
Humans
Incidence
Logistic Models
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Oxygen Consumption / physiology
Peptide Fragments / blood
Prospective Studies
Risk Assessment
Ventricular Dysfunction, Right / epidemiology,  physiopathology,  ultrasonography
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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